In Nebraska, an unlicensed midwife assists a home birth that ends in tragedy. The Defense believes the midwife took the correct decisions during the birth but the Prosecution allege she was inadequately qualified and charge her with Negligent Child Abuse resulting in Death. Is she a negligent midwife or a responsible caregiver?
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00:009-1-1, do you need police, fire, medical?
00:21I need an ambulance.
00:23My wife is in labor.
00:25The baby is stuck.
00:26Can you see the baby then?
00:28Yes, I can see the baby.
00:29Can you see the head then?
00:31No, it is.
00:34I'm sorry, what part of the body?
00:37Feet first.
00:42The prosecution was blaming Angie for the death of the child.
00:49She put herself out to be a skilled midwife and led a family to make decisions that endangered their child's life.
00:59There's no way Angie could have done what she was being accused of.
01:10I'm a midwife.
01:12What I do is not a crime.
01:13My name is Angie Hawk, and I was charged with negligent abuse of a child resulting in death.
01:29At the beginning of 2019, I was a wife and a mother of five.
01:40I was working as a traditional midwife for families birthing their babies in home rather than in a hospital setting.
01:47A family got in touch with me because they felt a home birth was what they were looking for for their family.
01:56This was the second pregnancy that I experienced with this family as their midwife.
02:00We did have a special relationship where we trusted one another.
02:08I got the call from mom at 2.30 a.m. saying her waters had opened, saying that contractions had started.
02:18We arrived at the parents' home June 15th at 6.30 a.m.
02:22In those first few hours, baby's heart tones were always very reassuring that baby was doing great.
02:30Around 7 p.m., I checked fetal heart tones, and that's when I noticed something was different.
02:36And so I asked for a light, and when I shined the light, that's when I saw a butt cheek and itty-bitty little toes.
02:50And I knew what we had was what we called a complete breach.
02:56I made it very, very clear that even though many breaches can be born naturally,
03:01I wasn't going to sugarcoat this for them, that this did come with elevated risks.
03:12So the parents made their decision to continue to labor at home.
03:23But then mom all of a sudden said she needed to go to the bathroom.
03:26I said, do you think you really need to go to the bathroom, or do you think that's baby?
03:34To which the mom replied, both, but I would like to sit here for a while.
03:38I said, well, just holler if you need anything.
03:40And the mom shut the door.
03:43Fifteen minutes later, I heard my name from the mother.
03:47I went to the bathroom, opened the door, and that's when I saw mom leaning over the tub,
03:53and the lower half of the baby was born, but the upper half of the baby still was in the birth canal.
04:01That is when I made the decision, without any discussion, to call 911.
04:12My wife is in labor.
04:14The baby is stuck.
04:16Can you see the baby then?
04:18Yes, I can see the baby.
04:19All right, just reassure mom, okay?
04:23They're driving to you.
04:25Yep, I hear them.
04:26I hear them on their way.
04:29It became pretty evident the EMTs did not want to leave without baby being born.
04:37I felt immense amount of pressure.
04:39The only thing left was really to try an episiotomy.
04:44The episiotomy was unsuccessful.
04:55I looked at the EMT helping and said, you have to go now.
04:59Dad was communicating with us over text message and phone calls, telling us that baby had been born in the ambulance.
05:14It was on life support at the hospital.
05:17There was still a glimmer of hope.
05:21So I was just fervently praying.
05:23I received a text message 48 hours from the time the baby arrived that they had taken baby off life support and she was gone.
05:44And I felt devastated.
05:45I felt devastated.
05:53My name is Stu Dornan.
06:09I'm a criminal defense attorney in Omaha, Nebraska.
06:12I've been practicing for 37 years.
06:14Can I grab that file on Angie Hock, please?
06:18I represented Angie Hock.
06:20Thanks much.
06:21Angie Hock was hired by a couple expecting a child and the birth is going to take place in their home.
06:28The law around home birthing is unclear.
06:44Being at the home birth is not illegal.
