Midwifery Legal News - Pennsylvania

The big news this week is that a Pennsylvania appeals court has overturned the State Board of Medicine's decision against Diane Goslin, who was charged with practicing medicine without a license and practicing midwifery without a license. In the decision, the Commonwealth Court of Pennsylvania made the crucial distinction between Midwifery and Nurse-midwifery:

Thus, section 1 of the 1929 Law regulates, by the issuance of certificates, persons who are not registered nurses with nurse-midwife licenses, but who make a practice of attending women in childbirth gratuitously or for hire.11

Given the different purposes of the two statutes, we conclude that the nurse-midwife charges against Goslin under the 1985 Act did not give Goslin adequate notice to defend against the midwife offenses described in the 1929 Law.12

11 We recognize that statutes in pari materia shall be construed together, if possible, as one statute. Section 1932(b) of the Statutory Construction Act of 1972, 1 Pa. C.S. §1932(b). However, the 1985 Act and the 1929 Law do not relate to the same class of persons. Although both relate to midwifery, the 1985 Act relates to the licensing of registered nurses as nurse-midwives and the 1929 Law relates to the granting of certificates to other persons who attend women in childbirth.

12 Moreover, we note that, although the Board concluded that Goslin violated section 1 of the 1929 Law by holding herself out to the public as a midwife, section 1 does not make such conduct unlawful. It is section 5 of the 1929 Law that prohibits a person from “advertising herself as a midwife” without a certificate or a license. 63 P.S. §175.

The ruling apparently means that Ms. Goslin will be able to resume attending births.

Links:
Text of the decision (pdf)
Story from the Philadelphia Inquirer
SaveHomebirth.com
Midwives Alliance of Pennsylvania
PA Pundits has commentary here and here.
Commentary and video from Independent Childbirth.

Midwifery in the News

In the news this week...

California - Midwife surrenders licenses to regulatory boards.

Florida - Linda McGlade and her daughter-in-law, Tanya McGlade, will get a new trial after being convicted in 2006 of practicing midwifery without a license, a third-degree felony:

Under the law, there are three components to midwifery: supervising labor and childbirth; advising as to the progress of the childbirth; and rendering prenatal and postpartal care. Also, there is no standard instruction for the crime of midwifery, according to the 4-page ruling written by Chief Judge Stevan Northcutt.

Judge Nicholas may have misled jurors to believe they could use only one of the three elements of the charge to determine if the McGlades were guilty, according to the higher court's ruling.

"In the absence of a standard jury instruction, the trial court clearly attempted to craft a proper instruction by employing the statutory language," Northcutt wrote in his opinion. "A defendant is entitled to have the jury correctly and intelligently instructed on the essential and material elements of the crime with which she is charged."

(Link)

The court "rejected the McGlades’ claim that they were entitled to a jury instruction on the defense they were engaged in the free exercise of religion" (Link). The full court opinion is available here (pdf).

Missouri - Midwife legislation still stalled in Senate; Fierce Debate Over Midwifery Licensure; Midwifery bill runs into issues in Senate.

Pennsylvania - Diane Goslin's case in the news. Midwives Alliance of Pennsylvania has more information.

Also check out Midwifery World's Legal Cases in the News.

I'm so behind, I'll never catch up

Here are a couple things on the radar today:

The Australian parliament is debating whether breastfeeding legislators should be given a proxy vote - that is, to have their vote recorded while they are out of the chamber:

The issue of breastfeeding in Parliament made headlines in 2003 when Victorian Labor MP Kirstie Marshall was thrown out of State Parliament for breastfeeding.

Committee members said the debate had resurfaced in light of an increasing number of new mums in the House of Representatives in the past decade.

The committee found only 10 female MPs had given birth while in office - out of a total of about 130 female MPs.

"Women have faced the difficult choice between prioritising their duties as a member with those of being a mother," members said.

Pennsylvania's governor signed that state's breastfeeding legislation. Although breastfeeding advocates would have preferred a stronger bill, it's better than nothing.

A Missouri judge has issued a temporary restraining order blocking implementation of HB 818 which decriminalizes direct-entry midwifery. This bill has caused a lot of controversy. Apparently, it's a circus over there in the Missouri legislature:

A senator secretly attached the provision to a bill intended to make health insurance more accessible to some Missourians. Gov. Matt Blunt signed the bill into law.

Several physician groups sued last Thursday, claiming the midwife language violates the Missouri Constitution by going beyond the bill’s health insurance title and by changing the bill’s original purpose.

The recently passed legislation says that regardless of the current felony statute, anyone with a “tocological certification” — meaning in obstetrics — from a privately accredited group can provide services related to pregnancy.

The title of the bill that passed described it as “relating to health insurance.”

(link)

Alabama has voted down its midwifery bill. Try again next year?

Nancy Ver Steegh of The Family Law Prof Blog reports Problems at Center Where Mothers Serve Prison Terms With Young Children:

"The authorities in California are investigating accusations that poor health care at a center where mothers serve prison terms with their young children led to the stillbirth of a 7-month-old fetus and endangered the lives of several children.

