Poll- Do you support "underground" midwives? - Page 9

[Buzzbuzz]

You ask if it is really so difficult to determine if someone's professional credentials.

I think it can be difficult when there is not an official body confirming someone's identity, credentials and fitness.  You have the potential for name changes, changes in residence and quite frankly, unrecorded wrong-doing and/or criminal behavior.

For exampIe, I think it was an Oregon midwife who introduced flesh-eating bacteria into the vagina of a woman giving birth by not wearing gloves.  I think she has changed her name several times since that occurred.  So it can be hard for someone who doesn't have the investigative skills of a private detective to pull all this information together.

[lovebeingamomma]

My opinion is only that people should follow the law regardless of what that means (as far as what options are left..I feel like we're going down a rabbit trail with arguing the safety of homebirth vs. illegal homebirth vs. UC vs. hospital etc.) and I think midwives are wrong to offer illegal services.  So do you respect that viewpoint or not?  I can't tell from your post.  
 

Originally Posted by Plummeting 

First of all, I didn't say anything about your opinion. I asked you to tell me what it was. If you think that asking someone to tell you exactly what their opinion is somehow constitutes disrespecting said opinion, that's not an issue that has anything to do with me. I can't read your mind, and if you want to have a rational discussion about a topic in which you expect everyone else to share their opinions, then it's only reasonable for you to tell us what yours is, if you're going to continually express your disagreement.

I did read BuzzBuzz's post. Perhaps you ignored the fact that it wasn't about an underground midwife, or at least if it was, she did not say it was. She merely said that the midwife wanted to transfer to the state with looser laws. Well, crappy midwives who were doing things they weren't really allowed to do might want to do that, whether the midwives were practicing legally or not. And your story only goes to disprove your other claim, which was that women have all sorts of options. No, they don't. Do you honestly think that the same thing wouldn't have happened had that family gone unassisted? That would seem incredibly naive.

[slmommy]

Quote:

Originally Posted by Buzzbuzz 

And, of course, licensing and legality are two separate things.  Oregon permits unlicensed midwives to legally practice, for example.

So in the loss case you spoke about it was a legal mw in OR who was illegal in WA? And the flesh eating bacteria... also legal mw?

Originally Posted by Buzzbuzz 

You ask if it is really so difficult to determine if someone's professional credentials.

I think it can be difficult when there is not an official body confirming someone's identity, credentials and fitness.  You have the potential for name changes, changes in residence and quite frankly, unrecorded wrong-doing and/or criminal behavior.

For exampIe, I think it was an Oregon midwife who introduced flesh-eating bacteria into the vagina of a woman giving birth by not wearing gloves.  I think she has changed her name several times since that occurred.  So it can be hard for someone who doesn't have the investigative skills of a private detective to pull all this information together.

... I thought CNMs have nursing licenses? and degrees? Would it be totally ridiculous to ask a mw you are interviewing about this, like her education, accreditation, background, diploma, etc.? 

and CPMs are through NARM... 

If you are in a state where only CNMs are premitted... and you did not want a cpm or lm because it is "illlegal" or "underground," wouldn't you ask the mw about some of these things in an interview? Or to differentiate between a CPM and LM? Even a lot of drs. display their diplomas, we ask cops for ID before entering our houses... would it be totally absurd/need the skills of a private detective to ask to see some of a mw's diploma/licensing/accreditation?? 

ETA: buzz, I realize licensing and legality are totally different, but the OP was specifically asking only about "legal" mws.

[Youngfrankenstein]

Maybe I should point out, since it seems to have been missed that I understand the legal repercussions that having an illegal mw would have.  I would have no re-course to sue her other than any other citizen and she also takes the risk.  A risk that the Ohio mw took and lost at.  The family is in misery because they never would have wanted her to be charged.  But I don't think this matters of law suits is where the "dangerous" part is coming from.  I stated upthread that I would love for this all to be official in Ohio.  But if I hire someone the day before the law goes into effect, it doesn't mean she was dangerous and unqualified one day and completely qualified the next.

