are the legal aspects of homebirth and midwifery?
can find the information below and much more by visiting PA Homebirth
birthing family is not in legal danger of prosecution in a homebirth in
PA, because it is unconstitutional to be forced to birth anywhere.
Accidental birth outside of a hospital is not a crime. There have been
cases of bad outcomes (fetal or maternal deaths are the only concern
and they are rare) being investigated, however since a family is
outside of the hospital system, they cannot be held responsible for the
if a mother does seek medical care and is under the care of a physician
and THEN chooses to go against medical orders and then has a poor
outcome it can be considered criminal because they were in the system
and chose to go against it. It is safer from a legal point of view to
never enter the medical-legal morass than to try to leave it once the
series of involved parties has grown to include a hospital, doctors,
their lawyers and a host of others.
legal rights of parents are being more and more eroded as the birth
industry grows stronger. Check with your legal counsel for the most up
to date legal advice.
the only fully legal and protected by law midwife in Pennsylvania is
the Certified Nurse-Midwife (CNM).
the fact that CPMs are registered, certified professionals, PA law does
not recognize their degree. Midwives can be charged with the practice
of midwifery without a license even when they hold the CPM degree. The
dedicated women who show up to help a woman birth risk their freedom,
bankruptcy and their financial lives to assist a woman in labor.
Hopefully you understand that risk when you work with your midwife.
CPMs often do their job as a spiritual calling.
Lay Midwives--TMs (granny midwives and traditional birth assistants)
are women not recognized by any certifying body and have varying
degrees of skill. Many do not choose to become certified because of
convictions, not because of a lack of skill. Some fiercely oppose the
recognition of certifications in midwifery because they believe birth
is a natural process and should never be regulated by any government
organization. Sometimes these women are part of religious groups and
service those populations. Some of these TMs may be the most
experienced midwives in an area, having been present at thousands of
births with skills to rival the most educated midwife with degrees and
certifications.. Reputation and personal choice favor highly in the
selection of a TM and you must use caution in your selection of a
midwife. These women face the same legal risks as CPMs, including jail,
bankruptcy and fines but more so because of a lack of documentation of
homebirth midwives in PA are alegal. They are tolerated in practice,
however if there is an active complaint (a lawsuit) filed, a midwife
may receive a cease and desist order. If there is a poor outcome
hospital staff at the transporting facility may alert the authorities.
While this is not as much of an issue in counties that are heavily
Amish and Mennonite, areas with a more suburban and urban population
are more likely to have a suspicious view of midwives and their
and TMs can still be brought to trial for practice of midwifery without
a license; this felony carries approximately a 2-year sentence.
Currently, the law only recognizes CNMs as providers of midwifery care.
Currently in PA a woman can have an unassisted labor at any time
anywhere, which has a 40% higher chance of problems than an assisted
delivery, but if a CPM or TM shows up to provide skilled care that
midwife can go to jail for the practice of midwifery without a license.
While it might seem archaic, it is the legal situation. But, the
dedicated women who show up to help a woman birth risk their freedom.
Hopefully you understand that risk your CPM/TM takes in order to attend
lack of legal status in for midwives PA becomes a problem for those who
are litigious. If you plan to sue your midwife or anyone else for a
poor birth outcome, consider those practitioners who carry insurance,
such as hospitals, OBGYNs and in hospital CNMs who have developed
protocols to protect themselves from litigious suits -- that is why
birth in hospital has the bizarre rituals it has developed.
and TMs are free to practice without those protocols, only because they
risk their personal freedom and financial lives in the process.
Midwives thrive in Anabaptist populations such as the Amish and
Mennonites because the people of those populations will not sue the
midwife for a poor outcome due to their religious convictions. While
poor outcomes are rare, they can happen anytime in birth. When lawsuits
do occur it often marks the end of a midwife’s career,
financial ruin and at worst jail time for the midwife.
of choosing a homebirth is placing yourself- the mother and father- of
the baby as the responsible party. If you cannot as a parent handle the
fact that you might bear a child with severe problems, you might need
to re-think what you are asking of reality. Anyone who risks the joys
of birth also risks having a child who is less than perfect. If you
choose to view such a birth, not as an Act of God, but as something
that needs to have blame placed on someone, you are not a good
candidate for homebirth.
you need to express your grief and suffering on these matters through
legal means, you must consider the hospital and its protocols as your
only choice. You are responsible for the risks and benefits of your
birth and the risks you put yourself and your child through in your
life. It is your job to make sure the person you have decided to have
in front of you during your birth is a qualified professional with the
equipment, training and skills to handle your birth and what might come
up in it. Midwifery cannot guarantee a perfect child but it can give
you the best odds of it occurring.
is no malpractice option for those who choose homebirth, so either
choose homebirth because it is the right decision for you and your
family and your belief system or go to the hospital and enjoy the
standard of care there.
You can find the information
above and much more by visiting PA Homebirth
material in this website is provided for information purposes only.
This information is not a substitute for, medical diagnosis, medical
advice, or medical treatment prescription. Consult your health care
provider for more information. If you are in Pittsburgh and
midwife, send email to PghMidwife (at) naturalattachment.com