Judge reluctantly acquits midwife. - page 2

Judge reluctantly acquits midwife Calls her behavior 'abhorrent' in Bloomfield baby's death... Read More

  1. by   libnat
    Religious reasons, some amish only want other amish(non-license, they don't finish high school) and no hospital.
  2. by   fromtheseaRN
    Quote from country mom
    I still don't get why people think home births are so great. Reading a story like this would be enough to send me straight to the OB unit.
    because humans have been birthing at home for... well, since the beginning of humans. hospital births are very, very new- in the last 100 years. for some people (especially any pregnancy that presents with any issue whatsoever, such as my own pregnancy), hospital births are a blessing. for some people, home births are. they are perfectly safe when there is a low risk pregnancy. the netherlands has one of the highest home birth rates in the (white) west and the lowest neonatal & maternal death rate.
  3. by   oramar
    So you think perhaps lay mid-wives are not being regulated because that is what the Amish want?
  4. by   P_RN
    I did a Google on the midwife's name and found kdka tv news had a news story from when the trial began. It said both parents were grads of Carnegie Melon University. There's also a mention that Ms Wilson had 20 years experience as a midwife.

    Here in my state it was not at all unusual for people with little money to have a "granny-midwife" for home births. I wasn't a Nurse yet when my kids were born but I did have a doctor and a hospital delivery for both.

    I just did as my parents had done, but I can see that I could have been easily persuaded the other way. My spouse was the only one of his sibs not born at home with a (non Nurse) midwife.
  5. by   ElvishDNP
    CPMs (who, btw, are NOT lay midwives) are not legally allowed to perform homebirths in my state either. We are a bit behind the times, IMO.

    The parents weren't prosecuted because they didn't break any laws. It's not illegal to have your baby at home.

    All that said, I have a friend a couple towns over that had both her kids at home with a CPM. And she says that if she were to have more kids, she'd use the same CPM and homebirth again. Not saying this to prove anything about the safety (whole other thread) but making the point that people can and do fly under the radar all the time.
  6. by   NRSKarenRN

    [color=#899aac][color=#899aac]cpms (certified professional midwives)
    in about one-third of states in the us, the cpm degree, granted by north american registry of midwives, (narm), the national certifying body of midwives, is enough to be legally considered a midwife. although in some states medicaid covers the costs of women who are not insured, pennsylvania is not one of those states. despite the fact that cpms are registered, certified professionals, pa law does not recognize their degree. midwives can be charged with the practice of midwifery without a license even when they hold the cpm degree. click here to help with activism to get that degree recognized in pa. states which license midwives offer the lm or licensed midwife distinction. the dedicated women who show up to help a woman birth risk their freedom, bankruptcy and their financial lives to assist a woman in labor. hopefully you understand that risk when you work with your midwife. cpms often do their job as a spiritual calling.,,,



    [color=#899aac]traditional birth assistants tbas (also called lay midwives and grannie midwives) these women are not recognized by any certifying body and have varying degrees of skill. many do not choose to become certified because of convictions, not because of a lack of skill. some fiercely oppose the recognition of certifications in midwifery because they believe birth is a natural process and should never be regulated by any government organization. sometimes these women are part of religious groups and service those populations. some of these tbas may be the most experienced midwives in an area, having been present at thousands of births with skills to rival the most educated midwife with degrees and certifications.. reputation and personal choice favor highly in the selection of a tba and you must use caution in your selection of a midwife. these women face the same legal risks as cpms, including jail, bankruptcy and fines but more so because of a lack of documentation of their

    http://www.pahomebirth.com/aboutmidwives.html


    [color=#0000cc]pa: a push to stop lay midwives - 5th feb, 09:12 am - nursing for ...
    iinquirer article not available


    natural attachment -- midwifery, homebirth & pennsylvania: legal ...

    laboring to save home births: amish groups rallied politically against state closure of midwife diane goslin's practice

    midwifery in the 21st century: the relationships between midwifery ...nursing and medicine


    state facts: certified nurse midwives in pennsylvania

    statistics
    - there are over 200 certified nurse-midwives in pennsylvania attending 9.4% of all vaginal births in the state (2004 vital statistics).
    - cnm’s delivered 12.5% of all rural county babies. cnm’s attend 30% or more of the births in 12 rural counties (clinton, fulton, huntingdon, juniata, lancaster, lycoming, mifflin, snyder, somerset, union, warren and wayne).
    - lancaster county, which only had 4.8% of total live births in pennsylvania, accounted for 32.4% of all live births in the state delivered outside of a hospital and 33% in a hospital.
    - in fulton county there is one cnm delivering 50% of the babies in the county.
    - in many inner city hospitals cnm’s deliver 25-30% of the babies (pennsylvania hospital, hahneman hospital).
    - these statistics do not include the work of nurse-midwives attending births that were transferred for physician care (c-section, forceps, vacuum) or the annual gyn care provided as routine and preventative (breast and gyn cancer screening) health visits for a high percentage of women. c-section and low birth rates are lower for women that have been cared for by nurse-midwives.
    july 20, 2007--certified nurse midwives obtain prescriptive authority after 20yr struggle.
    a powerpoint presentation detailing the process


