My midwife was arrested! Please read...

[Sue G in PA]

I just received a letter from a new non-profit,http://www.inservicetowomen.org telling of her arrest on March 16, 2011 and asking for donations for her defense. She is being charged with involuntary manslaughter, child abuse and practicing medicine w/out a license. I don't know many details. I am simply heartbroken. Karen was my midwife for 6 out of my 7 children. She delivered 4 of my children (2 ended up as transports...my choice). She is probably one of the most skilled and experienced midwives I know. I know that many of you here have had homebirths or used a midwife for your births and are supportive of homebirth and midwifery. Karen's trial begins on June 7, 2011 and she faces up to 30 years in prison. :001_huh: If you pray, please pray for her. The outcome of this trial will not only effect Karen's life and the lives of her 2 daughters and her grandchildren, but the future of midwifery in general. If you feel led to support Karen with a donation, please visit http://www.inservicetowomen.org or "like" them on FB. Thanks for reading and praying. Oh, and I really don't want this thread to turn into a debate about midwifery or homebirth. Please.

Edited April 19, 2011 by Sue G in PA
link fixed. thanks.

[amydavis]

Hey, I just tried to use the link and it wouldn't work. I checked them out on FB, and it looks like it should be http://www.inservicetowomen.org

 

So, a "to" instead of a "for".

[Ravin]

This is sad to hear. Unfortunately, it's a risk I'm sure she knew she was taking every time she attended a birth, given the illegal status of direct-entry midwifery in PA. It's contrary to evidence-based models of obstetric care.

 

http://mana.org/statechart.html

[Julie in CA]

I didn't know that there were midwives who specialize in twins and breech births. :001_huh:

[kalanamak]

http://www.washingtonpost.com/local/midwife-faces-involuntary-manslaughter-charges/2011/04/18/AFTsqs1D_story.html

 

I don't believe, if convicted, she'll get 35 years. That said, doing a homebirth on a breech 43 year old primap is a bit different than a "everything normal until something went wrong" delivery.

[HomeschoolMum]

Are you serious?? It is ILLEGAL to have homebirths and use midwives according to that website ??? What on earth for ? Do only obstetricians deliver babies in America?

[collinsmom1]

I am really sorry to hear this story! I will be praying!:001_huh:

[Sue G in PA]

Thanks for the link to the news story. I couldn't find it anywhere! Karen is a tremendously skilled and knowledgeable midwife. She is very pro-homebirth but she would NEVER put the life of a mother or baby in danger. My last child was delivered by Karen. I had some bleeding during labor and when Karen arrived and checked his heartrate, it was "faint". She looked at me and said, "we need to get you to a hospital NOW!". She doesn't take unnecessary risks. As it turns out, my baby was just in an awkward position and his heartrate was fine. I delivered him at home 20 minutes later (an ambulance was called just in case) and he was perfectly healthy. This case sounds odd. Karen will advocate for the mother and her choice but never would she do this at the expense of a baby's life. NEVER. And, she has delivered MANY breeches w/out complication...even footlings. This is tragic, don't get me wrong and my heart goes out to the family involved. I'm not blaming anyone here...just wanted to share.

[roxanne23]

.

Edited January 4, 2023 by roxanne23

[mamachanse]

Such a terrible thing to happen to a midwife and the community. :(

[kalanamak]

One of the really tough parts about OB is having two patients. Sometimes the care of one is not the best for the other.

 

Too bad about the state line business. Technicalities like that might hamstring her. I'm assuming any insurance she had would use the state license bit to shut her out.

 

Do keep us updated.

[kalanamak]

Do only obstetricians deliver babies in America?

 

Many family practitioners do, too. I 'll have to look into it, but does anyone know if ARNPs can?

 

Heck, I delivered a couple in training, with only an FP intern, a hundred miles from the nearest C section. Scary, though.

[happypamama]

I'm so sorry to hear this! I think some of my friends have used her. I will be praying for her.

[farmgirlinwv]

Are you serious?? It is ILLEGAL to have homebirths and use midwives according to that website ??? What on earth for ? Do only obstetricians deliver babies in America?