[littlest birds]

Originally Posted by Buzzbuzz 
Your point regarding UCing and consumer protection makes no sense.  A UC-er needs no consumer protection because they are not consuming the services of a health care provider or any other third party.

"Should we add some legislation to require women trying for hbs/mws/uc to pass a written test to make sure they know the legalities of their state and possible medical consequences of their choices and actions?"

I know this isn't a popular position anymore, but an internet connection and google does not an expert make.  I don't want to have to become an expert airplane mechanic before I get on a plane.  I don't want to have to become a pharmacist before I feel safe taking medicine.  And, in reality, I don't think I could become an airplane mechanic or a pharmicist without devoting many hours and years of time.  Given that is the case, I look to the government to regulate certain areas to help me avoid injury and fraud.  I think having a system that regulates health care providers on the state level is an important part of ensuring consumer safety and injury -- just like having drugs tested by the FDA and dispensed by a licensed PharmD is an important part of ensuring consumer safety and avoiding injury.  While being an educated consumer is important, I think it is false to claim that an individual can, on their own, replace all the protections of the FDA for example, or the NTSB.

We already have those regulations of health care providers.  The community has already determined that births are safest in the hospital.  The regulations are the reason homebirth is so inaccessible.  Hospital births aren't "what you expect is what you get" either.  How many docs say they support natural birth but when it comes down to it have a 30-50% C-section rate?  How many ladies are shocked to discover that their bodies won't only be cut if there for a true emergency only after it is too late?  No legal recourse for that at all.  AND because of the regulations women must accept that as the only best legal option in many cases. 

I step outside of that regulated system for good reason.  If I wanted those protections I would have stayed in it and never had a homebirth.  As a consumer, if I don't even know the legality of homebirth and homebirth attendants in my area, then that's my own fault and responsibility.  If I choose a homebirth the risks are on me, not my attendant, and I know that.  If a woman doesn't go out of her way to know that much, then she is not really prepared to step outside of the system and do such a self-reliant thing as choose a homebirth.  A homebirth is a lot like a UC as far as consumer liability THANK GOODNESS!  That is exactly what I wanted--a more experienced woman than myself to be with me.  That is all.  No fooling myself she's a doctor.  No fooling myself that either she or I couldn't make a disastrous mistake.  At least she knows more than I do and won't personally be in physical pain during an emergency.  My midwife missed our twins who were in fact surprise twins, we'd missed a couple of appointments at the time and it's a long story why.  We were relaxed and healthy and things came up for her and for us...  I got a different midwife and had another homebirth 3 years later.

I don't have to learn to be an expert on midwifery to choose a midwife.  That is different from doing my homework and not making assumptions.  I have not asked an outside party to protect me from fraud.  You can't control and protect against everything.  If you need that you should definitely choose the most legal well-regulated birth option.  You are comfortable with the role of government in controlling health decisions.  Personally, I am not.  I don't believe the government is capable of providing anything reasonable in terms of regulation.  From what I can tell if it's regulated enough for insurance providers to be willing to insure the midwives, it's overregulated.  There's a big price to pay for consumer protection.  It's protection based on accepting exactly the medical model that causes the problems in the first place.  Exactly the same insurers are currently the top excuse for the high c-section rate. 

(My italics wouldn't turn off!  Sorry it's weird!)

And for what it's worth I don't believe FDA approved drugs are safe.  I wish I could trust that regulatory body but I certainly don't.

[slmommy]

 Littlest birds, thanks for eloquently saying in one post what I have been fumbling about in 4...

[Plummeting]

Originally Posted by Buzzbuzz 

I believe that the Big Push For Midwives agrees that there is no such thing as alegal status.  My understanding is that if there is no statute permitting midwifery and money changes hands, a midwife in such state can be prosecuted for practicing medicine without a license.

