By Jennifer Antonik, Momma Trauma Blog Photo credits: Maryland Friends of Midwives DOVER, DE -- The midwife "witchhunt" or "crisis," as some call it, reached Delaware recently when Certified Professional Midwife (CPM) , Karen Webster, was given a cease and desist order by the state for practicing medicine without a license or permit. Her name was listed on a certificate of live birth, which prompted the state to investigate. Webster is from Maryland but practices midwifery in several states including Delaware. She sat in a conference room packed with supporters to provide her testimony and evidence to support her defense during her hearing today. The arguments on both sides were clear. Legal counsel for the State of Delaware was firm in the reason they were there: Webster decidedly broke the law and practiced medicine in Delaware without a permit or license. Webster, who represented herself with the help of an advocate as she could not find legal counsel willing to take on her case, contended that she practices midwifery and not medicine. She also argued that CPM's cannot obtain a permit to practice in the state of Delaware due to current regulations which she has tried actively to change. State representatives repeatedly objected to this line of defense as they felt it was not directly related to the case. Those objections were overruled. There is currently only one CPM in the entire state with a permit to practice "non-nurse" midwifery, according to Kristen Bennett who is the Nursing Director with the Delaware Division of Public Health and testified for Webster's defense. This CPM, according to Webster, was grandfathered in when regulations were changed in 2002. According to Bennett, this CPM currently works with Dedicated to Women, however, a quick search of their Website shows only one Certified Nurse Midwife (CNM) and no CPM's on staff. In the past ten years, no new CPM's have been permitted to practice in Delaware. Among other requirements, CPM's in Delaware must be able to establish "a collaborative agreement with a Delaware licensed physician with obstetrical hospital privileges." However, this is not possible as malpractice insurances will not cover CPM's. This barrier means that no doctor in Delaware is able to work directly with non-nurse midwifes. Webster never once denied the fact that she had been practicing non-nurse midwifery in Delaware, however, she contended that the charges against her were wrong. She went on to add that she has been incorrectly charged with practicing medicine in Delaware without a permit or license when instead, she should have been charged with practicing midwifery without a permit or license. The representative for the state brought forth Jean Betley, an investigator from the Division of Professional Regulation as their main witness. This investigator went through evidence submitted for the state which detailed information from Webster's Website stating that she offered midwifery care to clients in Delaware as of the printed date from 2011. She also discussed a certificate of live birth which seemed to have been certified and signed off on by Webster. Webster denied the signature and the state representative agreed that it did not look like it had been signed by her. Webster brought forth two main witnesses, Dr. Mark Anthony Umobi and Bennett. Dr. Umobi, who currently practices obstetrics and gynecology in Dover, remained neutral to midwifery care and stated he did not know enough about CPM's to greatly entertain the idea of working with one through his practice. When asked about his current insurance coverage, Pro Insurance, he said he was unaware of the company's stance on CPM's. Bennett testified to the current permit application process, however didn't get into great detail on the process itself or what is needed by a CPM to proceed. Webster said in an email, "She was actually a hostile witness and not very helpful. In the end, she actually withheld some vital information I was attempting to extract from her, but was more honest with one of my daughters (also a nurse) after the hearing. She has originated most of the charges against CPMs in the past several years." As the hearing concluded, the facilitator read a current definition of the practice of medicine from the Delaware Code: Title 24, Chapter 17 (Medical Practice Act), Sub-chapter 1, 1702 includes the following in the definition of the Practice of Medicine: "Offering or undertaking to prevent or to diagnose, correct, and/or treat in any manner or by any means, methods, or devices a disease, illness, pain, wound, fracture, infirmity, defect, or abnormal physical or mental condition of another person, including the management of pregnancy and parturition" The conference room, which was filled with midwife supporters, erupted with laughter when this definition was read as pregnancy and childbirth is (in normal situations) a natural process of life and not a disease, illness, infirmity, etc. Some blurted out, "Midwifery is not medicine!" While others murmured that pregnancy was not an ailment which needed to be treated. Webster contended that the practice of midwifery was, in fact, different than the practice of medicine and while midwifery can sometimes mix with medicine, it remains a separate discipline. There have been several court cases in the past which have ruled that midwifery is not to be included in the scope of medical practice, however, these were not brought up in this hearing. Prior to proceedings, Webster motioned that any and all members of the Delaware Board of Medical Licensure and Discipline who are also affiliated with or insured through the Medical Society of Delaware not be involved in any proceedings or decisions as they have conflicts of interests pertaining to her case. This case remains unresolved. The Delaware Board of Medical Licensure and Discipline will deliberate the facts and proceedings and contact Webster within 10-15 days with their ruling, to which she can object should she so desire within 20 days of that notice. Please visit our petition in conjunction with the Delaware Friends of Midwives to help make regulatory changes in Delaware. Were you able to make the hearing today? What were your thoughts? How can we help the current midwife crisis?
5 Comments
Gina
1/17/2013 12:24:59 pm
Thank you for this update. Karen is an angel of a human being and my thoughts and prayers are with her.
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Jennifer, Momma Trauma
1/18/2013 12:00:51 am
Petition Update: Sign & Share!!
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Dana C Davis
1/30/2013 02:30:00 am
Someone represent this lady! Is it illegal to give birth at home on your own without anyone there? I can't imagine anyone could mandate that we have help at all with this bodily function that has been going on forever. So if your friend is there while your giving birth and helps in any way are they committing a crime? It's just so crazy the way our laws are set up. It is such an infringement on women's rights.
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5/11/2013 11:05:50 pm
Dentists who are cared for teeth of our children need to have quality equipment.
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