06:48But unlicensed midwives are not allowed to intervene in a medical fashion.
06:54The prosecution believed that Angie had misrepresented her qualifications to the parents, that she was qualified to deliver a breech baby.
07:11The prosecution's position was that Angie was incompetent to deliver a breech baby at the home.
07:18Angie was charged with negligent child abuse, resulting in death.
07:24The penalty for that is serious.
07:27It's up to 20 years in jail.
07:37I felt that there really wasn't anything that I could do to fix the situation.
07:43And that makes you feel helpless as a husband.
07:49Her being accused of that type of behavior was very hurtful.
07:53Not just to her, but to me as her husband, to our family, to our reputation.
07:58Because that's not who she is and that's not who we were.
08:02Very much concerned also for the well-being of the family.
08:06Thinking, how is this going to affect the lives of five little children?
08:10Angela Hawk was charged with negligent child abuse, resulting in the death of a child.
08:21According to a police report, Hawk was helping deliver a baby at home when the baby was breached.
08:25The Douglas County Attorney's Office says Hawk turned herself in.
08:30The process of getting arrested and handcuffed was humiliating.
08:36I'm a midwife.
08:36What I do is not a crime.
08:40And yet I was being treated like a criminal.
08:53The prosecution's theory was that Angie wasn't properly trained and wasn't competent to attend this home birth.
09:02Shelby, can you pull up her bio?
09:05Sure.
09:06The first paragraph of Angie's bio.
09:24My name is Angie Hawk.
09:26My journey as a birth professional began in 2004, discovering my calling to help women find their power and ancient wisdom through traditional midwifery.
09:35When we saw phrases like find their power and ancient wisdom, we immediately thought, well, the prosecutor is going to try to play this like Angie's some type of quack.
09:50Hocus pocus.
09:52A hocus pocus sort of deal.
09:53There was something else that she said that we found a little bit concerning.
09:59Nothing contained in these pages should be considered legal or medical advice.
10:04Birth is not a medical event.
10:06It's really important as a criminal defense attorney, especially when you're approaching the trial, to put yourselves in the prosecutor's shoes.
10:16And if I'm the prosecutor here, I'm definitely very interested in that statement, and I'm going to try to twist that statement and make it seem like Angie doesn't know what she's talking about, that she's ignorant or maybe even delusional.
10:36You know, if I'm the prosecutor, that statement's huge.
10:45The state's case was that Angie wasn't properly trained, that she was arrogant in believing that she could handle a breech birth.
10:56These are the photos that law enforcement took of the search of Angie's house.
11:11This is a certificate of attendance to a midwifery training program called the Art and Science of Breach Birth.
11:19What this shows is that she did have training, not only in midwifery in general, but specifically in breech birth.
11:30This was another important one for us.
11:33This concerns birth emergency skills training.
11:37Here was another certificate of completion.
11:40It says here that in 2018, Angie completed 27 hours of professional training in holistic pelvic care.
11:52This was a huge positive for us.
11:54We have evidence that shows that Angie was very well trained and that she was competent to be a midwife.
12:00We had to challenge the prosecution on the fact that she was not negligent or reckless with respect to what she did, and that did not cause the death of the child.
12:12Prior to becoming a midwife, I had four children on hospital settings.
12:30The hospital wouldn't allow me to follow my bodily instincts.
12:35And I was always met with some type of resistance, particularly in my three prior births.
12:41I wanted unconditional support and the ability to follow my instincts.
12:47My philosophy towards birth is I believe that birth is a natural event of a woman's body.
12:54After my fourth was born, I decided that Nebraska was going to have better options and I was going to be a part of that.
13:02I did self-directed training to become the midwife that I wanted to provide for people and the midwife I wish I had.
13:12With that, I also wanted international experience.
13:15I did a tour over in Haiti where I worked as a midwife.
13:18I did that because of the level of services I wanted to provide to people.
13:24The prosecution was going to argue that Angie misled the parents with respect to her qualifications
13:51and her experience and whether she had communicated her experience with delivering a breech baby.
