Danielle Yeager once believed she’d never be able to have children.
In 2012 she was diagnosed with stage 1 cervical cancer and feared she may never get pregnant because of treatment and possible complications that could affect fertility.
So, when the casino-worker became pregnant in 2013, she and husband Michael were overwhelmed with joy.
She never would have imagined that several months later, her first-born child Gavin would die after the midwife delivering her son failed to spot signs that his heart beat was slowing.
While Ms Yeager, then 28, had undergone care throughout her pregnancy with the midwife Christy Collins, she was unaware that the supposed birthing expert was in fact practicing midwifery without a license.
Ms Yeager told DailyMail.com: ‘If she would have sent us [to the hospital] just a little bit sooner he would be alive. But instead… she kind of played God with us.’
Danielle Yeager at her baby shower in 2014. The Las Vegas casino worker had wanted a natural home birth to deliver her first-born child
Ms Yeager said her midwife Christy Collins repeatedly dismissed her concerns until it was too late for doctors to save her newborn
And experts say Ms Yeager is, sadly, far from the only expectant mother who has hired a midwife and later found herself in this tragic position.
Midwives are specialized health professionals who care for the mother and baby throughout the pregnancy, during the birth and for several weeks postpartum. They are not licensed doctors and have a limited scope of practice.
The Florida Council of Licensed Midwifery, which meets only three times a year, has pursued discipline against just 36 of 170 midwife complaints over the last decade, USA Today reported.
At least 10 of those complaints involved fatal incidents.
A Washington Post examination into Maryland’s Board of Nursing, which oversees midwives, faces a backlog of more than 6,200 unresolved complaints filed against thousands of nurses and midwives.
There are very few statistics when it comes to the deaths of babies under the care of midwives because of differing state laws, varying methods of reporting and incomplete investigations.
The problem, experts say, is the discrepancy in the qualifications required of midwives across the country.
The American College of Obstetricians and Gynecologists (ACOG) acknowledged that a lack of standard rules governing midwifery could lead to needless harms to mothers and babies.
The organization told DailyMail.com: ‘ACOG advocates for implementation of the International Confederation of Midwives’ standards in every state.
‘All midwives — whatever their title or professional designation and regardless of where they practice — should meet the ICM standards. Patients in every state should be guaranteed care that meets these important minimum standards.’
The practice of midwifery tends to take a more holistic view, supporting natural approaches to pregnancy and birth. There are three types of midwives: certified nurse-midwives; certified midwives; and certified professional midwives.
Certified nurse-midwives are registered nurses with graduate degrees and medical training. Certified midwives have graduate degrees but no nursing license. And certified professional midwives rarely have advanced medical training or abilities and learn mostly through apprenticeships with more experienced midwives.
A Healthgrades profile for Ms Collins states she is a certified professional midwife (CPM).
After having a hard time finding an obstetrician she felt comfortable with and on the advice of a friend, Ms Yeager considered hiring a midwife. When she found Ms Collins, she decided to move forward with her as the sole practitioner for the duration of her pregnancy and a home birth.
Home births accounted for 1.4 percent – 51,640 – of the 3.6million births in the United States in 2021, an increase of 12 percent from the prior year and the highest level ever since at least 1990, data from the Centers for Disease Control and Prevention showed.
A 2017 report from ACOG found planned home births were associated with a two-fold increased risk of perinatal death and a three-fold increased risk of neonatal seizures and serious neurological dysfunction.
While there has been a rise in midwifery services, ACOG recommends that hospitals are the safest place to give birth.
Many home births are overseen by midwives, but an exact number is not known.
A 2020 analysis of infant death records found neonatal mortality was 13.66 per 10,000 live deliveries for all planned midwife-supervised home births. A separate study found the neonatal death rate of doctor-performed hospital births was 5.9 per 10,000 deliveries.
Experts have called these ‘tragic’ deaths ‘avoidable situations,’ but the increased risk could be a result of wide disparities when it comes to midwife training and regulation across the country.
In the US, 13 states do not regulate certified professional midwife practices. Of those, five — including Nevada, where Ms Yeager gave birth — are actively considering legislation that would require CPMs to be licensed and five are drafting licensure legislation.
Three states — Nebraska, Kansas and Mississippi — have no regulations in place and are not actively considering or planning legislation.
At the time of caring for Ms Yeager in late 2013 through February 2014, Ms Collins was practicing with the Las Vegas-based home Sweet Birth clinic – but she had relocated to the city sometime after being put on probation in California.
A court in Los Angeles had sentenced her to three years’ probation in January 2012 and a fine of nearly $10,000 after the California Board of Medicine caught her practicing midwifery without a license.
The ruling put Ms Collins on probation, meaning she could not practice without a license, but it did not prohibit her from crossing state lines to perform her services. Soon after she moved to Nevada, where no license is required to provide midwifery care, so she slipped through the legal cracks.
The ‘wild west’ nature of Nevada, Ms Yeager told DailyMail.com, allowed Ms Collins to repeatedly lie about her medical background, obscure the fact that she and her baby were in danger when an ultrasound technician found no amniotic fluid around the baby and escape accountability by moving to another state.
Ms Yeager also said her midwife repeatedly discouraged her from going to the hospital.
She told DailyMail.com: ‘So when I met my midwife… she actually had me thinking [we] were hiring a nurse midwife. I didn’t know the difference between a certified nurse-midwife or CPM.