 

Surely, you're not surprised. If it's practically illegal to give your neighbor a zucchini, it's sure as shootin illegal for adults to make their own decisions! If parents in Chicago can't be trusted to pack their dc's lunch, you can't be expected to be able to make big medical decisions! Silly patient! Only certain, specially trained professionals know what's good for you! Please do as you're told or we'll have to increase the amount of drugs we put in your food and water....That would be unfortunate, they're expensive and you haven't been paying enough taxes recently.

 

semi-sarcastic

[dirty ethel rackham]

How sad - for the couple, for the midwife, for midwifery in general.

 

The article had a glaring error.

 

Carolyn L. Gegor, program director of the Nurse Midwifery/Women’s Health Nurse Practitioner Program in the School of Nursing and Health Studies at Georgetown University Medical Center was quoted as saying

 

“In states where midwives who are not certified through the American College of Nurse-Midwives are not considered legal, they do become an underground group,†she said. “They’re forced to do that so they’re not prosecuted.â€

 

As of 2008, 26 states recognized direct-entry midwifery by statute. The Certified Professional Midwife (CPM) certification is used for licensure in 24 states. All states recognize the CNM certification (through ACNM)

[ktgrok]

Are you serious?? It is ILLEGAL to have homebirths and use midwives according to that website ??? What on earth for ? Do only obstetricians deliver babies in America?

 

Certified Professional Midwives are illegal in 26 states :glare:

 

I'm very lucky to live in a state that licences them.

[MrsBasil]

This is sad to hear. Unfortunately, it's a risk I'm sure she knew she was taking every time she attended a birth, given the illegal status of direct-entry midwifery in PA. It's contrary to evidence-based models of obstetric care.

 

http://mana.org/statechart.html

 

It doesn't appear to be illegal in Virginia where the birth took place. Though the article Kalanamak linked states she wasn't licensed to practice in Virginia.

Edited April 19, 2011 by MrsBasil
To spell kalanamak's name right!

[kalanamak]

The article had a glaring error.

 

Carolyn L. Gegor, program director of the Nurse Midwifery/Women’s Health Nurse Practitioner Program in the School of Nursing and Health Studies at Georgetown University Medical Center was quoted as saying

 

“In states where midwives who are not certified through the American College of Nurse-Midwives are not considered legal, they do become an underground group,†she said. “They’re forced to do that so they’re not prosecuted.â€

 

As of 2008, 26 states recognized direct-entry midwifery by statute. The Certified Professional Midwife (CPM) certification is used for licensure in 24 states. All states recognize the CNM certification (through ACNM)

 

??But she is saying if they are not cert via ACNM, when are not considered legal in some states. Okay, "all states recognize CNM cert via ACNM", you say. But I thought Ms. Gegor was referring to midwives who are not CNM via ACNM.??

[dirty ethel rackham]

Ah, I see. I guess I needed to parse that sentence to get what she meant. That was part of her "if" clause, not her statement.

 

I guess I am touchy because direct entry midwives (even CPM's) are illegal here in IL and actively prosecuted. Most of the counties in our state do not have a homebirth provider within a 2 hours drive. And most of those counties do not have options for VBAC (or natural birth, really.) (I deleted what was to become a soap-box speech!)

[gaillardia]

Very sorry to hear of the whole thing. Karen was our mw for our last baby. I was considered high risk by OB because of age, but this was our 7th baby, and Karen didn't consider me high risk. Everything went okay IMHO, if I'd have been in hospital it would have ended up a caesarean (forgive spelling).

Please keep us posted on the further developments.

[keptwoman]

Are you serious?? It is ILLEGAL to have homebirths and use midwives according to that website ??? What on earth for ? Do only obstetricians deliver babies in America?

Not just America. Australia is making it very very difficult to home birth, midwives who attend homebirths will not have insurance coverage which will pretty much stop them attending. The OB lobby here have done a fine job :glare:

[weddell]

Are you serious?? It is ILLEGAL to have homebirths and use midwives according to that website ??? What on earth for ? Do only obstetricians deliver babies in America?

 

 

Different states have different laws. It depends on the kind of midwife and where they deliver. I had a certified nurse mid-wife who delivered in a hospital. I think that kind of set-up is legal everywhere. It is when you get into direct entry midwifes and homebirth that different states have different laws. Some states also have birth centers that are somewhere in between home and a hospital.