And, of course, licensing and legality are two separate things.  Oregon permits unlicensed midwives to legally practice, for example.

But your understanding doesn't have anything to do with whether or not unlicensed midwifery is illegal and/or 'underground'. You believe that if there is no statute permitting midwifery and that money changes hands, this somehow makes it illegal. The law is often ambiguous about all sorts of things. We don't like to believe that, as it makes us feel more comfortable thinking that everything is absolutely black and white, cut and dried. It gives us a sense of security. The truth is that there are some things that just aren't like that. Furthermore, being prosecuted for something is NOT the same thing as being guilty of something. Midwives have been prosecuted for such things and found innocent. It's not like there's a conviction every time this happens. So what does that mean then? That your understanding is wrong? That the whole jury of 12 was wrong, but you and the prosecuting attorney are right?

I'm aware that licensing and legality are two separate things, but so are licensing and whether or not a midwife is 'underground'. So are legality and whether or not a midwife is 'underground'. Furthermore, if midwifery is technically legal, but no there is no path to licensure, then a woman choosing a midwife in such a state is in the SAME position as a woman choosing a midwife in a state where midwifery is illegal. She still has to find out everything she needs to know on her own. That's the problem with this entire discussion. We aren't even all talking about the same thing.

Originally Posted by Buzzbuzz 

Additionally -- you shouldn't confuse an unwillingness on the part of the state to enforce the law with the actual legality of any particular action. 

And you shouldn't confuse prosecution of midwives who deliver babies as evidence that the law actually bars them from doing it.

Originally Posted by lovebeingamomma 

My opinion is only that people should follow the law regardless of what that means (as far as what options are left..I feel like we're going down a rabbit trail with arguing the safety of homebirth vs. illegal homebirth vs. UC vs. hospital etc.) and I think midwives are wrong to offer illegal services.  So do you respect that viewpoint or not?  I can't tell from your post.  
 

I respect you as a person. I respect your ability to reach conclusions that are different than my own, and I respect that intelligent people can and often do disagree. I accept that you are an intelligent, educated person who has formed an intelligent, educated opinion. I respect that. I do not, however, think your opinion is just as valid as any other opinion out there, if that's what you mean by respect. I'm not a relativist. I think there are some issues on which people can disagree, and neither is right or wrong. I don't think this is one of them. I can see where you're coming from. I understand what you mean. I just think you're wrong. I don't believe thinking someone is wrong is 'disrespectful'.

[littlest birds]

Originally Posted by lovebeingamomma 

My opinion is only that people should follow the law regardless of what that means (as far as what options are left..I feel like we're going down a rabbit trail with arguing the safety of homebirth vs. illegal homebirth vs. UC vs. hospital etc.) and I think midwives are wrong to offer illegal services.  So do you respect that viewpoint or not?  I can't tell from your post.  
 

I respect your opinion best when you apply it only to your personal choices.  It makes me nervous when you refer to what other people should do, but as long as it's opinion and not an effort to control other people than I am fine with it. 

People should not follow the law of their government when it goes against greater laws.  When it goes against moral and spiritual laws I think they should not feel they must follow it. 

Let's say I live in a location where I can't access any legally-practicing midwife for a homebirth and don't consider UC a viable option.  Following the law threatens my freedom from various unwanted and unnecessary surgeries and drugs and it even means I have no say over who touches and sees my private parts.  It means placing my body in the hands of people I do not trust.  My ethical beliefs about personal bodily integrity tend to trump my belief in laws, even though I am generally extremely respectful of laws.  The only fully legal options in many places require a willingness to sacrifice basic bodily integrity and choice and I do not believe we are ethically obligated to do that.

Let's say I believe that birth is a spiritual process and that every intervention not absolutely required is an assault on God's natural order.  At that point I would be going against my religion to put myself in a place where multiple unnecessary assaults against that natural unfolding are guaranteed.  Those laws humble and foolish as they sound are greater than the ones that stand in the way of midwives.  

