Indiana homebirth? - Mothering Forums

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#1 of 25 Old 06-23-2007, 03:26 PM - Thread Starter
 
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I currently work with an LM and reside in S Florida-
I am looking at possibly moving to Indiana, does anyone know whatthe legalities of midwifery/homebirth are in Bloomington?
Thanks in advance,
Mary Rainer
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#2 of 25 Old 06-23-2007, 05:42 PM
 
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Check out the the Indiana tribal area. There are many homebirthers and even a homebirth group that meets. I know that there is homebirth support in Bloomington from parents and midwives, but in Indiana, unless you are a CNM, non-certified providers are "illegal". The catch is, the state won't pass any laws concerning the liscensure of CPM's.
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#3 of 25 Old 06-24-2007, 12:00 PM
 
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Apparently, there are some counties where the DA's are more or less friendly to it, so some midwives won't work in some counties. However, there ARE midwives working. I agree, go check in finding your tribe.

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#4 of 25 Old 06-24-2007, 08:00 PM
 
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I would say it is an area of active Midwife hunting-- I think if you move there don't plan to work as a mw but as a lobbyist -- or save about 30-50 thousand dollars to pay a lawyer/legal fund
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#5 of 25 Old 06-24-2007, 10:31 PM
 
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I had a home birth in Indiana (and so did a lot of my friends). My understanding was that midwifery was neither legal nor illegal.

I have a great name if you want it. She's in Indianapolis.

I suggest talking to midwives working in birth centers and hospitals to get names of home birth midwives. That's how I found several that I interviewed.

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#6 of 25 Old 06-24-2007, 10:38 PM
 
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Homebirth is legal here in Indiana but its the licensure of midwifes that is an issue.

Midwives have to be licensenced to practice here but the state only recognizes CNM licenses. Therefore even CPMs who are licensed are not recognized by the state and can be prosacuted. There are CNMs here in Indiana who attend homebirths and there are CPMs and DEMs who fly under the radar. You just have to ask around. Btw Bloomington is a VERY homebirth friendly commuity. Probably the most homebirth friendly you will see here in Indiana.
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#7 of 25 Old 06-24-2007, 11:05 PM
 
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but hasn't there been more than one recent prosicution in the Bloomington area? no parental complaints- DA specifically targeting -- I am pretty sure that there have been some things here on MDC calling for help -- and I am on a couple of midwifery lists with a mw from that area who has had legal trouble --
and the practice of unlicensed midwifery is against the law- frankly illegal - only CNMs at this time are recognized as licensed. even if you have had a home birth or even if you have skirted legal problems yourself do not mislead someone else that things are fine there-- if the area has so many consumers why is midwifery not frankly legal?
-----------
here is a midwifery legislation address--
http://www.indianamidwiferytaskforce.org/


here is a NY times article on the subject

http://www.nytimes.com/2006/04/03/us...rssnyt&emc=rss
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#8 of 25 Old 06-25-2007, 10:32 AM
 
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but hasn't there been more than one recent prosicution in the Bloomington area?
Yes the midwife is from Bloomington but she is not being prosicuted in Monroe county (where Bloomington is located) but rather Shelby County which is about 30 mins south east of Indianapolis. I'm not aware of anyother legal problems in the Bloomington area. The only other recent midwifery case in Indiana that I am aware of is the case of a "church midwife" catching a very premature baby. The church/family did not believe in any type of medical care and therefore the child was allowed to die. The "midwife" had no formal training what so ever.

There are other midwifes that are DEMs and CPMs that are actually quite open about their work in Indiana and have websites up that advertise their services.

I never said in my post that midwifery as a CPM or a DEM was legal just let her know while it isn't legal there are other legal choices, CNMs and that while it isn't legal there are CPMs and DEMs who do choose to practice here.

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if the area has so many consumers why is midwifery not frankly legal?
um politics. Just because there is support for something doesn't mean its going to become legal right away. There are hundreds of homebirthers that come to the rallies and meetings at the statehouse to support homebirths and midwives. There is a thriving homebirth community here. We even have support in the the House and the Senate. How else would the bill get sponsored.

No Indiana is not the most midwifery state around but alot is being done to change that right now. There is a very active lobby pursueing the licensure of DEMs and CPMs.
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#9 of 25 Old 06-25-2007, 11:02 AM
 
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Yup, so that is why certain midwives don't practice in the counties that seem to be less friendly toward midwifery(especially the one in which she was prosecuted)...but will practice in others in Indiana...

And she did say that generally they haven't had much of a problem up to this point, but that, as pp said, it's the licensure that is in question...she was prosecuted for practicing medicine and midwifery WITHOUT A LICENSE, because they don't recognize the CPM as a license...that's my understanding of it.

