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Discussion Starter #1
We're considering moving to a new state in a few years, one of which is Michigan. Since I haven't completely given up on my dream of being a midwife I looked up the status of midwifery there. This is what I found:<br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Legal Status of Direct-Entry Midwives:<br>
Direct entry midwifery is currently legal through judicial interpretation or statutory inference.<br><br>
Status of Midwifery:<br>
Direct entry midwifery is currently legal through judicial interpretation or statutory inference. This means that direct entry midwives are free to practice, but are not regulated by the state government.</td>
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What exactly does that mean? Are midwives in Michigan able to be licensed or certified, or can they not practice at all?
 

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hmmmm... looks like midwives are legal, but no certification is available. Everyone (regardess of previous certification/experience/training) must be "direct-entry".
 

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Discussion Starter #3
So it's legal for them to practice, they just don't get licensed or certified? I was under the impression that it was illegal to practice without a license or certificate. That's why I'm confused.
 

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I'm not a health professional or lawyer, but it sounds to me like maybe a prosecutor took a DEM to court, and the judge decided that current MI law did not forbid DEMs. Or maybe a lawyer says that since there are no laws for it or against it, that means it is legal. Generally speaking here in the US if there are no laws against something, it is legal.
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>amydidit</strong> <a href="/community/forum/post/7945983"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">So it's legal for them to practice, they just don't get licensed or certified? I was under the impression that it was illegal to practice without a license or certificate. That's why I'm confused.</div>
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That statement has caused endless confusion, because it is essentially meaningless. What they are trying to say is that some court, somewhere in the state of Michigan has stated an opinion that midwifery in one particular case was not illegal. What it doesn't take into account is that a trial court decision is not binding on any other situations or any other courts.<br><br>
It is probably a lot more correct to say that in the absence of laws that either license midwives or specifically exempt them from the medical/nurse practice acts, midwives are vulnerable to criminal prosecution for practicing medicine or nursing without a license.<br><br>
Valerie<br>
Illinois
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>Valerie</strong> <a href="/community/forum/post/7947238"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">That statement has caused endless confusion, because it is essentially meaningless. What they are trying to say is that some court, somewhere in the state of Michigan has stated an opinion that midwifery in one particular case was not illegal. What it doesn't take into account is that a trial court decision is not binding on any other situations or any other courts.<br><br>
It is probably a lot more correct to say that in the absence of laws that either license midwives or specifically exempt them from the medical/nurse practice acts, midwives are vulnerable to criminal prosecution for practicing medicine or nursing without a license.<br><br>
Valerie<br>
Illinois</div>
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<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">:
 

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Valerie is correct, and her explanation applies to all states where DEM licensure is unavailable. In the case of Michigan, the misleading classification of "legal by judicial interpretation" is based on a 1939 Attorney General's opinion that was issued prior to the 1978 Medical Practice Act, which clearly defines midwifery as the practice of medicine without a license:<br><br>
PUBLIC HEALTH CODE<br>
Act 368 of 1978<br>
333.17001 Definitions; principles of construction.<br>
(1) As used in this part:<br>
(d) “Practice of medicine” means the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these acts.<br><br>
Katie Prown<br>
Legislative Chair<br>
Wisconsin Guild of Midwives
 

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Discussion Starter #8
Okay, so a midwife can practice, but also isn't protected? Is that correct? And if not, how does that differ from the states that are defined clearly as prohibited?
 

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Ok, I just deleted everything I wrote because I see now that most everyone already knows what I was writing about and I was being somewhat redundant.<br><br>
Sorry!
 

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I'm in Michigan and have been a MMA board member. What it means is that the multitude of safe midwives practice fairly openly. They have a good relationships with some state agencies like the newborn screening people and the hearing screening people. They also get paid by some insurance companies, but not by Medicaid.<br><br>
It also means that the non-nurse midwives (CPM, CM, DEM) are concerned that at some point a doc or prosecutor will get a burr under their blanket about an unsafe midwife and decide to outlaw anyone who is not licensed.<br><br>
We have had 2 CPMs in this state have their CPM credentials revoked, but so far that hasn't resulted in any legislative action.
 

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it means they are not regulated - and that the mws are really in the same boat as the states where it is stated clearly they are illegal-<br>
the only way you can ultimately be protected is if you are arrested and go to court and the court finds in a similar way as the past ruling -- that there is a ruling means there has already been at least one court case ---- Penn has had a similar statement made about it but Penn also has had several prosecutions- recently<br><br>
and bottom line what it means is that the state organizations need to really focus on a bill to legalize---
 

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I feel like everything is changing so quickly that it is hard to know what will be a midwife-friendly state and what will not. I started this work only 6 years ago and I never thought that nearly half the states in the U.S. would be legal for traditional midwives (though I know that many of those states are still not particularly easy places to practice). I feel like the time of the "alegal" state is passing. I wouldn't be surprised to see every state have specific legislature addressing homebirth midwifery (whether to regulate or prohibit it) within the next 5-10 years.<br><br>
Aside from the legal climate, Michigan is a very nice place to practice midwifery. I do feel vulnerable but at the same time practice very openly. I feel like I have a lot of resources here in my community and we have a great midwives organization with a long history. We are planning a national MANA conference in fall 2008 and hope to be able to show off just how strong we are!
 
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