What if you look at the work of a midwife as a calling from God?  Should that midwife not heed God's call and the pathway given to her?  Certainly she is most desperately needed as a midwife where it is most difficult to practice and there are too few practicing.  She is called to bring a blessing to women and babies and families, and not where it is easiest only. 

How many, many people have acted outside of the laws throughout history because they were doing God's work?  Or just doing what was right when it wasn't legal?  How about the underground railroad and anyone who helped a runaway slave, ever?  Should they have not done so?  There are so many, many examples of people who did what was right when it was against the law.  They are often called heroes later on. 

These midwives are my heroes.  Read my much earlier post again if you are interested in what I think of their courage in being revolutionaries and paving the way and doing what is right despite the risks.  They should be celebrated and thanked and praised and blessed and protected.    

[lovebeingamomma]

I can see where you're coming from, it's an interesting point of view.  As a Christian I do believe in two things regarding governing laws- that they are to obeyed (as scripture states), and that we are to obey God's laws above man's laws (as scripture also states).  So I get what you're saying, I really do.  However with this specific topic, I think it's a far stretch to say that a midwife would be called to operate outside of the law.  Because she is called to obey the governing laws (Christian midwives that is).  There is nothing about the alternative to homebirth- hospital or UC, that you could find in scripture as being a sin against your body.  To YOU it might "feel" wrong to have a doctor deliver your baby in a hospital, but that's just your feeling, you're allowed those feelings of course, but you can't support an argument with scripture to say that God would call you to ask someone to break the law for you (that is, hire an illegal midwife).  However if you really felt it was an assault against your body and feared hospital birth, surely praying for God's wisdom would afford you a way out of that without breaking the law.  Maybe he would call you to UC, maybe he would provide a gentle care provider that would completely respect you at a hospital birth (that happened to me, I cannot tell you how desperately I wanted a UC or homebirth but ended up at a hospital).  So to jump to the conclusion that we must break the law in order to obey God does not hold up.  This is coming from my 20 plus years as a Christian and studying the Bible daily, I'm not speaking for any other faith, spiritual belief, or any other understanding/belief about life or our bodies. And perhaps you weren't even referring to Christianity (not sure), but I just wanted to share my viewpoint about that.  

And on the note about controlling other people, I don't know how many times I have to say it, I respect everyone's free-will and you can do whatever you want!  The point of this whole thread for me was simply to gain understanding about how women view births with illegal midwives, why they seek it, why they support it.  The only thing that gets me upset is when people think I should be protecting these midwives, that they deserve my respect for what they're doing.  I don't respect what they're doing.  I respect them as people, I respect them as midwives, I just don't respect the act of providing illegal services.  I realize that they give women amazing support that they may not be able to get elsewhere, I understand that.  I don't at all view it the same though, as you said, in comparison to others throughout history who broke the law and are hero's.  Again though..I get what you're saying, and it totally makes sense, even if I disagree.  
 

btw I hadn't looked at this thread in months, it's gotten so lengthy, and I haven't re-ready anyone's posts.  Maybe we're just going around in circles here, but I'm enjoying the continued discussion.  I love getting into the minds of women especially around the topic of birth.  I don't think any less of anyone for choosing any type of birth even though I have an "opinion".  Birth is so personal, and I really honestly wish there were no laws or politics involved, but since there are, we might as well talk about it. 

Originally Posted by littlest birds 

I respect your opinion best when you apply it only to your personal choices.  It makes me nervous when you refer to what other people should do, but as long as it's opinion and not an effort to control other people than I am fine with it. 

People should not follow the law of their government when it goes against greater laws.  When it goes against moral and spiritual laws I think they should not feel they must follow it. 