Staff logs, statements by prisoners and interviews with investigators, staff members and prisoners’ families depict a facility where inmates and their children were denied hospital visits and medications, and where no one kept adequate records of accidents involving injuries that included a skull fracture and a broken collarbone."

Giving Birth With Confidence links childbirth issues to a recently-released government list of hospitals where heart patients are most likely to die in Out of the Dark: Transparency and Birth:

Transparency is suddenly a big deal. This government report follows on the heels of efforts in New York City, and communities across the country, to improve the level of transparency related to childbirth. Giving birth in the dark is an apt metaphor for the current state that women find themselves in when attempting to access information about maternity care. The recent NYC public advocates’ report identified that city hospitals although legally mandated to do so, are still failing to provide maternity information. Public Advocate Betsy Gotbaum is working tirelessly to insure that hospitals do what they are legally mandated to do…including reporting induction and cesarean rates.

Better get this posted before I get distracted by something else...

Midwifery Legal Update - Pennsylvania

I recently received the following:

Diane Goslin, a Strasburg, Pennsylvania midwife with more than 20 years (and thousands of babies) of experience, will stand trial before the State Board of Medicine at the Harrisburg State Courthouse on Friday, January 26 at 9:30 AM. She is being charged with practicing medicine without a license, practicing nurse-midwifery without a license, holding herself out as a nurse-midwife and holding herself out as practicing medicine.

I have yet to see a press release, news article, or website link on this, but I will update as I get more information. Also, there have been some questions rasied concerning "will stand trial before the State Board of Medicine". It is not clear if this is a criminal trial or an administrative hearing.

Also, Judy Wilson's court date is scheduled for January 30th. If I am reading this correctly, the hearing is the continuation of oral arguments on a Writ of Habeus Corpus. January is looking to be a big month for midwifery in Pennsylvania, a state which was considered "legal" for direct-entry midwifery before 2004.

Unassisted Births

The Pensylvanian Times Leader has published a story, Charged midwife's clients making other plans for home births about the options left for clients of Judy Wilson, the midwife arrested in April (see my April 29,2004 post).

One caveat: Vicki Pasterik, the client quoted in the article, has since claimed the reporter distorted what she said, saying: "The fact is, the first quote and the last attributed to me in the article are accurate. The rest are not." She does not promote unassisted birth, and has not yet contacted any other midwives, as the article states.

Nevertheless, the article brings up a good point, one that I have observed myself from women across the country who do not have access to homebirth midwives: many will "go it alone" at home rather than opt for a hospital birth.

Those who believe that homebirth is unsafe do women and babies no service by legislating or prosecuting out of existence those who attend homebirths. A better course of action would be to make homebirth safer (it is already safe, but that is another post) by ensuring that attendants such as midwives have access to quality training, are authorized to carry life-saving drugs such as pitocin and oxygen, and do not fear criminal charges or social disapprobation when properly transfering a patient into the care of doctor or hospital when compilcations arise.

Links:
Times Leader article.
Same article from PennLive.com.
Ebay auction for Judy's Legal defense.

Midwifery Legal Update - Pennsylvania

Judith Wilson was arrested last Friday in Pittsburgh, PA on charges of involuntary manslaughter, endangering the welfare of a child, and practicing midwifery without a license. Judy, a Certified Professional Midwife (CPM), had been under investigation since the November 2002 death of a footling breach baby who required resuscitation after delivery and died two days later in the hospital.

The baby's parents, Jonathan and Heather Daley, do not blame Ms. Wilson for the death and do not support the prosecution.

And the news goes from bad to worse. Allegheny County District Attorney Stephen A. Zappala, Jr. said Tuesday that he may empanel a grand jury to investigate unlicensed midwives and whether they should be charged. Previous to the current investigation, direct-entry midwifery in Pennsylvania has been considered "legal by judicial interpretation or statutory inference," according to the Midwives Alliance of North America. Pennsylvania regulates nurse-midwives, but makes no provision for non-nurse midwifery, though it is not specifically outlawed by statute.

As an aside, it would be completely legal for a midwife with identical training, experience, and certification as Judith Wilson to practice in Texas and at least fourteen other states. Ms. Wilson is credentialed by the North American Registry of Midwives (NARM).

Links:
Butler County midwife charged in newborn's death, Pittsburgh Post-Gazette.
Midwife charged in baby's death, Pittsburgh Live.com.
Grand jury investigation of midwives eyed, Pittsburgh Live.com.
Friends of Judy provides updates on the case and is organizing an auction to raise money for Judy's legal fund.
Jon & Heather Daley's website with an account of baby Isaac's birth and death.

THE COMMON LAW

The Commonwealth Court of Pennsylvania has abolished the doctrine of common-law marriage. According to the opinion, "[t]he circumstances creating a need for the doctrine are not present in today's society. ... Access to both civil and religious authorities for a ceremonial marriage is readily available in even the most rural areas of the Commonwealth. The cost is minimal, and the process simple and relatively expedient." It is not clear whether the abolition applies to existing common-law marriages or from what date future common-law marriages will be void.

Read article here.