[KidsHappen]

The midwife that I used with my fifth child was arrested for practicing medicine without a license. It lost everything he owned and served time. He never lost a patient or had an adverse outcome. He had me transfered because he felt that I had a cervical lip that was in danger of ripping. Turns out a ride to the hospital straightened it right out as I gave birth immediately after making it to the L&D floor. He was indian and mostly served the local indian and poor population that were not being served by the medical community anyhow.

 

My hubby is listed as the attendent of record for the birth of our third child (1st home birth). The fourth and sixth were delivered by CNM with dr. back-ups. I strongly support midwives and the rights of women to chose their own births. While it is a terrible tragedy for everyone involved in this case, I do hope that things turn out well for the midwife.

[Ibbygirl]

I didn't see it in the article that was linked, but does anyone know who it was that pressed charges against the mid-wife?

[Ravin]

Are you serious?? It is ILLEGAL to have homebirths and use midwives according to that website ??? What on earth for ? Do only obstetricians deliver babies in America?

 

The website I linked lays out the legal status of midwives state-by-state.

 

It doesn't appear to be illegal in Virginia where the birth took place. Though the article Kalanamak linked states she wasn't licensed to practice in Virginia.

 

I assumed it was PA because that's where the OP was from. The link she posted said this midwife delivered babies in PA and WV. Direct entry midwifery is illegal in PA and not illegal but unregulated in WV. In VA licensure is required. As such licenses are state-by-state, not having a VA license was likely part of the problem. Also, as far as I know malpractice insurance is not available (or is prohibitively expensive) for direct-entry midwives.

[Heather in VA]

The website I linked lays out the legal status of midwives state-by-state.

 

 

 

I assumed it was PA because that's where the OP was from. The link she posted said this midwife delivered babies in PA and WV. Direct entry midwifery is illegal in PA and not illegal but unregulated in WV. In VA licensure is required. As such licenses are state-by-state, not having a VA license was likely part of the problem. Also, as far as I know malpractice insurance is not available (or is prohibitively expensive) for direct-entry midwives.

 

 

Actually that website lays out the legal status of DIRECT ENTRY midwives. It does not address Certified-Nurse Midwives. I know that some CNMs do only hospital births but many do homebirths and are legal for homebirths in many states in which direct entry midwives are not legal.

 

I have had two homebirths in Virginia. When I had my last one (2003), direct entry midwives were still illegal. This is now not the case (so not everywhere is getting harder to have a homebirth). I had a CNM (certified nurse midwife) for both deliveries and she worked for BirthCare and Women's Health - the group mentioned in the article that declined the breech birth for the mother in question. I know from my own experience with them that they attempt to turn breech babies several times prior to referring them for a hospital birth so unless something very unusual occurred (or BirthCare didn't provide the prenatal - it's hard to tell from the article) then attempts would have been made to make it a safer delivery. They don't just refer to the hospital on a whim.

 

The biggest problem for this woman is going to be the licensure issue. In Virginia you have to have a license and it isn't reciprocal. The problem is, she's based in Maryland. She doesn't have a license there either because direct entry midwives are illegal in Maryland. Homebirths in Maryland require a certified nurse midwife. And according to the OP, she practiced in Pennsylvania where direct-entry is also illegal. So while the article quotes her attorney as saying she was clearly qualified, if he wants to introduce all of those births as proof that she's qualified, he'll be admitting she has been practicing illegally for years. This Virginia birth is actually more legal than most of her births because here you can be a direct entry midwife. She just didn't get a license.

 

I am a big advocate of home birth but I really think that practicing with disregard for the law is more damaging to homebirthing than it helps. Regardless of how competent or qualified this woman is, if she had been licensed and practicing within the law, this situation would not be nearly so grave. Licensed OB's lose patients. It's awful and tragic. And yes - there is malpractice and both OBs and midwives can be sued. But because she chose to do this illegally, the legal risk to her magnified 10-fold and its reflection on midwives in general is poor. Imagine what you would think if a very competent, super experienced, well-loved OB had a baby die during birth and you found out he didn't have a license to practice medicine because he didn't want to get one. You would be appalled. That's really what happened here. She lives close enough to Virginia to attend births here. It's legal for her to practice here - as long as she has a license. She has the experience to get a license. She decided not to. A very tragic decision for her and her family.

 

Prayers for her, her family and the family of the little baby lost. So much grief.