Regardless, they have what seems to be a fairly active community, and I bet if you get in touch with them, you'll find a niche. Actually, I don't know if she's found one, but I believe that a certain midwife in that area is currently looking for an apprentice...

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#10 of 25 Old 06-25-2007, 11:18 AM
 
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but I believe that a certain midwife in that area is currently looking for an apprentice...
I'm pretty sure she is... I actually just read somewhere something to that effect.
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#11 of 25 Old 06-25-2007, 11:49 AM
 
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sorry to come off so gruff- I understand and did unlicensed mw care for years and years- after watching one gal after another get into trouble I just woke up- maybe midwifery revival is only 20-30 years old but I still think that is a long time to not have a law passed to make it legal for women to serve women, and it drives me crazy. I am also thinking that someone should have said to me sooner- what are you doing- this is the core fight the legislation the legal recognition of the importance of choices for women -- look I hate politics and yet that is the bigger chunk of the reality- midwives just serving women without the midwife having a legal status has not really changed a thing - certain families have had birth experiences they have wanted or limited choices in who can provide for them but the state still does not respect or support that choice or even really truly care about the safety and happiness of it's women and children...

Tattoos/ tattoo parlors have become quite the fad and in fairly short order their licensing has been streamlined- I see no politics involved there-- very simple and straight forward in most places even with past associations with the drug community, bikers and other "rebels".
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#12 of 25 Old 06-25-2007, 01:19 PM
 
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Tattoos/ tattoo parlors have become quite the fad and in fairly short order their licensing has been streamlined- I see no politics involved there-- very simple and straight forward in most places even with past associations with the drug community, bikers and other "rebels".
I totally see what your saying. I think the difference between tattoo parlors and midwifery is all about money. No one really stands to loose money by legalizing tattoo parlors. Really the state stands to gain money because of all the licesensing fees and such. But with midwifery there is a bunch of money to be lost by the medical community and the they have soooo much clout when it comes to the legal process here. The OB/GYN led anti-midwifery lobby here is very, very active here. The biggest hurdle being faced here is a particular person who is very much conected to the medical community who keeps blocking the bill from being heard. Its so frustrating... isn't government suppose to be for the people..not about the people w/ lots of money.
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#13 of 25 Old 06-25-2007, 01:27 PM
 
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Oooooh, yes. Tatoo parlors don't have people with very dddeeeepppp pockets (ie: the medical community and their lobbyists) up against them, though. The politics part of midwifery IS important. However, I think, after just observing for a short while, that until the midwifery community as a whole can come to a consensus about what the legalities should be and then get together as a unified front, from STATE TO STATE TO STATE, we're going to continue to get nowhere with legalizing, licensing, etc.

The problem is, that many midwives see a definate need for uniformity of licensure and the legality of said licensure. Many others, though, see regulation, especially where those deep pockets of the medical community and their non-evidence based medicine comes in, as a very slippery slope, though. Am I right?

So, should we really all come together and find a way to agree on what we're fighting for, so that we can fight together? Makes sense to me. BUT, I've not been working in the field that long. I"m not tired, or sensitive, or just want to do my job with nobody bugging me about it, either. I know that what we do is tiring. It's long hard hours. It's emotionally draining sometimes. I think that, when I've been doing it for a long time, I might not have the emotional energy to THEN go to the capital and fight for us politically, too.

How about we get a political fund going, ladies? And hire ourselves some good lobbyists! I'm thinking that if we could find some eager young law students with undergrads in women's studies, we could hire them relatively inexpensively...

*sigh*

But first, we'd have to decide on what we really (the majority) want them to lobby for. And then we have to be willing to spend that extra energy and time to back them up. All of us. Because in reality, the majority of the medical community has that uniformity of message, and their lobbyists to speak for them with political savvy. Is it really possible for all of us to get on the same message? And I'm not picking a fight here. I'm really asking an honest question of our community.

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#14 of 25 Old 06-27-2007, 12:08 AM
 
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-----------
here is a midwifery legislation address--
http://www.indianamidwiferytaskforce.org/


Thanks for posting this, we need help from interested consumers in the state.
contact the above if you want to help...

Every woman should have the right to a midwife birth if she wants, and the midwives should be able to practice without the fear of being sent to jail.

Midwife, Wife, Mother of 5 (6) and "Ga-Ma" to 5 adorable grand children...
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#15 of 25 Old 06-27-2007, 12:19 AM
 
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I can't add anything that hasn't been said... I'm still going to rallies and sending emails/letters etc. Someday that darn bill is going to get passed!
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#16 of 25 Old 06-27-2007, 11:49 AM
 
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Originally Posted by courtenay_e View Post
Because in reality, the majority of the medical community has that uniformity of message, and their lobbyists to speak for them with political savvy. Is it really possible for all of us to get on the same message? And I'm not picking a fight here. I'm really asking an honest question of our community.
Very good point. I think the biggest stumbling block is the ongoing perpetuation of the myth that midwives in states without licensure are "alegal," when in fact they're subject to criminal prosecution not only for the unlicensed practice of medicine/nursing but for manslaughter, reckless endangerment and the possession/use of controlled substances (i.e. Pit).

