Midwifery Legal Update - Florida & Indiana

In Florida this week, Linda McGlade and her daughter-in-law Tanya McGlade were sentenced to 2 1/2 years in prison after being found guilty of practicing midwifery without a license. The charges stem from the 2004 childbirth death of another daughter-in-law, Mara McGlade. The Florida case is a bit bizarre, because Florida licenses direct-entry midwives:

The defendants said they never claimed to be midwives, a profession regulated by the state. They said they merely attended an unassisted home birth, which is legal.

But Circuit Judge Edward Nicholas noted that they checked the heart rate of the fetus, delivered oxygen to the mother and examined the placenta.

(link:"Women sentenced for unlicensed midwifery")

In Indiana, Jennifer Williams, CPM, pled guilty on Wednesday to a charge of practicing midwifery without a license ("Ind. midwife pleads guilty in infant death"). As part of the plea deal, the charges of practicing medicine without a license were dropped. No charges were brought in connection with the death of the baby. Ms. Williams' case gained national notoriety after she was featured in a New York Times article ("Prosecution of Midwife Casts Light on Home Births"). In May, she brought suit against the Attorney General of Indiana, requesting that the state clarify the definition of midwifery. Indiana regulates nurse-midwifery, but has no statute regarding the practice of direct-entry midwifery.

From Ms. Williams' press release:

I am a Certified Professional Midwife which means that I am a fully trained and fully educated midwife and credentialed through the North American Registry of Midwives. There are two types of certified midwives in Indiana, and elsewhere in the United States - Certified Nurse Midwives and Certified Professional Midwives. In many other states across the country Certified Professional Midwives practice legally, with the sanction of the state. CPMs in these states are able to accept insurance and Medicaid reimbursement and interact fully with the medical establishment. Indiana chooses to prosecute these same CPMs with felony charges, instead of utilizing CPMs in the maternal child- health care system, which desperately needs support and re-enforcement.

Prosecuting CPMs is a short-sighted waste of money, time and effort. CPMs are not criminals or felons. They are well-trained professionals who practice with the highest of standards, who pass academic and clinical skills board exams, and undergo peer review and continuing education, just as any other health care professional does. Indiana should be incorporating these midwives into the health care system, rather than prosecuting them.

Midwifery supporters in Indiana have been trying for years to pass legislation legalizing and regulating direct-entry midwifery, but have been blocked by Sen. Patricia Miller, a nurse and the chair of the Senate Public Health Committee ("Desperate midwives: Sen. Miller continues to block legislation").

News links:
State questions legality of midwifery
Trying to boost at-home births
Midwives fight to practice in Indiana

Blogs:
Kemplog - Midwives vs. State and Midwife Takes Plea
**Updated 6/17/06 to add: Legal Status of Unlicensed Midwives in Indiana
Belly Tales - Homebirth Prosecution
Chai There - Calling my elected official
5 Dollars - Midwife charged in Edinburgh case