 

Heather

[Melissa in Australia]

Not just America. Australia is making it very very difficult to home birth, midwives who attend homebirths will not have insurance coverage which will pretty much stop them attending. The OB lobby here have done a fine job :glare:

Not completely correct. It is government paid insurance coverage that midwives cannot get. Midwives could still get private insurance, they will just have to pay for it themselves.

[tex-mex]

Many family practitioners do, too. I 'll have to look into it, but does anyone know if ARNPs can?

 

Heck, I delivered a couple in training, with only an FP intern, a hundred miles from the nearest C section. Scary, though.

We had a certified nurse midwife deliver my son -- in a birthing suite with a jacuzzi. Drug free. It was a wonderful experience.

 

So sorry to hear of the breech birth and lawsuit.

Edited April 20, 2011 by tex-mex

[Lisa R.]

I know very little about home births. Would most midwives chose to deliver a breech birth at home? While I realize her lack of license in Virginia is an issue here, is it also an issue of allowing a risky birth to take place at home?

[Jennifer in MI]

I delivered my fourth at home with a DEM. She would do a homebirth breech baby only after an u/s confirmed a particluar type of breech (butt first - I forget the name - frank?) AND only if the mother had already had a baby (proven pelvis).

 

I'm such a rule-follower that it was really hard for me to hire her, knowing full well she was not legal in MI.

 

I'm SO sorry Sue.

[....]

Surely, you're not surprised. If it's practically illegal to give your neighbor a zucchini, it's sure as shootin illegal for adults to make their own decisions! If parents in Chicago can't be trusted to pack their dc's lunch, you can't be expected to be able to make big medical decisions! Silly patient! Only certain, specially trained professionals know what's good for you! Please do as you're told or we'll have to increase the amount of drugs we put in your food and water....That would be unfortunate, they're expensive and you haven't been paying enough taxes recently.

 

semi-sarcastic

 

 

I hear ya'!

 

Sue, I'm so sorry for your friend.

[BlsdMama]

I find it ironic that our country legitimizes pro-choice and then refuses the mother to choose to birth the way she'd like. :glare:

 

Really, doesn't the government have better things to do?

 

I am incredibly sorry this mother lost her child. It is a horrible thing. :(

[Pretty in Pink]

I am a big advocate of home birth but I really think that practicing with disregard for the law is more damaging to homebirthing than it helps. Regardless of how competent or qualified this woman is, if she had been licensed and practicing within the law, this situation would not be nearly so grave. Licensed OB's lose patients. It's awful and tragic. And yes - there is malpractice and both OBs and midwives can be sued. But because she chose to do this illegally, the legal risk to her magnified 10-fold and its reflection on midwives in general is poor. Imagine what you would think if a very competent, super experienced, well-loved OB had a baby die during birth and you found out he didn't have a license to practice medicine because he didn't want to get one. You would be appalled. That's really what happened here. She lives close enough to Virginia to attend births here. It's legal for her to practice here - as long as she has a license. She has the experience to get a license. She decided not to. A very tragic decision for her and her family.

 

I agree, esp. with the bolded portions.

[Rivka]

I had both my babies drug-free in the hospital with a Certified Nurse Midwife. My son even had a waterbirth. I am hugely in favor of midwives and woman-centered, family-centered care.

 

I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it. It's tragic. Serious errors in judgement were made all around.

 

And I agree that there's no excuse for practicing in a state that licenses DEMs without getting licensed.

[mommaduck]

Praying, Sue. I also pray for my former midwife (though she is a CPM...CPMs have been harassed in this state time to time also). This is awful. Especially when we have a segment of the population that refuses to use hospitals and sometimes will only trust a DEM from their community.

[Jody]

This makes me mad! We can abort babies everyday, but as soon as an unlicensed midwife come into the picture we can throw the book at them. If she was doing a great job and women liked her what is the problem?

 

I know it is all about the control and money! It is not about the women giving birth. Oh it just makes me furious!

[Sue G in PA]

I didn't see it in the article that was linked, but does anyone know who it was that pressed charges against the mid-wife?

 

The state is pressing charges. That is what makes this so blasted frustrating. It's NOT the couple...it's the state! Thy are just going after Karen as a "scapegoat" for ALL midwives who do homebirths. Make sense? The birth itself was in September...6 months before her arrest! I tried calling her this morning to see if she was okay but got her voicemail.

[Impish]

I don't understand why she didn't comply with licensing.