‘And when you hear the term certified professional, you obviously think, “wow, they’ve got letters just like a doctor.” You don’t think that doesn’t mean anything. It’s a made up title. So I totally was like oh, she does ultrasounds and testing and she’s more medical minded. She’s perfect for us
‘But no, she wasn’t a nurse midwife. She was a CPM and pretty much most of the stuff that she told us was a lie.’
In February of 2014, at 42 weeks gestation, Ms Yeager was already overdue — a full-term pregnancy is considered to be between 39 and 41 weeks — and was growing concerned when Ms Collins told her it was ‘not a big deal’ she was past her due date.
But when Ms Yeager’s mother kept insisting something was wrong, Ms Collins sent her patient to get an ultrasound.
Ms Yeager said: ‘To convince me that everything was fine, she sent me for an ultrasound, to physically show me that my baby was okay. So then we can go off and just continue having a home birth as planned.
‘And so we went to an ultrasound and my son had no [amniotic] fluid. Everything else was fine. Everything was good, but there was no fluid in there at all.’
But the mom-to-be said the ultrasound technician didn’t tell her — he only said the results would ‘go to your midwife.’
Amniotic fluid acts as a protective barrier around the fetus, regulates temperature in utero, provides the fetus with essential nutrition and assists in staving off infection.
Without that crucial cushion, a baby’s lungs may not grow properly, causing breathing problems at delivery.
Ms Yeager said her midwife told her to drink more water, go for a walk and then go home and take a bath. She gave her an ‘herbal concoction’ and sent the couple home with a portable ultrasound to monitor their baby’s heart rate. Ms Collins said to call her if the heart rate dropped and didn’t come back up.
When asked if they should go to a doctor, Ms Collins said no.
In speaking to USA Today in 2018, Ms Collins told the publication that she repeatedly urged Ms Yeager to seek medical attention but that her client refused.
However, according to the USA Today investigation, text messages, medical records and interviews with other sources confirm the family’s account.
Ms Collins did not return a request for comment from DailyMail.com.
Meanwhile, the midwife had asked a colleague to post a public query on Facebook containing her clients health status and waited for other practitioners to comment on the post.
She told Ms Yeager she had contacted her ‘mentors,’ but Ms Yeager said the post spread like wildfire and received hundreds of comments. Any urges that Ms Collins send her client to the hospital were deleted almost as soon as they were posted, she said.
A follow-up ultrasound revealed Gavin’s heart rate had dropped to 90 beats per minute, far below the healthy range of 120 to 160 bpm.
Finally, Ms Collins suggested going to the hospital, but not the one close by — a facility 30 minutes away. Upon arrival and a quick exam, Ms Yeager was rushed into an emergency C-section to deliver Gavin.
The baby boy was born alive but not breathing and the medical team found he was covered in meconium D, or fecal matter. He had sucked it back into his airway and was in great distress. Doctors could not resuscitate him.
Ms Yeager told this website: ‘They did the best they could, but you just need more time… if she had called it that morning, he would be alive.
‘But instead… she kind of played God with us where she was like, “it’s no big deal.”’
When a midwife-assisted birth results in a baby’s death, grieving parents typically have little recourse.
Lawsuits against CPMs are rarely pursued because midwives are not required to hold medical malpractice insurance and in several states where there are no laws, complaints against midwives languish.
CPMs are credentialed by the North American Registry of Midwives (NARM).
NARM told the Post it has revoked the credentials of 10 of the more than 4,300 midwives it has certified over 30 years, but the reasons why were not revealed.
Because CPMs operate without any national set standards, there is little, if any, accountability when a home birth goes wrong.
In Ms Yeager’s case, her midwife fled the state after her birth.
She said: ‘She disappeared when my family started asking her questions like where did she go to school, where did she come from. They wanted to know a little bit more. And as it turns out, she came from California, because she was on probation when she was my midwife. She was practicing there without a license.’
Ms Yeager, who now has a six-year-old son born via a planned C-section, added that her family contacted the California authorities for help, but got none.
She said: ‘They were like, “if you had even one law on midwives in Nevada, we would go pick her up and she would go to jail because she’s on probation.
‘“But because you have absolutely nothing, the only thing that I can do is take it to a judge and make [her probation] go a little bit longer.”’
Ms Collins moved to Florida where she currently lives. Her Facebook page under a different name used to say she was a midwife and studied midwifery at the National College of Midwifery, but that has since been deleted.
Determined to help other women avoid her tragedy, Ms Yeager has been very vocal in pushing to have laws changed surrounding midwifery, posting often on a memorial Facebook page for Gavin.
Gavin would have been 10 years old this week.
She wrote on his birthday: ‘I have spent almost 10 years trying my best to warn others to not end up like this. I have witnessed so many countless families over the years lose a child… Listening to each story and feeling all their pain and trauma. Knowing exactly what they went through and what life will forever be like for them now.
‘I have tried so damn hard to change laws in my state and other states, but laws aren’t for good people. Laws are made for the bad to tiptoe around.
‘As these years have gone by and I have watched the world keep turning, I realized there was only one thing that I could give Gavin for his 10th birthday. Since I couldn’t give him justice nor change, I wanted to give him love.
‘We don’t grieve Gavin from a negative place or bad feelings. We grieve Gavin out of love. True, pure love. It’s where the pain comes from. How much love we have for him, even without him here. The anger is my passion from how deep my love runs through my veins and into my soul.’
