Less than two months after upstate New York midwife Elizabeth Catlin was indicted on 95 felony charges for providing home-birth support to the sizable Mennonite community of Yates County, another birth assistant was arrested on similar counts, prompting both women, and a lineup of supportive birth activists united as Friends of Elizabeth Catlin, to hold a virtual press conference this week about the region’s maternal-healthcare crisis — even making connections to the current coronavirus outbreak.
“What has happened with Elizabeth and what has happened with me … in New York state is a tragedy, and nothing more than a modern-day witch hunt,” Melissa Carman, who was arrested on March 5 and is awaiting a March 20 court appearance, told the logged-in birth activists and members of the media.
Carman is president of the nonprofit NY-CPM, and has been working with other advocates and state officials, including NY Assembly Member Richard Gottfried, to change the state law in a way that could allow Certified Professional Midwives (CPMs) like herself and Catlin to become licensed.
Catlin — whose midwifery certification is recognized in 34 states but not New York, and who primarily assisted women in the large hospital-averse Mennonite community of Yates County during planned home births — was arrested in December of 2018. A year later, she was indicted on a wide array of charges, including criminally negligent homicide, of an infant who died after the laboring mother was transferred to an area hospital. She now awaits trial.
Meanwhile, New York State Police have arrested Carman on charges of unauthorized practice of a profession and hindering prosecution, for allegedly aiding Catlin “with her illegal midwifery practice, in and around Penn Yan, N.Y. … by discussing private medical issues of maternity patients, giving advice and offering to assist in birth and prenatal appointments.”
Carman also allegedly agreed to “unlawfully provide Catlin with prescription maternity drugs, without a prescription,” according to the press release sent to Yahoo Lifestyle by the arresting officer and lead investigator in each case, Mark Eifert.
Eifert declined to answer further questions about either matter, “as there is a trial pending and both cases are intertwined,” he told Yahoo Lifestyle.
At Monday’s virtual press conference, at which organizers demanded “all charges be dropped,” Catlin and Carman were both present and spoke briefly. Others included Indra Lusero, president of the Birthrights Bar Association; Vicki Hedley, president of the Midwives Alliance of North America (MANA); Ida Darragh, Executive Director of the North American Registry of Midwives (NARM), which issues the CPM credential; and a local Mennonite woman who remained anonymous, keeping her video feature off but speaking out in support of Catlin.
“Liz made it clear from the beginning that she is not a licensed midwife, she is a birth attendant,” the woman said. “Nobody blames Liz for the death of the baby. My community looks at it as God’s will.”
She added that those parents — whose baby boy was born septic at a local hospital following the mother’s transfer there by Catlin, and who died while being rushed to yet another hospital for care — “said, ‘It has been very hard. We could not breathe. We are constantly reminded that Liz is being blamed. We don’t blame her, why should somebody else?’”
Lusero spoke to the highly confusing midwifery laws in New York. “Some people just assume that the law is rational. On this issue, that’s not the case,” she said. “New York state has a conflict between the law and the statute, and the law and the regulations. So, credentialed midwives [are] not all able to practice because of the regulations, but not statute … There is room for much discretion at many steps. It’s absolutely not the case that these midwives have to be criminally charged, charged with felonies and investigated in the way that they have been.”
Still, the state offers a path to licensure for only two types of midwives: Certified Nurse Midwives (CNMs), the majority of whom work with OB/GYNs in hospitals and who are licensed by earning a master’s degree, maintaining a registered nursing license and graduating from a CNM education program; and certified midwives (CMs), who must also earn a master’s degree, partake in an education program and take a CNM-equivalency exam.
CPMs, meanwhile, become nationally accredited through an apprenticeship or educational program (Catlin trained through an Idaho-based midwifery program, and through an apprenticeship under a licensed midwife), or a combination of the two; there are nearly 3,000 CPMs in the U.S., almost all of whom attend home births (representing only about 1 percent of births). While there was once a path for granting an exception to licensure in New York, that changed in 2011, excluding midwives like Catlin because they don’t have a master’s degree.
The International Confederation of Midwives (ICM), a worldwide, non-governmental organization that works to “advance the profession of midwifery globally” and unify standards, agrees with the stance that higher education be a foundation of midwifery training. And the official position on midwives of the American College of Obstetricians and Gynecologists (ACOG) endorses ICM’s standards.
Nevertheless, there is a lack of maternity care providers in New York’s rural upstate region, along with hospitals that are closing at “record rates,” Carman said on Monday, making the area one of the many “maternity care deserts” across the country. “There are more than a dozen counties that do not have a maternity care provider and have no access to a midwife — or, if they do, she would be practicing illegally, and risks her life every single day to try to provide care to these women,” Carman said.
The need for more prenatal care, particularly out of hospital, is even greater now, she said, given the current pandemic. “The worst place that a low-risk, healthy [pregnant] woman should be is in a hospital full of sick people that could potentially have the coronavirus. We need more midwives, we need to allow more to become licensed.
“CPMs are the only maternity care providers who receive specific training in managing low-risk out-of-hospital births,” noted the Friends of Elizabeth Catlin press release. “The inclusion of CPMs in these emergency systems allows hospitals to focus on seriously ill patients, while simultaneously shielding healthy pregnant patients from infection.”
Midwives, added Dahlyt Berezin-Bahr, a CPM who was also in the press conference, “may be the first call that someone who suspects having coronavirus will call. Many will call us before their doctor, so we would almost be first responders to symptoms.”
Finally, Catlin — a mother of 14 and grandmother to 20 who recently sold her home to pay her attorney and has been raising additional money through a GoFundMe page — made a final plea for expanded maternity care and expanded midwifery licensure.
“I really hope that we can listen to the voice of the women, not only in New York state but everywhere. We want to choose where we have our babies and we want to choose with whom we have our babies. Now, with two arrests, New York state just made the maternity care crisis that much worse.”
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