 

Just b/c someone *can* drive doesn't mean that they're legally entitled to. If an unlicensed driver was in an accident, they'd be charged accordingly...so I guess I just don't see a difference.

 

Is it ridiculous that some states are apparently against midwifery altogether? Absolutely! It sounds as though if she'd complied with the licensing issues, she'd be in a far better situation.

[mommaduck]

I don't understand why she didn't comply with licensing.

 

Just b/c someone *can* drive doesn't mean that they're legally entitled to. If an unlicensed driver was in an accident, they'd be charged accordingly...so I guess I just don't see a difference.

 

Is it ridiculous that some states are apparently against midwifery altogether? Absolutely! It sounds as though if she'd complied with the licensing issues, she'd be in a far better situation.

 

Not true in this state. There have been CPM's that have been harassed and taken to court also.

[mommaduck]

The state is pressing charges. That is what makes this so blasted frustrating. It's NOT the couple...it's the state! Thy are just going after Karen as a "scapegoat" for ALL midwives who do homebirths. Make sense? The birth itself was in September...6 months before her arrest! I tried calling her this morning to see if she was okay but got her voicemail.

Yet the state doesn't prosecute negligent OB's. Nope, you have to lawyer up and sue to attempt that.

[Mimm]

I had both my babies drug-free in the hospital with a Certified Nurse Midwife. My son even had a waterbirth. I am hugely in favor of midwives and woman-centered, family-centered care.

 

I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it. It's tragic. Serious errors in judgement were made all around.

 

And I agree that there's no excuse for practicing in a state that licenses DEMs without getting licensed.

 

:iagree:

 

This is such a tragic story. I understand very much wanting to have a non-medicalized non-traumatic birth experience. But a c-section isn't the end of the world. A dead baby is the end of the world (the parent's world). I say this as someone who was terrified of the possibility of a c-section. I wanted to give birth in a birth center, but my insurance refused to cover it even though it would have been much less expensive than the hospital birth. Instead, I switched doctors three times till I got one who didn't laugh at a 20 year old first time mom telling him she would give birth without drugs. He was actually the backup doctor for the birthing center I wanted to use. He let me have my way and I have no complaints at all for how I was treated in the hospital.

[Impish]

Not true in this state. There have been CPM's that have been harassed and taken to court also.

But isn't the licensing *some* protection? At least in the eyes of the court?

 

I can see the fact that she isn't licensed weighing heavily against her in the eyes of a judge. I honestly don't understand the rationale of not getting whatever professional accreditation is available, if for no other reason than CYA.

 

I'm not saying that she's a bad person, or anything like that. I'm saying I genuinely don't understand why she wouldn't have covered herself as much as possible, *esp* in an area that's known to be difficult to the profession.

[Sue G in PA]

I am a big advocate of home birth but I really think that practicing with disregard for the law is more damaging to homebirthing than it helps. Regardless of how competent or qualified this woman is, if she had been licensed and practicing within the law, this situation would not be nearly so grave. Licensed OB's lose patients. It's awful and tragic. And yes - there is malpractice and both OBs and midwives can be sued. But because she chose to do this illegally, the legal risk to her magnified 10-fold and its reflection on midwives in general is poor. Imagine what you would think if a very competent, super experienced, well-loved OB had a baby die during birth and you found out he didn't have a license to practice medicine because he didn't want to get one. You would be appalled. That's really what happened here. She lives close enough to Virginia to attend births here. It's legal for her to practice here - as long as she has a license. She has the experience to get a license. She decided not to. A very tragic decision for her and her family.

 

Prayers for her, her family and the family of the little baby lost. So much grief.

 

Heather

 

I don't know all the specifics. I used Karen for 6 of my births, knowing full well that direct-entry midwives were illegal in MD (where 3 of my births were). She IS legal in PA, I believe. Anyway, I sought out a midwife who would do a VBAC at home and Karen would. It's not that she didn't WANT to get a license...she COULDN'T b/c MD doesn't and won't recognize her. Make sense? As for VA, I don't know the reason she didn't pursue getting that stupid piece of paper. Probably b/c she doesn't do many births there to begin with. This case was obviously an exception. Karen has delivered many breech babies. I feel so heartbroken for the family involved but it isn't even them bringing the charges! This is simply a case against ALL MIDWIVES and HOMEBIRTHS, IMHO. And Karen is well-known and well-loved. High profile. The whole thing just stinks. :glare:

[lisabees]

 

I am a big advocate of home birth but I really think that practicing with disregard for the law is more damaging to homebirthing than it helps. Regardless of how competent or qualified this woman is, if she had been licensed and practicing within the law, this situation would not be nearly so grave. Licensed OB's lose patients. It's awful and tragic. And yes - there is malpractice and both OBs and midwives can be sued. But because she chose to do this illegally, the legal risk to her magnified 10-fold and its reflection on midwives in general is poor. Imagine what you would think if a very competent, super experienced, well-loved OB had a baby die during birth and you found out he didn't have a license to practice medicine because he didn't want to get one. You would be appalled. That's really what happened here. She lives close enough to Virginia to attend births here. It's legal for her to practice here - as long as she has a license. She has the experience to get a license. She decided not to. A very tragic decision for her and her family.

 

Prayers for her, her family and the family of the little baby lost. So much grief.

 

Heather

 

I had both my babies drug-free in the hospital with a Certified Nurse Midwife. My son even had a waterbirth. I am hugely in favor of midwives and woman-centered, family-centered care.

 

I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it. It's tragic. Serious errors in judgement were made all around.

 

And I agree that there's no excuse for practicing in a state that licenses DEMs without getting licensed.

 

:iagree: I guess I need to further investigate why one wouldn't get a license or why a pregnant mother would want to use a direct-entry midwife vs a certified one. FWIW, I am in PA and used a CM for all four of my babies at a freestanding birth center.

 

I wish all families the best. It is always tragic.

[mommaduck]

But isn't the licensing *some* protection? At least in the eyes of the court?

 

I can see the fact that she isn't licensed weighing heavily against her in the eyes of a judge. I honestly don't understand the rationale of not getting whatever professional accreditation is available, if for no other reason than CYA.

 

I'm not saying that she's a bad person, or anything like that. I'm saying I genuinely don't understand why she wouldn't have covered herself as much as possible, *esp* in an area that's known to be difficult to the profession.

 

*snort* (not at you) unfortunately, I believe the issue is the lack of law in this state. It's not ILLEGAL to homebirth here or use your choice of DEM, CPM, CNM (as I understand it...in fact, my first homebirth was my midwife's last birth needed in order to take the CPM exam, though she was licensed by an international agency in another country). But, if something goes wrong, then you are open to prosecution under the full extent of the law...something the rest of the medical community is protected from. And it's many times due to a decision made on the part of the parents (or refusal to follow the midwife's orders or something that could have just as easily gone wrong and ended in a loss inside a hospital as well as outside of it). One case was where the parents refused to follow the midwife's orders after the baby was born (baby needed treatment for something) and the baby died a few days later because the parents refused to have the baby treated. The state/county went after the midwife, not the parents!

 

We also live in an area (Sue and I) where there are people that will refuse to see anyone except a CPM or even anyone except a DEM. In this sense, an experienced and educated DEM is helpful to the community.

[Perry]

But, if something goes wrong, then you are open to prosecution under the full extent of the law...something the rest of the medical community is protected from.

 

Yet the state doesn't prosecute negligent OB's. Nope, you have to lawyer up and sue to attempt that.

Sure they do, if they're practicing without a license.

 

Practicing without a license

 

Main article: Healthcare provider requisites

In most jurisdictions, the provision of health care services is regulated by government, and individuals found to be providing medical, nursing or other professional services without the appropriate certification or licence may face sanctions including even criminal charges leading to prison. The number of professions subject to regulation, requisites for individuals to receive professional licensure, and nature of sanctions that can be imposed for failure to comply vary across jurisdictions.

For instance, in the United States, under Michigan state laws, an individual is guilty of a felony if found to be practicing a health profession subject to regulation without a valid license or registration of their own, or exceeding what a limited license or registration allows. The state laws define the scope of practice for medicine, nursing and a number of allied health professions.[12] In Florida, practicing medicine without the appropriate license is a crime classified as a third degree felony,[13] which may give imprisonment up to five years. Practicing a health care profession without a license which results in serious bodily injury classifies as a second degree felony,[13] providing up to 15 years' imprisonment.

In the United Kingdom, healthcare professionals are regulated by the state; the UK Health Professions Council (HPC)[14] protects the 'title' of each profession it regulates. For example, it is illegal for someone to call themself an Occupational Therapist or Radiographer if they are not on the register held by the HPC.