    laws for practicing as midwife by state: http://mana.org/statechart.html
    Last edit by NRSKarenRN on Apr 25, '09
  7. by   fmwf
    Quote from oramar
    Excuse me for being confused. So a nurse midwife is a very strictly regulated profession but then any old person can come along and call themselves a "lay midwife" and not be regulated?

    The midwifery scene of the US is layered--unlike lets say, UK, Canada, Netherlands. In US there are Direct-Entry (Non-nurse:CMs, CPMs, LMs) and Nurse Midwives (CNMs)--both types are recognized in various forms by the ACNM (American College of Nurse Midwives).

    Homebirth midwives can be CNMs or CPMs or LMs (licensed midwives). The beauty of the CPM of the US is that it is internationally known and valid. The US is unique as setting and preserving an excellent standard and designation for this vital practitioner. (Robbie-Davis Floyd, PhD, Mainstreaming Midwives) These women (CPMs) qualify by taking meeting an international standard & exam. CPMs receive an education & certification by 4 paths including (but not limited to): 1) attending a formal program with an approved curriculum of the MEAC at a degree-granting institution like Bastyr University, Miami-Dade College or 2) passing the ACC exam for CNMs. NARM (North American Registry of Midwives) issues and monitors this certification.

    Just to be clear, a CPM is decidedly not a lay midwife. (Some folks might not be getting this.) Some people do refer to lay midwives as "renegade" midwives because these don't follow the standard of the WHO or the ACNM. Or "plain" midwives, who are members of, or found among plain folks like the Mennonites or Amish.

    Some folks, though, practice in states that are not recognizing them at their own risk. (I myself am really afraid to go to jail I tell ya! So I aspire to be a CNM which is recognized in all 50 states with varying priveleges though.)

    The science and stats of homebirth have not met up with the controversy of this birth (home) option. Insurance associated with obstetrics has circumscribed what all practitioners (MDs, PAs, CNMs, CPMs, LMs) may or may not do. This automatically cuts out CPMs in a lot of states. And CNMs too for that matter. Ask some OBs/MDs--they too have suffered as well.


    .
    Last edit by fmwf on Apr 25, '09 : Reason: omission
  8. by   Batman24
    I would have called 911. If the mother still wouldn't go to the hospital I could document that and the medic would be able so substantiate it. Plus with the medics there perhaps between the few of us we could get her to go to the hospital. Maybe with another medical person telling her she was in need it would have gotten her to go.

    What kind of formalized education does a Certified Professional Midwife have?! Are they certified by the state in a standardized test?! I do think it should be regulated in some way so those with no training can't go out there and cause harm to unsuspecting mothers. Do most states require the midwife to be a RN first?! I know very little about all this but I'm not against midwifes in the least.
  9. by   DeLana_RN
    Quote from amandamaren
    because humans have been birthing at home for... well, since the beginning of humans. hospital births are very, very new- in the last 100 years. for some people (especially any pregnancy that presents with any issue whatsoever, such as my own pregnancy), hospital births are a blessing. for some people, home births are. they are perfectly safe when there is a low risk pregnancy. the netherlands has one of the highest home birth rates in the (white) west and the lowest neonatal & maternal death rate.
    Yes, women have been birthing at home (or in the fields, or other places) since the beginning of time, which is why maternal and/or infant mortality was very high in those times and average life expectancy very short (of course, non-hospital births weren't the only reason for this*, but many, many women died in childbirth).

    In this case, the infant death probably didn't have to happen if the woman could have been transferred to the hospital in time for a section. Of course, you cannot force anyone to accept any kind of medical treatment (which I assume is part of the reason for the verdict). I wonder if the midwife explained to the parents adequately the risks involved (or perhaps was too worried about getting in trouble herself?)

    A sad case.

    DeLana

    *I am aware that hospital births weren't necessarily safe in the past either.
  10. by   Apgar10
    Quote from oramar
    Excuse me for being confused. So a nurse midwife is a very strictly regulated profession but then any old person can come along and call themselves a "lay midwife" and not be regulated?
    On another network I belong to for midwives this was said by a court observer:
    Judy was charged with two felonies: Involuntary Manslaughter and Endangering the Welfare of a Child. She was also charged with the Summary Offense of Practicing Midwifery without a certificate.