Indiana is one of the few states whose medical practice act specifically refers to midwifery as the unlicensed practice of medicine, but that's merely a formality. Plenty of other states without that statutory language have prosecuted midwives, and more than a few midwives have served prison sentences in so-called "alegal" states. Dozens more have spent fortunes on legal fees and administrative fines only to end up with a plea arrangement that makes it impossible for them to qualify for licensure and legal practice in the future.

Meanwhile, while we continue to debate the legal status of midwives and the merits of licensure, the medical and legal communities in unlicensed states have unified behind a very clear message: midwives are dangerous, and when a baby dies in their care they deserve to be criminally prosecuted, regardless of whether or not they were at fault. And in fact, mounting a criminal investigation/prosecution is the only means available in unlicensed states to actually determine if the midwife was at fault or if she provided negligent care.

The idea that an Indiana midwife won't be prosecuted because she's not practicing in a certain county is beyond naive. Jennifer Williams isn't the first midwife there to be prosecuted and until the law changes, she won't be the last. And given the attention her case has generated, all it's going to take is one politically ambitious prosecutor in a previously friendly community to read the writing on the wall and realize that prosecuting a local midwife is a slam dunk that will not only up their rate of successful prosecutions, but will garner them lots of publicity as well.

I would advise anyone considering moving to Indiana and starting a practice there to take this history and the strong potential for future prosecutions into consideration.

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives
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#17 of 25 Old 06-27-2007, 12:40 PM
 
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Beautifully said...So, Katie, is there anybody lobbying for us in general? Is there a fund to support that? Is there a unified body trying to get midwives and those who WANT the safety etc. of a midwife attended birth on message?

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#18 of 25 Old 06-27-2007, 01:00 PM
 
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Originally Posted by courtenay_e View Post
How about we get a political fund going, ladies? And hire ourselves some good lobbyists! I'm thinking that if we could find some eager young law students with undergrads in women's studies, we could hire them relatively inexpensively...
As a sometimes-less-than-eager old law student (I am 55, with four grown children and a 20-year past history as a homebirth midwife), I don't think you are likely to find too many law students who are willing to work as cheap lobbyists

But beyond that (and correct me if I am misunderstanding you), this isn't a problem that can be lobbied and legislated on a national level. In our federal system, the states have the right to license and regulate health care professionals, including midwives. So what you really need to do is to look at your own state law -- if midwifery is not licensed (and I don't recall which state you are in), then find a way to work with others to write a licensing bill, lobby your state legislators, and change your state law.

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#19 of 25 Old 06-27-2007, 02:31 PM
 
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Ohhhhh, I know several young law students who have paid to go work at the Hague, because they're interested in international crimes prosecution, or in Africa, because they are interested in law surrounding THOSE courts, and I myself worked as a peon in politics because though it paid crap, it was a cause that was close to my heart(and I figured I'd never be able to afford to take that kind of job again in my life!)..there have GOT to be some students who are willing to be PAID (however little...)for a possibly less glamourous job (though the one at the Hague was less than glamourous, in a dark room with constant crummy weather for weeks on end...), to work in a field that interests them...it's women's rights on a whole bunch of levels!

Too, yes, it IS regulated state to state, however, the american medical association is just as on message as the wisconsin, illinois, or indiana medical associations. They all stand to lose money and "power" by losing those, oh, what 20% of births that they might lose with the legality of the midwifery standard of care? And so we need to have a large group who is willing to stand together state to state, with the same message over and over, while working within their own particular political climates to effect change.

Sorry for the soap box. This is why I left politics. I'm an idealist. It's hard to meld what SHOULD be, what is possible to do with what we have, and what IS.

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#20 of 25 Old 06-27-2007, 02:46 PM
 
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Ohhhhh, I know several young law students who have paid to go work at the Hague, because they're interested in international crimes prosecution, or in Africa, because they are interested in law surrounding THOSE courts, and I myself worked as a peon in politics because though it paid crap, it was a cause that was close to my heart(and I figured I'd never be able to afford to take that kind of job again in my life!)..there have GOT to be some students who are willing to be PAID (however little...)for a possibly less glamourous job (though the one at the Hague was less than glamourous, in a dark room with constant crummy weather for weeks on end...), to work in a field that interests them...it's women's rights on a whole bunch of levels!
I would suggest that working on international crimes prosecution at the Hague is a bit different (in terms of experience as well as how it looks on a resume) than a minimum wage job trying to be a lobbyist for a state midwifery organization. But perhaps you know a different group of law students than the ones I know...