Let's say I live in a location where I can't access any legally-practicing midwife for a homebirth and don't consider UC a viable option.  Following the law threatens my freedom from various unwanted and unnecessary surgeries and drugs and it even means I have no say over who touches and sees my private parts.  It means placing my body in the hands of people I do not trust.  My ethical beliefs about personal bodily integrity tend to trump my belief in laws, even though I am generally extremely respectful of laws.  The only fully legal options in many places require a willingness to sacrifice basic bodily integrity and choice and I do not believe we are ethically obligated to do that.

Let's say I believe that birth is a spiritual process and that every intervention not absolutely required is an assault on God's natural order.  At that point I would be going against my religion to put myself in a place where multiple unnecessary assaults against that natural unfolding are guaranteed.  Those laws humble and foolish as they sound are greater than the ones that stand in the way of midwives.  

What if you look at the work of a midwife as a calling from God?  Should that midwife not heed God's call and the pathway given to her?  Certainly she is most desperately needed as a midwife where it is most difficult to practice and there are too few practicing.  She is called to bring a blessing to women and babies and families, and not where it is easiest only. 

How many, many people have acted outside of the laws throughout history because they were doing God's work?  Or just doing what was right when it wasn't legal?  How about the underground railroad and anyone who helped a runaway slave, ever?  Should they have not done so?  There are so many, many examples of people who did what was right when it was against the law.  They are often called heroes later on. 

These midwives are my heroes.  Read my much earlier post again if you are interested in what I think of their courage in being revolutionaries and paving the way and doing what is right despite the risks.  They should be celebrated and thanked and praised and blessed and protected.    

Edited by lovebeingamomma - 3/15/12 at 8:53pm

[Plummeting]

Originally Posted by Buzzbuzz 

You ask if it is really so difficult to determine if someone's professional credentials.

I think it can be difficult when there is not an official body confirming someone's identity, credentials and fitness.  You have the potential for name changes, changes in residence and quite frankly, unrecorded wrong-doing and/or criminal behavior.

For exampIe, I think it was an Oregon midwife who introduced flesh-eating bacteria into the vagina of a woman giving birth by not wearing gloves.  I think she has changed her name several times since that occurred.  So it can be hard for someone who doesn't have the investigative skills of a private detective to pull all this information together.

You think she has changed her name? Do you have any evidence of this? And are you saying that the fact that she supposedly gave someone an infection by not wearing gloves has anything to do with her legal status? Have you seen The Business of Being Born? That midwife is a licensed CNM in New York, but during the movie she caught two babies barehanded! I'll be honest, I was pretty shocked and was quick to check that my midwives wear gloves when catching babies or doing anything else. So using a licensed midwife doesn't prevent you from getting someone who is apparently more than willing to catch your baby with her bare hands, even when there's plenty of time to put gloves on, and until someone blames those midwives for giving them MRSA, you aren't going to know about it. So again, licensing is not the issue here. Women have to ask questions of their midwives. Period. And if you see someone doing something to you barehanded, tell them to STOP, just like you'd tell a doctor not to cut an episiotomy if you didn't want or need one.

Were you aware that perineal tears are a risk factor for catching MRSA (a "flesh-eating bacteria") in the hospital? And if a woman developed a vaginal or perineal MRSA infection after a hospital birth, would you suggest that the doctors were not wearing gloves? There are women who carry MRSA in their vaginas, just like there are women who carry GBS there. While I STRONGLY disagree with midwives not wearing gloves, I'm not going to throw someone under the bus because one of her clients got a MRSA infection. We have no idea if that woman was already carrying MRSA. We have no idea if she would've caught MRSA even if her midwife had been wearing gloves (just like people in the hospital do). We only have a story (well, you have it, I haven't heard it before) of a midwife who didn't wear gloves, whose client developed a vaginal infection. Not exactly convincing evidence that she got it from the midwife and it would've been prevented by wearing gloves. Everyone in the hospital wears gloves. Women still get MRSA-infected perineal tears. I just thought it was important to point that out.