    On the count of Involuntary Manslaughter, the language in the statutes that address that charge are very clear that for a person to be guilty of manslaughter, there has to be malicious intent. The DA could not prove beyond a shadow of a doubt that Judy had malice and took the life
    of the child purposely. Her actions did not rise to a criminal level. The judge could have lowered to charge to a misdemeanor, but he chose instead to acquit her of the charge and found her "NOT GUILTY".

    On the count of Endangering the Welfare of a Child, again the language in the statues involve malicious intent, and also a disregard for human life and an indifference to the consequences. The judge said there there was no "practically certain" evidence that Judy had a disregard
    for human life. In fact, her attorney argued that it was just the opposite. By her actions, she was attempting to preserve life. Again, rather than lowering the charge, he found her "NOT GUILTY".

    On the Summary Offense of Practicing Midwifery without a license, Judy's attorney addressed this in his closing arguments. He talked about the 1929 statute that addresses "midwives" in general. That statute calls for a certificate for midwives and the fine for not having a certificate
    is $10-$100. (Yet the state has no procedure in place for obtaining a certificate.) He then talked about the Medical Practice Act of 1985, which was not meant to replace the 1929 Law, but was an addition that addressed CNMs, a specific type of midwife. He said that there is an ambiguity where midwives can me charged for not having a certificate, but there is no certificate to be had.

    The judge, in his sentencing expressed his contempt for the state for requiring a certificate in the statute, but not following through with a process by which to achieve one. He suggested that this is something the legislature needs to look at.

    One thing that I did not see reported was this quote from the Judge that I wrote down in my notes: "I CAN NOT PROHIBIT YOU FROM PRACTICING MIDWIFERY, BECAUSE IT'S NOT IN THE STATUTE". He admitted that based on the current laws, MIDWIFERY IS NOT ILLEGAL.

    Let me be clear, Judge Machan was very stern in his reprimand and many of the news outlets reported that. Most of them failed to point out that he, besides being a judge, is a licensed physician, and his "opinion" was clearly biased by his medical background. In every situation, Judge Machan took the word of the Medical Professionals over Judy's. Although his medical bias played a part in formulating his opinion, we believe it also allowed him to see through the medical opinions put out by the DA which were clearly not founded in fact. (For instance, she stated in her closing arguments yesterday, that because the mother had a small build, it should have sent up a "red flag" to
    Judy that the baby was breech.)
  11. by   Apgar10
    Quote from Batman24
    What kind of formalized education does a Certified Professional Midwife have?! Are they certified by the state in a standardized test?!
    We are certified by passing a test that would be similar to the NCLEX and we are licensed by the state. States don't "certify" us, they license us. Not all states have a licensing option.

    Do most states require the midwife to be a RN first?!
    Half of them do. In the half that don't, being a midwife other than a nurse-midwife is either illegal or unregulated (as in the state of Pennsylvania where this story is based).

    Since you admittedly don't know a lot about midwives, you can start here for more information on the educational and credentialing process: North American Registry of Midwives :spin:
  12. by   fromtheseaRN
    Quote from DeLana_RN
    Yes, women have been birthing at home (or in the fields, or other places) since the beginning of time, which is why maternal and/or infant mortality was very high in those times and average life expectancy very short (of course, non-hospital births weren't the only reason for this*, but many, many women died in childbirth).

    In this case, the infant death probably didn't have to happen if the woman could have been transferred to the hospital in time for a section. Of course, you cannot force anyone to accept any kind of medical treatment (which I assume is part of the reason for the verdict). I wonder if the midwife explained to the parents adequately the risks involved (or perhaps was too worried about getting in trouble herself?)

    A sad case.

    DeLana

    *I am aware that hospital births weren't necessarily safe in the past either.
    actually, the fact that neonate and maternal death rate is much lower now is due to the discovery of microbes, and the steps that were taken since- sterile/aeseptic materials and antibiotics. as soon as doctors and midwives started washing their hands the death rate fell dramatically. that topic is covered extensively in many infectious disease courses.
  13. by   opus13
    Quote from libnat
    even if she did, the paramedics also couldn't force her to go to the hospitial and i doubt they could have been anymore successful performing a breach delivery.

    still should have to covered her own behind but that doesn't mean anything would have happened differerently.
    actually we can force the mother to go to the hospital, it's kind of a trick but unless there is a religious reason for the baby not to go, we say that the parent's action are placing the child at risk of injury and have the police put the baby in protective custody (very easy to do) and transport the baby, but they're attached so mom has to go.

    karl
    emt-p
    gn in 3 wks

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