The dilemma I have huge anger at my brother’s wife for her actions, which I feel are directly responsible for my nephew being handicapped. For her first birth she had an emergency C-section, but she then chose to have a Vbac (vaginal birth after ceasarean) home birth for her second child – against all recommendations from her doctor.

The home birth went terribly wrong and my nephew has been left permanently damaged. It’s a tragedy almost Shakespearean in its proportions. I knew my brother was browbeaten, but not to the extent he would let his wife harm their child.

It’s caused major rifts in the family. I think my brother didn’t feel supported and has pretty much cut me off because I was so upset. My heart is breaking over this. I feel my nephew was exposed to severe parental negligence and I cannot get past my anger over it.

Mariella replies Those are very serious accusations. You do appear unusually animated about what is an extremely personal matter, probably none of your business and a miscalculation rather than a crime. Pontificating about the affairs of others is nothing new to yours truly, but at a certain juncture one does have to recognise that people have a right to make their own mistakes.

I’m very sorry to hear about your nephew and I have no doubt his condition pains his parents far more than it does you. Nobody could have predicted such an eventuality, not even the doctor and, although you feel strongly that they made the wrong decision, it’s one that was theirs alone to make and then to live with the consequences.

Why should it enrage you that they took a small risk and paid a very high price? The far more natural reaction to such a misfortune within your immediate family would surely be empathy. Instead you’re raging and blaming, making assumptions about your sister-in-law’s culpability and generally acting like a demonic harpy instead of a concerned in-law.

We all dice with decision-making, most of us getting it right and wrong in near equal measure. Even the most cautious can wind up on the wrong side of fate. I’m no medical expert, but there is plenty of advice out there, from the NHS and others, saying that a Vbac birth is a perfectly safe option. Added risks occur in 0.35% to 2% of women, odds that most of us would consider entirely acceptable. A C-section is a medical procedure many would want to avoid. The hospital stay and recuperation time are much prolonged so I can understand why your sister-in-law might not have wanted to repeat the experience. I’m not going to get into a debate about the pros and cons of 21st century birth options, but they are plentiful. Some would consider a water birth an indulgence, others are determined to go drug free and still others are eager to avail themselves of any drugs they can lay their hands on.

You use incredibly emotive language – “parental negligence”, “browbeaten”, “tragedy” of “Shakespearean” proportions no less – and although you admit to carrying huge anger I wonder if you understand how much that anger is carrying you. Rage, applied to this sad state of affairs, is inappropriate and unhelpful. Your brother and his wife made a perfectly valid choice, one many other parents have opted for with happy results. Childbirth has decreased in danger for both mother and child in the developed world. As a result many prefer to welcome a new baby in the comfort of their own home knowing they can easily reach hospital if necessary.

I’m not in a position to judge whether this incident is part of a pattern of indulgent behaviour that might justify your judgmental stance. Whatever your sister-in-law’s past misdemeanours it strains credibility that your current strife is rooted in this poor woman’s regrettable decision, which even in your description can’t be considered much more than miserable misfortune. I’d be looking to myself if I were you, and delving deep to try to ascertain why you’ve taken this so personally. Do you have children yourself? Is there a lot of past history between you and your brother? Could your response be exaggerated for reasons other than the obvious?

Whatever the answers I’d urge you to set about some honest soul-searching. We spend a lot of time vicariously living other people’s lives these days, whether it’s the Kardashians or celebrities in the jungle, giving us an unrealistic sense of our connection to strangers. You seem to be suffering a similar malaise by confusing whose life you are living and I’d urge you to direct attention back to your own. Any excess emotional energy would be better directed to helping them cope with the challenge of your disabled nephew rather than chastising them for their culpability in his condition.

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