 

[mommaduck]

Sure they do, if they're practicing without a license.

 

Midwives are not required law here to have a license...this is due to lack of law. The rest of the medical community has law that applies to them and they are required to hold license. There have been groups that have attempted to remedy this situation in order to protect midwives (some want a law that requires license and others want a law that allows them to practice without the witchhunts...and yes, there have been witchhunts as well as I know of a case where it was due to jealousy between who preferred which midwife).

 

And no, the state does not go after legal OB's when something goes wrong. You have to lawyer up. However, the state does go after legal midwives when something goes wrong, even if the wrong was something totally unrelated the birth and the child died days later due to parental negligence and refusal to follow the midwife's advice.

 

Licensing doesn't mean the same to everyone. I've known some license idiots in my time. I've known some unlicensed, but well skilled and common sensed people as well. And vise versa.

Edited April 19, 2011 by mommaduck

[happypamama]

Just a note: DEMs/CPMs are not *illegal* in PA. They're also not completely legal. They are considered to be "alegal." They're not generally actively prosecuted, and it is not illegal to have them attend a homebirth (you can have anyone you want at your birth, in PA anyway), but if they do certain things, they can be charged with practicing medicine without a license, which is indeed illegal, since PA doesn't recognize a CPM license.

 

As for why someone wouldn't go ahead and get the law-approved license, well, there are multiple reasons. One, to get a CNM license requires specific education, and a lot of CPMs/DEMs have more informal training. Two, CNMs are required to have a physician backup, and as such, they generally can't do certain things, like breech births or twins. Many CPMs/DEMs don't believe that those types of births are necessarily risky and want the freedom to decide for themselves what births they are comfortable attending.

[Heather in VA]

 

As for why someone wouldn't go ahead and get the law-approved license, well, there are multiple reasons. One, to get a CNM license requires specific education, and a lot of CPMs/DEMs have more informal training. Two, CNMs are required to have a physician backup, and as such, they generally can't do certain things, like breech births or twins. Many CPMs/DEMs don't believe that those types of births are necessarily risky and want the freedom to decide for themselves what births they are comfortable attending.

 

Virginia (which is where this happened) doesn't require you to be a CNM, they require a direct entry midwife to have the CPM license. What you are talking about is not the law here in VA. If someone is a CPM, they just apply for the license here in VA. No additional training, back-up physician etc is required. (actually back-up physicians are not required here for CNMs either but we are discussing direct entry) A Direct entry midwife must get the CPM certification to be legal in this state. This is not the same as requiring a CNM (which is usually a master's degree). There are no guidelines when acting as a licensed CPM in Virginia saying X birth is ok and Y birth is not. It is simply a licensing procedure where you track your experience, have it validated by a licensed practicing midwife and pass an exam. They have all the freedom they want in deciding what births to attend. With that freedom, comes the responsibility of dealing with the consequences. I think had this midwife been legally practicing, the criminal case would have been much weaker. I don't agree with the idea of a breech birth for a first time mom at 43 being a good homebirth candidate but that would have been her choice (and legally her choice). To prove criminal liability would have been harder had she been legal. Being that she wasn't, it's just going to be much harder for her to justify her actions.

 

And as much as we all want to see direct entry midwives and homebirths legal in all states, it won't be much of an argument in this case because they are legal here. She just didn't follow the procedure to get licensed. As someone above said - it's legal to drive a car. That doesn't mean you can do it without a license, no matter how good and experienced of a driver you might be. And if you end up hurting someone, by accident, then the penalty is much worse than if you had an accident as a legal driver.

[Pretty in Pink]

She just didn't follow the procedure to get licensed. As someone above said - it's legal to drive a car. That doesn't mean you can do it without a license, no matter how good and experienced of a driver you might be. And if you end up hurting someone, by accident, then the penalty is much worse than if you had an accident as a legal driver.

 

Exactly.

 

I don't see why it matters whether or not there are people in rural areas who prefer a DEM. If they are illegal, they are illegal. They are fully aware of what they are doing, of the wording of the laws, of what behaviors on their part constitute practicing medicine. These women know the risk they are opening themselves up to when they attempt to walk such a fine line, or to outright break the law.

 

If this midwife was going to deliver even just one baby in the state of VA, then she should have sought licensing.