14:00It was going to be crucial to us what exactly the parents were going to say with respect to what happened during this delivery.
14:09Did Angie go with me to the hospital?
14:21She was going to follow us and she got flat tire.
14:25And my husband followed behind because they said that he couldn't ride in either of the two influences.
14:31Tell me a little bit about Angie or the at-home births, the philosophy on that.
14:36It's more comforting to be at home, less people, no pokes and prods, no checks.
14:44I don't need an ID.
14:45I don't have intervention.
14:48Okay, I'm just going to be straight with FEO.
14:51I mean, there's some concerns about the certification held by Angie.
14:58You signed a contract with Angie?
15:00Tell me about that contract.
15:02She lays out that she's uncertified, unlicensed, and she says that she has, like, the correct neonatal trainings and emergency birth skills and has two different breech birth trainings.
15:20What this shows was that she was totally upfront and honest with this couple.
15:28She just gave them the truth about what she was and what she wasn't.
15:34And this mom obviously knew what she was signing up for.
15:40Keith, can you take a look?
15:41I'm almost certain that I saw that in that birthing contract.
15:45The contract reads, as parents choosing a home birth with Nebraska Birth Keeper, you are taking responsibility for your own pregnancy and birth, and therefore you are responsible.
15:59Later on, it says, I do not make decisions for you.
16:04I will help you get the information necessary to make informed decisions, but you are the final decision makers.
16:10It was not going to be possible, in our opinion, for the prosecution to paint the mother as the victim of a fraud.
16:20And that was something that was just incredibly beneficial to our case.
16:27The mom's statement right after the birth was very reassuring to us, but now we needed to drill into exactly what happened in that house.
16:40Every detail in the EMT's reports was critical to analyze, as we needed to show that nothing Angie did or didn't do was the cause of the child's death.
17:05This house gives you a sense of the type of home that this birth took place in.
17:10The EMT's enter the house.
17:14According to their report, they arrived on scene and were directed upstairs.
17:19At the top of the stairs, we had a female on all fours with another female holding the baby.
17:27Angie expected them to immediately transport mother and child to the hospital.
17:31Instead, she said the EMT's seemed to be expecting her to deliver the child before they transported mom to the hospital.
17:43Angie told us that she felt that the child's best chance to survive was if she performed an episiotomy.
17:51An episiotomy is a surgical procedure that's designed to make the opening bigger so the baby can be safely born.
17:57In order to perform the episiotomy, Angie needed surgical scissors.
18:05According to Angie, the EMT's said they didn't have surgical scissors and they offered her a scalpel.
18:12She didn't want to use a scalpel.
18:15She asked the EMT's repeatedly for a pair of surgical scissors.
18:21She did not get any.
18:24Instead, the EMT's offered her trauma shears.
18:28The purpose for trauma shears is to cut clothes off a victim.
18:33They're not designed for a surgical procedure.
18:37We were talking about life and death for the baby.
18:41And I hated to do that to mom because we were already in a traumatic situation.
18:47And I knew that would add to that.
18:49I didn't want to do that.
18:52But we had to do that.
18:54After two failed attempts to perform an episiotomy, the EMT's finally transported mother and child to the hospital.
19:06We felt that the prosecution would say that Angie should have taken the scalpel offered by the EMT's.
19:21That Angie didn't know what she was doing.
19:24That the EMT's were right and she was wrong.
19:28These details were very important.
19:30We knew the prosecution would use them to make a case against Angie.
19:33We had to find a way to use them to defend her.
19:48I was charged with negligent abuse of a child resulting in death.
19:53It was a heavy weight to think of facing the max amount of sentencing of 20 years.
20:01I knew I would be missing out on most of my kids' childhood.
20:17And my youngest, pretty much all of it.
20:19I started mentally preparing what that would look like, doing journals for each of the kids so that I could share my heart on paper that they could go back and read it.
20:31What we needed to do as a defense team was to find areas where something happened out of Angie's control.
