Pennsylvania Court Rules Lay Midwife Can Continue Home Birth Practice

Main Category: Nursing / Midwifery
Also Included In: Pregnancy / Obstetrics;  Litigation / Medical Malpractice
Article Date: 29 May 2008 - 7:00 PST

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The Pennsylvania Commonwealth Court ruled 5-2 on Friday that a Lancaster County, Pa.-based midwife was not practicing medicine without a license by assisting at home births, the Philadelphia Inquirer reports. The ruling lifts a cease-and-desist order from the State Board of Medicine against midwife Diane Goslin. State officials initially charged Goslin because she is a lay midwife and not a nurse midwife (Couloumbis, Philadelphia Inquirer, 5/24).

Only people who have nursing degrees can be licensed to practice midwifery in the state, but Pennsylvania law does not prohibit the practice of lay midwifery -- usually defined as midwives trained through apprenticeship (Daily Women's Health Policy Report, 2/7/07). The court did not address whether it is necessary to be certified as a nurse-midwife to practice midwifery in the state, the Inquirer reports (Philadelphia Inquirer, 5/24).

Some advocates have argued that safe home births in the state -- which has a large Amish population that largely does not have health insurance and relies on the comparatively low cost of lay midwifery -- would decrease without lay midwives. Lay midwives attended almost 50% of the 3,481 out-of-hospital births in the state in 2004 (Daily Women's Health Policy Report, 2/7/07).

"Our only interest in this is to make sure that those providing care to the people of Pennsylvania are licensed, know what they're doing and do so safely," Gerald Smith -- senior counsel for the Pennsylvania Department of State, the administrative agency for the medical board -- said. He added that the state has not decided whether to appeal the decision to the state Supreme Court.

James Kutz, Goslin's attorney, argued that state law allows "conventional" midwives to carry out functions associated with the natural development of childbirth, which include ensuring labor progresses normally and "catching" an infant when it is born. Kutz added that he believes the court left the door open to allowing for two classes of midwives (Philadelphia Inquirer, 5/24).

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