About the investigation


About the investigation

Oklahoma is one of nearly a dozen states that don’t license or regulate the midwives who oversee the majority of out-of-hospital births.

Non-nurse midwives, who assist the rising cohort of women delivering at home or in freestanding birth centers, are accountable to no state agency. They face no oversight or discipline when a delivery they handled ends in death. With no restrictions, they can continue to practice unmonitored and unchecked, putting Oklahoma mothers and babies at risk. 

Last year, GateHouse Media started receiving tips about deaths that occurred during or after out-of-hospital deliveries overseen by midwives in Oklahoma. Because the state does not require non-nurse midwives to report these outcomes, GateHouse Media decided to tally the deaths itself. 

Hear more from reporter Lucille Sherman:

Why did you start this investigation? 

GateHouse Media published a nine-month investigation into the out-of-hospital birth industry in 2018. Called “Failure to Deliver,” it found that out-of-hospital deliveries are more dangerous than many midwives claim. It also found that midwives often escape accountability, even when babies die under their care. 

Reporter Lucille Sherman visited Oklahoma to attend a home birth last year as part of that investigation. As an Oklahoman herself, she was interested in the fact that non-nurse midwives are unregulated in the state. After that trip, she started hearing from people throughout the state about their concerns related to the lack of regulation.

How did you learn about these cases? 

We learned about each of these cases in different ways. Some originated from tips, others we found through obituaries or social media posts. All but one were confirmed through public records. The one that was not confirmed through public records relied solely on public social media posts to piece together what happened.

Why did you rely so heavily on social media? 

Unlike states that require midwives to report their outcomes — including births, deaths, injuries or hospital transfers — to an oversight agency, Oklahoma has no such rule. Instead, many midwives post information about their cases and outcomes on social media. 

We therefore relied on social media to confirm information received from tips and other records we obtained. 

Any social media posts we relied on for evidence were made publicly. Anyone could have found them. None were obtained through third parties. 

Why aren’t you including the positive side of home births? 

As investigative journalists, our job is to tell in-depth stories that make communities safer, healthier and more knowledgeable. When we invest many months in stories like this, it’s because we uncover information that we think the public needs to know and can’t find anywhere else.

The downsides of home births have not been widely reported, while the benefits of it have been featured heavily by local and national media outlets. Our job as journalists is to make the public aware of issues like these, and hold those who handle life and death accountable.

Why aren’t you reporting on hospital deaths? 

There are many issues in hospitals, as our colleagues throughout the country have reported in recent years. NPR, ProPublica and USA Today are among those that exposed concerning rates of maternal mortality within hospitals and held hospital providers accountable.

But because of a broken system in the state of Oklahoma, what we haven’t seen is midwives held to the same account for negligence, or preventable deaths that occur on their watch.

Why are you including the stories of families who asked that they not be included? 

We respect the families’ rights to privacy and did not publish their names or the names of their babies despite the fact they were cited in the public records we obtained. That said, this story is an accounting of the deaths related to out-of-hospital deliveries, and we felt it important to provide information about each case.

Project credits

Lucille Sherman | National data reporter

Emily Le Coz | National data & investigations editor

Dak Le | News engineer

Mara Corbett | Creative operations editor

Dave Morris | Oklahoman director of video

Sarah Phipps | Oklahoman photographer