When midwives are under investigation:
what can you do to help?

Because Ohio has no laws in place regulating the practice of non-nurse (direct-entry) midwifery, even competent, qualified practitioners in our state are vulnerable to prosecution and criminal charges for helping families have the safest possible out-of-hospital birth. Here in Ohio in 2002, Mennonite midwife Freida Miller was arrested and imprisoned for administering an anti-hemorrhagic drug (Pitocin) to a mother who was experiencing excessive bleeding after childbirth.

Administering stabilizing medications is not the only action that could get a direct-entry midwife in trouble under Ohio's laws. Checking blood pressure or urine for problems at prenatal visits and making assessments about the progress of labor could be construed as practicing medicine or advanced-practice nursing without a license and lead to criminal prosecution -- even when the midwife has acted safely and appropriately and mother and baby are healthy.

Unfortunately, Ohio and other unlicensed states have recently become much more aggressive about shutting down direct-entry midwives. The American Medical Association (AMA), the physicians' "trade union," is concerned about competition from other practitioners and is encouraging and funding state government investigation and prosecution of unlicensed practitioners. Some Ohio midwives are already under investigation, and we can expect more investigations and charges filed, in coming months.

If you have received, or are receiving care from an unlicensed midwife, remember:

You have done nothing wrong or illegal. There are no laws restricting Ohio families' right to birth their babies in the location of their choice, or to hire whomever they wish to attend them. Contact an attorney if you feel coerced or threatened to reveal information.

Do not answer questions about your midwife from anyone you do not know personally and trust implicitly. Even if you were delighted with your care and think your midwife was wonderful, what you tell investigators can be used as evidence to convict your midwife of practicing medicine without a license. During the investigation process, anything you say will be used against your midwife!

Do not share your midwife's name and contact information with anyone you do not know. In the late 1990s in Illinois, 8 midwives were issued cease and desist orders after being contacted by an undercover investigator posing as a pregnant woman seeking midwifery services.

Consider keeping your file and chart at your own home and bringing them with you to prenatal visits. This ensures that if your midwife's files are seized during an investigation, your private medical records will not be part of the evidence.

If you need to transport to a hospital during your planned out-of-hospital birth, think twice about asking your midwife to accompany you. Unless she has arrangements with a supportive back-up physician, this could be a very dangerous situation for her. Plan ahead and discuss with your midwife what you will do in the event that transport becomes necessary during your birth.

Do what you can to support your midwife personally if she is investigated or charged. Bring meals, offer child-care, ask what you can do to help. This is a time of enormous stress and difficulty for her and her family.

Do what you can to help with legal costs and fund-raising for defense of any midwife who is charged in Ohio. Legal battles are extremely costly, and the precedent set has implications not only for the midwife who is charged, but for every midwife and every family choosing out-of-hospital birth throughout the state.