21:02Because we don't have to show that she didn't cause the death.
21:08We just have to say there's doubt.
21:10Something else could have been responsible for this child's death.
21:13In the EMT reports, they noted a slight delay, but it turns out that what should have been a nine-minute journey grew to almost 20 minutes because of construction en route.
21:37It wasn't the EMT's fault, but this delay really could have meant the difference between this baby surviving or not.
21:46Another key detail in the EMT reports caught our attention.
21:53The paramedics noted that early in the ambulance ride, the child had good color.
22:01We knew that the prosecution's strategy would be to say that this baby's oxygen supply was cut off while Angie was doing something that she wasn't supposed to do, wasn't certified to do when she was still in the house.
22:20If the child had good color, then that tends to contradict the idea that the child's oxygen supply had been cut off for some period of time before the child even got in the ambulance.
22:37In the EMT report, it said they attempted to resuscitate the child, but it didn't provide any other details.
22:54But the mom was there, and the mom was conscious during the entire birth.
23:01We went back to the audio of the interview of the mom.
23:04We were trying to get her out in the ambulance.
23:16I was too fatigued to push anymore, but then I got a urge to push.
23:22And then, like, I had, like, a good push, and she came out.
23:26But, yeah, she didn't cry.
23:28They were trying to oxygenate her.
23:30They weren't getting a good seal on her face.
23:33The mom's impression was that the EMTs didn't properly resuscitate this child.
23:42This was a revelation.
23:48This was a key piece that we knew we could build our defense around.
23:52We had real inconsistent information that we could use to create a narrative that something went wrong in that ambulance ride that had nothing to do with Angie Hawk.
24:07As we got closer to the trial and it was coming up, the reality of my wife facing a 20-year potential sentence was very huge to think about.
24:34There is a major concern if all of a sudden mom can't be there for the next however many years.
24:47She is an equal partner to me.
24:52She is a complement in so many areas that I fall short.
25:01It's heartbreak for our family.
25:04It's an extreme challenge moving forward to not have my partner, the love of my life, in my life with me the rest of that time.
25:13When they spoke to law enforcement, nothing that the parents said, in our view, incriminated Angie or suggested that she was negligent or reckless.
25:43Everything we had heard was that the mom essentially was adamant about not coming to testify, that she didn't want to testify, that she didn't want to get dragged into this.
25:55If she was not going to be available for trial, then we had to satisfy the court that we could get her statements in right after the birth that were very favorable if she refused to be a witness.
26:12As the trial approached, we tried repeatedly to get in contact with the parents without success.
26:30And we had done everything under the sun to subpoena her as a witness for us.
26:35We weren't able to do that.
26:37Following the loss of the baby, I was still very much in contact with the parents, and they were still very, very welcoming to me.
26:50There was no blame.
26:51There was no blame.
26:52But both were advised by police to cease contact with me.
26:56So leading up to trial, I didn't know if their perspectives of me had changed.
27:05We heard from the county attorney that they had spoken to the father, and according to them, the father and the mother potentially had a change of heart.
27:18We might be in a situation where the parents would take the stand and blame Angie for the death of their child.
27:36We got a call from the prosecutor on Friday before the trial on Monday saying that she is in our office right now if you want to subpoena her.
27:48The fact that she went directly to the prosecutor's office made us think that she had had a change of heart, and potentially our worst-case scenario was coming true where the mother might be the state's witness and that they were going to be able to use her testimony to try to say that Angie was negligent.
28:11It turned the best evidence that we had into potentially an absolute nightmare.
28:23This was unexpected.
28:25It was potentially devastating to our case, and it forced us to switch gears at the last moment.
28:35Walking into the courtroom, the atmosphere was tense.
28:50The prospect of not seeing my family again for 20 years, except in visitation, was devastating.
29:00I didn't want this trial to be in vain.
29:02I wanted it to be used to make change in Nebraska.
29:06So midwives could stop servicing their families in fear.