As to "women's rights"...ah, well...that is a whole other issue. Suffice to say that approaching this issue as a "women's rights issue" has never worked legislatively.

Quote:
Too, yes, it IS regulated state to state, however, the american medical association is just as on message as the wisconsin, illinois, or indiana medical associations. They all stand to lose money and "power" by losing those, oh, what 20% of births that they might lose with the legality of the midwifery standard of care? And so we need to have a large group who is willing to stand together state to state, with the same message over and over, while working within their own particular political climates to effect change.
I agree regarding the AMA (and probably just as significantly, ACOG, the AHA, and the ANA.) But again -- this is an issue that must be addressed according the the history and law of each specific state. I do agree that many of the same issues (regarding safety, education, etc, as well as issues associated with NARM and the CPM credential) are faced in all the states. But getting back to your original post, what I am saying is that any "national effort" (if indeed that is what you were suggesting) to raise funds and hire lobbyists is not likely to be successful.

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Sorry for the soap box. This is why I left politics. I'm an idealist. It's hard to meld what SHOULD be, what is possible to do with what we have, and what IS.
Oh, I am an idealist as well -- why else would I still be involved with this issue (however tangentially at the moment) after almost thirty years? But idealism must be tempered with a good knowledge of how state law works.

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#21 of 25 Old 07-01-2007, 02:49 PM
 
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So, are the CNM's in Indiana actually able to practice homebirth? I know in some states, they are "allowed" to, but the reality of finding backup, insurance and stuff is prohibitive that they actually can't do it . We looked into moving to Indiana, but with small children, I think I would be afraid of the current situation. Here in PA, there's lots of fluff, but pretty calm overall.
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#22 of 25 Old 07-01-2007, 03:04 PM
 
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So, are the CNM's in Indiana actually able to practice homebirth? I know in some states, they are "allowed" to, but the reality of finding backup, insurance and stuff is prohibitive that they actually can't do it . We looked into moving to Indiana, but with small children, I think I would be afraid of the current situation. Here in PA, there's lots of fluff, but pretty calm overall.
Well...the 2 who practice legally near me don't seem to have many problems, but i know they are required to have backup, because the one i see told me that, although she doesn't have backup for me, since I am not techincally her client.

CPST
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#23 of 25 Old 07-01-2007, 03:37 PM
 
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I don't have all the "rules" looked up but it looks as though the physician part is no longer a "law"

848 IAC 3-1-2
“Practice of nurse-midwifery” defined
Authority: IC 25-23-1-7
Affected: IC 25-23-1-1; IC 25-23-1-13.1
Sec. 2. “Practice of nurse-midwifery” means the practice of nursingand the extension of that practice, including well-woman
gynecological healthcare, familyplanning, and care to the normal and expanding familythroughout pregnancy, labor, delivery, and
post-delivery. (Indiana State Board of Nursing; Nurse-Midwifery Rule 1, Art 2; filed Jun 15, 1979, 4:41 p.m.: 2 IR 1131; filed Jul
29, 1994, 5:00 p.m.: 17 IR 2872; readopted filed Nov 6, 2001, 4:18 p.m.: 25 IR 939)NOTE: Transferred fromthe Medical Licensing
Board of Indiana (844 IAC 3-1-2) to the Indiana State Board of Nursing (848 IAC 3-1-2) by P.L.185-1993, SECTION 16, effective
July 1, 1993.
848 IAC 3-1-3
Association with licensed physician; jurisdiction of board (Repealed)
Sec. 3. (Repealed by Indiana State Board of Nursing; filed Jul 29, 1994, 5:00 p.m.: 17 IR 2879
--------------------------------------
so you know of atleast 2 CNMs doing home births-- in our state the CNMs are independent providers but there is only one CNM I know of that does home births-- the rest work with doctors in clinic and hospital settings -- and the doctors and hospitals they work with define and restrict the CNM's practices and abilities---
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#24 of 25 Old 07-01-2007, 07:04 PM
 
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Good to know! But then, this was over 3 years ago she told me this, lol, so perhaps it was correct at the time!

Here, I only know of the 2 doing homebirths, but there are a bunch affiliated wth loacl hospitals. 1 practice is pretty much allowed to actually practice midwifery...the other are heinous medwives of the worst sort. the "good" ones are awesome though, they are the only providers that "allow" waterborths and eating during labor, and had only like a 5% C/S rate the last few years - and an epis rate of about 5% also.... The absolute best choice for a hospital birth around here.

CPST
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#25 of 25 Old 07-04-2007, 03:06 AM
 
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There are more in the area too. If anyone wants their contact info, PM me and I can get it to you. I know a number of CNM's that have a homebirth practice in the northeren Indiana area.

Midwife, Wife, Mother of 5 (6) and "Ga-Ma" to 5 adorable grand children...
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