[Valerie]

Originally Posted by Buzzbuzz 

I believe that the Big Push For Midwives agrees that there is no such thing as alegal status.  My understanding is that if there is no statute permitting midwifery and money changes hands, a midwife in such state can be prosecuted for practicing medicine without a license.

And, of course, licensing and legality are two separate things.  Oregon permits unlicensed midwives to legally practice, for example.

You are absolutely right.  THERE IS NO SUCH THING AS "ALEGAL"!  "Alegal" means "outside of the law," but in states where midwives are subject to prosecution for practicing medicine or nursing without a license, they are clearly not "outside of the law."  I understand the attractiveness of the term -- geez, there was a time I used it myself, swearing up and down that midwifery in Illinois was not illegal, but *alegal."  For a lot of midwives it is comforting to believe that they aren't *really* doing anything illegal...nosirree...they are "alegal."  They somehow function outside of the law.   It took too many badge-wearing, subpoena-carrying men at my door, and too many appearances in courtrooms as a derfendant, to make me understand that there is no such thing as an "alegal" midwife (well, law school helped, too :).  In short, if a state's law neither specifically permits midwifery, nor specifically exempts it from the medical/nurse practice act, those who practice midwifery in that state are subject to prosecution for practicing medicine or nursing without a license.  In short, they are *illegal.*  For more information on the subject of "alegal", you might want to check out Ida Darragh's essay in From Calling to Courtroom (callingtocourtroom.net).

By the way, in general it is not "money changing hands" that determines  whether one is practicing medicine without a license, but, rather, the things that one does.  In other words, if a midwife is doing things that are considered by her state to be the unlicensed practice of medicine, it doesn't matter whether or not she is paid.

Valerie

Former CPM/homebirth midwife

Editor and co-author, From Calling to Courtroom

Current RN

Current Illinois-licensed attorney

[lovebeingamomma]

Valerie, is the mom doing anything illegal by hiring an illegal midwife?  In a recent conversation I saw someone said there was a loophole in our state, that it was perfectly legal to hire whomever we want, that it really doesn't matter if they're doing anything wrong, because the mom isn't so her butt is covered.  Thoughts?

[MichelleZB]

I support midwifery being integrated into the medical system, like it is here in Ontario. And yes, that means that the state/province/country needs to come up with education standards and licensing.

Lots of my friends have had unmedicated hospital births attended by midwives. Some have had legal homebirths. I had an unmedicated one attended by a doctor and nurse in my hospital--because since the midwives have been running in and out of hospitals, the labour nurses have been seeing a lot more normal births and nobody pushes the drugs anymore. It's good for everyone.

[Valerie]

Originally Posted by lovebeingamomma 

Valerie, is the mom doing anything illegal by hiring an illegal midwife?  In a recent conversation I saw someone said there was a loophole in our state, that it was perfectly legal to hire whomever we want, that it really doesn't matter if they're doing anything wrong, because the mom isn't so her butt is covered.  Thoughts?

That is a great question.  I suppose, *in theory*, a parent could be charged with something like reckless endangerment if a prosecutor could show that the very hiring of an illegal midwife endangered lives.  On the other hand, I think most prosecutors don't want to go down the rabbit hole of establishing that midwives are so very dangerous that to even hire one is criminal!  I suppose anything is possible, but I have never heard or read of such a case.  Quite the contrary -- those trying to prosecute an illegal midwife will often try to get the parents on board, portraying them as the hapless victims of an obstetrical hobbyist.

Perhaps a greater danger to parents in recent years is the increasing involvement of CPS.  I have been part of a couple cases involving hospital transports after a planned homebirth. where hospital staff called in CPS to investigate.  I am aware of several others across the country. 