29:16And if that meant me going to prison, I was willing to do so.
29:22Judge, we're here today because of Angie Hawke's arrogance.
29:28She put herself out to be a skilled midwife and led a family to make decisions that endangered their child's life.
29:42This isn't about midwifery law in Nebraska.
29:57It's about the fact that she believed she knew how to deliver a breech baby.
30:03I was well trained and they knew that.
30:09Anyone that has worked with me or knows me knows that when I am with my family serving in the capacity that I do,
30:17I work with nothing but humility.
30:22Angela Hawke is being made into a scapegoat for the accidental death of an infant child
30:28whose parents exercise their right to have a home birth.
30:32When you consider all the facts, was it Mrs. Hawke's actions and her actions alone
30:37that placed their child in a situation where her death was probable beyond a reasonable doubt?
30:50The first witness to take the stand was the father.
30:53I knew the last conversations we had were very amiable ones,
30:58but I had no idea where he was at.
31:03Yes, I do recognize this.
31:16What is exhibit 128?
31:17It is Angie Hawke's birth keepers contract.
31:22She listed that she had some breech training.
31:25Remember that?
31:26Yes.
31:27Okay.
31:28Did she tell you she had training in delivering breech babies at this point in time?
31:32Yes.
31:33Angie reassured us that she had breeched training and that she had attended a course for it as well.
31:42Did she tell you whether she actually ever had delivered any babies?
31:47I cannot recall.
31:51I was desperate to hear from them because I wanted to know what was going on in their lives
31:57and I still never stopped caring for them.
32:02Do you think you were given the correct advice from Angie Hawke to make a decision about whether to go to the hospital?
32:09I believe that she fulfilled what she was explaining in her contract.
32:16Hearing his testimony was very reassuring.
32:18He saw me for who I was and that I provided the services that they hired me for.
32:35The father's testimony was a huge positive, but we also knew we still had five EMTs and paramedics, the obstetrician and other witnesses.
32:46So we took it as a win, but the battle was far from over.
32:53The EMTs were up next to testify.
32:56I really didn't know what to expect.
32:59My main concern was what was going to be said about the attempted episiotomy.
33:06When you get to the top of the stairs, what do you see?
33:08I see a female on her hands and knees with a baby hanging out and the birth person helping holding the baby at that time.
33:21The prosecution tried to get the EMTs to question Angie's actions.
33:26She asked for a pair of scissors, which we thought was kind of odd, but somebody handed them to her.
33:36They're trauma scissors used for traumas such as shootings, car acts to cut clothes off people, not to cut skin and tissue.
33:43Matt Carroll advised we have scalpel in our OBGNY kit.
33:48It's a sterile scalpel.
33:50The prosecution was convinced that Angie should have used a scalpel instead of trauma shears to perform the episiotomy.
33:59And in that situation, based on your training experience, did you believe scissors were an appropriate tool?
34:06I did not have any training, but I would not suggest ever using trauma scissors to cut skin.
34:13Why?
34:14It's not what they're made for.
34:18That piece of testimony was crucial.
34:20The state argued that Angie's action of attempting an episiotomy with trauma shears was not only the wrong action, but no one with any medical training would ever try to do an episiotomy with trauma shears.
34:38The prosecution's star witness was the obstetrician in this case.
35:00She made the 911 phone call to law enforcement.
35:04Were you making the report because you were concerned about the midwife that was delivering the child or concerned about the parents?
35:14About the midwife.
35:16And why were you concerned about the midwife?
35:18Because from what I could put together, this looked very much like a preventable injury.
35:25The obstetrician's testimony, it was hard to hear.
35:29To make it an effective episiotomy, what has to happen?
35:32So usually the muscle layer would be disrupted.
35:36And what do you have to know in order to do that?
35:39You need to know that the baby's head is not caught by the cervix.
35:44This was not in any way an effective episiotomy. Would you agree with that?
35:49It was the smallest one I had ever seen.
