Pennsylvania Midwife Charged With Practicing Medicine Without a License
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Tuesday, January 30, 2007
Lancaster Online is running a story about Diane Goslin, a Pennsylvania lay midwife that serves the Amish and Mennonite community. Goslin appeared before the state Board of Medicine on Friday to face charges for practicing medicine without a license. (Pennsylvania does not license direct entry midwives.)From the article:
The 15-minute hearing allowed Goslin's attorney and the state to review and agree on the facts of the case. There was no testimony, and a decision is not expected for at least six months.
Goslin admits she holds no license and does not have credentials required by the state to get a midwife license, including a registered-nurse degree and a passing grade on an exam.
But the 49-year-old says she is certified to perform midwifery by North American Registry of Midwives, a certification organization which she said is recognized by 28 states, but not Pennsylvania. She also has 25 years' experience in the ancient tradition of midwifery, most often serving women in local Plain communities.
She also disputes she helped deliver a child in 2005, an event from which the accusations against her stem, saying she was "present for the birth of the child, but did not 'deliver' the child."
Goslin faces $40,000 in fines if charged.
To note, Goslin is licensed by NARM, a certification that is recognized by 28 states. (My own state of Ohio also fails to recognize or issue licenses to NARM midwives.)
The problems here are three fold...
1.) Direct entry midwives are needed within the Amish, Mennonite and even English communities. For those without insurance, the cost of a home birth generally runs less than half that of a standard vaginal hospital birth. Since home birth has been proven to be every bit as safe as hospital birth for low risk women (and to have lower morbidity rates) direct entry midwives provide a safe and cost effective way to handle birth.
From the article:
One speaker, Daniel King, an Amish father of eight from Lancaster County, said lay midwives offer those in Plain communities a less-costly option of home birth — which Goslin said typically costs $800 to $2,000 — compared with a minimum cost of $6,000 for hospital births.
"(Lay midwives) can come to our homes any time of the day or night because we have no transportation," King said. "There are high costs in hospitals, more disease in hospitals. My wife is more comfortable at home. We have no insurances.
"My wife and neighbors are afraid of what will happen to them if Diane Goslin gets shut down."
2.) Direct entry midwives are currently "alegal" in states like Pennsylvania and Ohio. That means that they're not breaking any laws when they attend births (unless they perform a medical procedure like an episiotimy, stitching a tear or administering prescription drugs) but they also risk prosecution any time someone wants to claim that even catching a baby counts as "practicing medicine." In states where lay midwifery is alegal, most midwives DO carry life saving medicines like pitocin or methargine for dealing with hemmorage knowing that if they use them to save a mom's life, their own freedom is at risk.
3.) On the other hand, when direct entry midwives are brought "into the system" by state licensing boards they are usually forced to operate under much stricter guidelines. In most states that recognize DEMs they are unable to attend breech deliveries, multiples deliveries, births before 38 and after 42 weeks and in a variety of other situations. That takes control of birth out of the hands of the mother and places it in the hands of a doctor.
Of course there's also the issue of a small number of midwives going up against the huge ACOG lobby. The last recorded figure I heard put planned, attended home births at about 0.5% of births each year. That makes for a pretty small group of supporters fighting for the right to home birth. That said, there were more than 300 supporters gathered at the courthouse in support of Goslin.
I'd encourage any Pennsylvania readers to consider contacting their local newspapers and representatives to show their support for Goslin.
Labels: Childbirth Issues
When my husband and I first started talking babies - i knew i didn't want to give birth in a baby factory. So i began researching midwives. We had hopes of moving back to Pittsburgh, PA in order to be surrounded by family, but their laws kept us from moving back. Specifically my outrage from the case below.
http://www.friendsofjudy.org/
In short - "Judy" delivered a baby that she suggested should be delivered in a hospital due to its position. However the parents faith told them to go with the will of God. The child passed, and the state is suing her. The family of the dead child started this support group for the midwife.
So here I am 7 mos preg happy and healthy in DC. I wish PA would get a clue.
Unbelievable. Our girls were born peacefully at home in Oregon. There will be no more empowering experience in my life than birthing my girls at home. Women will push out their babies where they are most comfortable.....for most of us this is at home.
ok first off I just wanted to say I came here b/c of all of the links to your post about the NPB... but I'm staying around b/c I adore your blog.
anyhow I life in maryland and i an a doula who's hoping to work as a midwife in the future. homebirthing is where my heart truely is, but i cant pratice as a direct entry midwife here. Lay midwifery is illegal here.cOne has to become a CNM. I have no desire to become a nurse before becoming a midwife. sure they may have some similiar jobs and know about similiar topics - but a nurse is not a midwife. nor does being a nurse make one a better midwife. one really doesn't prepare you to be the other. I have absolutely no desire to be a nurse as I feel I would be a terrible one as it's not my calling.
at anyrate we plan on moving sometime b/c of this very law! I see no hope of it changing any time soon sadly. I know of too many midwives being sued and harrassed about this. It's so risky for them.