Valerie

Former CPM/homebirth midwife

Editor and co-author, From Calling to Courtroom

Current RN

Current Illinois-licensed attorney

[Plummeting]

Originally Posted by Valerie 

You are absolutely right.  THERE IS NO SUCH THING AS "ALEGAL"!  "Alegal" means "outside of the law," but in states where midwives are subject to prosecution for practicing medicine or nursing without a license, they are clearly not "outside of the law."  I understand the attractiveness of the term -- geez, there was a time I used it myself, swearing up and down that midwifery in Illinois was not illegal, but *alegal."  For a lot of midwives it is comforting to believe that they aren't *really* doing anything illegal...nosirree...they are "alegal."  They somehow function outside of the law.   It took too many badge-wearing, subpoena-carrying men at my door, and too many appearances in courtrooms as a derfendant, to make me understand that there is no such thing as an "alegal" midwife (well, law school helped, too :).  In short, if a state's law neither specifically permits midwifery, nor specifically exempts it from the medical/nurse practice act, those who practice midwifery in that state are subject to prosecution for practicing medicine or nursing without a license.  In short, they are *illegal.*  For more information on the subject of "alegal", you might want to check out Ida Darragh's essay in From Calling to Courtroom (callingtocourtroom.net).

By the way, in general it is not "money changing hands" that determines  whether one is practicing medicine without a license, but, rather, the things that one does.  In other words, if a midwife is doing things that are considered by her state to be the unlicensed practice of medicine, it doesn't matter whether or not she is paid.

Valerie

Former CPM/homebirth midwife

Editor and co-author, From Calling to Courtroom

Current RN

Current Illinois-licensed attorney

But what I'm saying is that the term is irrelevant. She's saying that if the law doesn't specifically allow midwifery, it's illegal. I'm saying that if the law doesn't mention it at all, that is going to be determined by a jury, IF it's ever prosecuted, and it might not be. So then where are we? You're saying it's illegal in places where women get prosecuted, but what about when they're found innocent? Was it not illegal? Do you believe the jury was just too stupid to understand the law? What are you saying?

For instance, since you're a lawyer, you know that in many states, the "practice of medicine" includes doing anything for the treatment of disease/illness/injury. Pregnancy isn't a disease, illness, or injury. If a midwife isn't giving medications she's not authorized to give, she's got a good case for herself, if she's attending a normal, low-risk birth, which is, by definition, none of those things described above. So if she's prosecuted for practicing medicine without a license, sure, they can DO that, but did she really practice medicine without a license, if all she did was catch a baby? Not by the state's own definitions she didn't. That would mean that what she's doing is not illegal. Something isn't illegal just because someone finds some way to contort the law around to make it so.

Edited by Plummeting - 3/16/12 at 11:44am

[Buzzbuzz]

Plummeting - I think you are explaining quite well for everyone else how easy it may be for a consumer to be confused about the legal status of her midwife.

Valerie -- is there a potential issue for doulas here as well, if they cross certain lines (in terms of advising, actions, etc.) even in states where only licensed midwifery is legal?

[slmommy]

http://en.wikipedia.org/wiki/Home_birth#United_States

takes about all 3 seconds and has a map. There are many other resources that explain state-state specifics.

ETA - http://mana.org/statechart.html very specific about legality/licensure/not regulated but not prohibited/prohibited for CPMs

[Buzzbuzz]

Also -- the arguments that you are making are all ones that might assist a midwife in a court of law if she is accused of the illegal practice of medicine.  However, I do not think that a list of defenses and a determination by a jury is what most pregnant women are thinking about when they are trying to learn if their midwife can legally practice within a particular state.

[Buzzbuzz]

http://en.wikipedia.org/wiki/Home_birth#United_States

takes about all 3 seconds and has a map. There are many other resources that explain state-state specifics

Of course - the article internally contradicts itself right by that map.  One part references 23 states in which direct entry midwifery is illegal but the subsequent listing in the next paragraph and the map show 10 states.

[Buzzbuzz]

I'm also not sure I would be running to NARM for its opinion on this -- it certain has an interest in presenting things in the best light and is not a statement about what a prosecutor may or may not choose to prosecute in any particular state.