35:50The obstetrician's testimony was extremely damaging because she was a medical expert and her opinion was that it was Angie's negligence that caused the baby's death.
36:05The state had focused a lot of energy on the idea that when Angie tried to do an episiotomy with trauma shears, that was a terrible mistake.
36:21And we tried to lay a trap for the prosecution.
36:26As difficult as this might be to imagine, if you were in a situation with a stuck breech baby and every second counts for the prevention of hypoxia.
36:34We walked the obstetrician through a scenario, the same scenario that Angie faced.
36:41And you had a choice between making more room for your hands with a scalpel or trauma shears. What would you choose?
36:48Trauma shears.
36:49Why?
36:51Risk to the baby.
36:55If you were to use a scalpel to perform an episiotomy, you could absolutely risk death to that infant immediately by just a mis-slip of that scalpel.
37:09We were able to get the obstetrician to admit that if she were in the same position as Angie, she would have done the exact same thing.
37:19This was the biggest revelation that we had been able to obtain through testimony.
37:25Were you able to make finding out a cause of death?
37:50I did.
37:51And what was that?
37:52what was that? It was lack of oxygen to the brain was the cause of death. Did you list any
37:57contributing fact findings? I did preach presentation. Does the color of a neonate at birth give any
38:12indication of whether the neonate is capable of being resuscitated? Well, if the color's pink,
38:18it's an indication that they're more healthy. If they're blue, it's a sign that they're less
38:22healthy. Let's assume that the neonate comes out with good color and is capable of resuscitation,
38:27but that resuscitation does not commence until four minutes after her birth. What's that going
38:32to mean for the baby? So resuscitation, if it's done properly, can keep a heart going and bodies
38:37out of oxygen if it's done properly. What if it's not done properly? If it's not done properly,
38:42then there would be problems. The EMT records and the testimony showed that the child had good color
38:51when they were born in the ambulance. The baby was getting oxygen until some point after they were born
39:00in the ambulance. What that shows is that the baby didn't get her oxygen supply cut off in the house
39:09under Angie's care.
39:13You signed our contract with Angie. Tell me about that contract.
39:32She's basic. Tells you about her. Tells you about her. Certification.
39:38What were her certifications?
39:41She says that she has the correct neonatal trainings and emergency birth skills and she has two different
39:52breech birth trainings. I wouldn't use her if I didn't trust her. And we've decided for when we're ready,
40:02again, that we'll use Angie's. So I have no resentful feelings towards her. I still want her involved
40:08in my pregnancies and next birth.
40:11I'm a little bit of a prayer for us.
40:23I was ready to accept whatever was going to come down.
40:48And now it was just up to the judge.
40:55Good morning, everyone.
41:01Before I announce the verdict, I want to acknowledge the attorneys in this case for
41:05their hard work and professionalism.
41:08What happened was tragic, but the court cannot find that the state has proven beyond a reasonable
41:15doubt that Angela Haack acted criminally.
41:19The court finds Angela Haack not guilty.
41:27When the judge read the verdict, I just felt a rush.
41:40It was validation of what we were saying all along.
41:47I want to stop this from happening to other midwives and other families.
42:08I don't want all that I've been through to be in vain and for nothing.
42:12And so that's why I'm working hard to make some real change.
42:23Knowing that I wasn't going to be separated from my family was a huge relief.
42:34Through this, my thoughts never left that family.
42:40And I still pray for them.
42:43And I still think about that baby every day.
42:45Before I announce the enemy's back, I hope to love you.
42:52And I hope that you're the only one who've been through the security of the state and
42:55my head is very impressive.
42:56Thank you for the possibility.
42:57And I would love to say.
42:58Thank you for being a proud sweetheart.
43:00You are now my lovely friend.
43:01I have a great beginning and all of my friends, that's kind of crazy, and I think that's
43:02impressive.
43:03I hope to be a good example of the family-related time to see you.
43:04The next day.
43:05I'll see you.
43:06The next day.
43:08I'll see you.
43:09I'll see you next day.