I am pregnant with baby #4, living in PA. My midwife is the only one in my city and she has trouble keeping other midwives because no one wants to stay in PA. Malpractice insurance is so high and PA is not at all midwife friendly. I would LOVE to have a homebirth but insurance won't cover it and I can't afford the fee upfront(it would be $3000). It seems such a shame to me because I am in a good position to save the insurance a lot of money with a homebirth-I live only a few blocks from the midwife's home, I'm close to her business and I live within 10 minutes of 3 hospitals in case of an emergency. I think birth would be much less traumatizing for both mothers and babies if there were more homebirths, not to mention the rest of the family! Try keeping 3 kids quiet and off the dirty floor and equipment at the hospital! There are many more reasons to have a homebirth, but I won't get into them now.....I wish PA would get a clue also!!
I am sickened by this witch hunt. Let women have their babies in peace, in the manner that they desire, and stop hunting the midwives. All it does is put some women in a more dangerous situation because they will birth alone instead of accompanied.
dear ladies, i am a lactation consultant that, yes, works in a hospital. I have also worked in the NIcu where a lay midwife ended up with a very bad name because of some very bad outcomes after she attended their home birth. PLEASE be aware that lay midwives should only attend "low risk" births, and that at any birth, anything could happen. i LOVE children and have cried over the loss life and serious deficits i have seen from home births gone bad.
Anonymous, it's a shame when someone without skills and knowledge practices in any environment; home or hospital.
I ache for women who have had their births misdirected and their children injured in both locations.
I cheer for the women who find skilled providers who assist them in their births in both locations.
As future midwife in Lancaster county I would not support this woman. In the case of Diane vs. the state of PA, it is not a battle against midwifery it is a battle against Daine herself. She making a very bad name for all midwives. I don't care how many years she has been practing or how many healthy babies she has delivered. Most births if given the time will happen without a hitch. It is her handling of the one's that go wrong that is the problem.
In Lancaster County we have 5 homebirth midwives listed in the yellow pages and more that are not. All of them have plenty of business. All of them have had babies die and mothers be hospitalized during or after birth. So you have to ask yourself, "why is Diane Goslin the only one in the news and having legal troubles?" "why is Diane Goslin not allowed to step foot inside any hospital in the county, when the others are?" If you want to know why ask the other lancaster county home birth midwives.
ddoula, What has this Diane Goslin done? If you don't want others speaking of you this way - I would be very careful about what I say about others. Do you know first-hand the facts you are hurling?
Doula's are just coming into this arena and playing hard-ball with such verbiage may not be the best way to enter. Be cautious and humble - as you enter so you leave. Maybe someone like you is the reason the witch-hunt goes on... Most of what i have heard in over thirty yrs of practice as a midwife, is comments like these destroying opportunities for women to make right decisions based on their knowledge of truth. Slander is a bad idea based often in jealousy, with gossip often birthing it.
We, as birth attendants, need to heed "A house divided against itself cannot stand." God knows, we need to stand together or we will self-implode. What we do is deeply spiritual and if we want our backs covered we need to be accountable to a higher power. Slander is not the answer.
ddoula, What has this Diane Goslin done? If you don't want others speaking of you this way - I would be very careful about what I say about others. Do you know first-hand the facts you are hurling?
Doula's are just coming into this arena and playing hard-ball with such verbiage may not be the best way to enter. Be cautious and humble - as you enter so you leave. Maybe someone like you is the reason the witch-hunt goes on... Most of what i have heard in over thirty yrs of practice as a midwife, is comments like these destroying opportunities for women to make right decisions based on their knowledge of truth. Slander is a bad idea based often in jealousy, with gossip often birthing it.
We, as birth attendants, need to heed "A house divided against itself cannot stand." God knows, we need to stand together or we will self-implode. What we do is deeply spiritual and if we want our backs covered we need to be accountable to a higher power. Slander is not the answer.
My girlfriend and I am having our first baby boy this coming February. She has already had a surgery to remove cancer from her cervix and was told she could not have children. Everyone around us has told us to view this pregnancy as a blessing but now she wants to have a home birth. I view this as an unnecessary risk. From my reading, a midwife is NOT a doctor. A hands-off birth CAN be performed within the safety of a hospital. I understand women wanting to be as comfortable as possible and I support that, but I will not place anymore risk on this pregnancy than already is evident. We live in Pennsylvania and if I wish this option (home birth) was not available for our situation but people seem to want to be as trendy as possible in our day and age. I am ashamed the midwife we have spoken with has not used her expertise (and I use this lightly) to not worry about her getting paid and honestly let my child be born in the safest possible environment. Maybe I'm overly nervous, maybe I just need to vent. I just want a healthy son and a happy mother to be with him. Why take such risk?
I am a Doula who is studying to be a Lay Midwife. I have always been into alternative methods besides Western Medicine. But it wasn't until I when through a bad experience in the hospital with one of my children, along some of my friends having very bad experiences, that I decided that this was a calling for me. I live in PA where there isn't many Lay Midwife. More is needed. Women should have that freedom of choice. Before there was Doctors and Hospitals, there was Midwifes!!! There's a Midwifes in every women only if we choose to embrace it!!!.
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