Midwives vs. State
Jennifer Williams, a Bloomington based midwife facing criminal charges in Shelby County connection with the death of a child she delivered is now suing the State of Indiana.
Ms. Williams is unlicensed. Indiana requires midwives to be RN’s and have special training. Ms. Williams’s attorney Michael Ausbrook (of the blog INcourts) says the law is not clear:
“The law is a mess,” Williams’ attorney, Michael Ausbrook, told The Herald-Times for a story Tuesday. “Because of the mess, we’re not claiming we know exactly what it is, but we’re pretty sure what it’s not.”
Link (News-Sentinel).
The lawsuit reportedly seeks to get a court ruling on whether a license is required to serve as a midwife.
I would like to see how Mr. Ausbrook is structuring his argument. There is a statute out these for licensing (IC 25-23-1-13.1). The legislature has chosen to make the practice of midwifery without a license a class D felony (IC 25-22.5-8-2) and at least one decision from the Indiana Court of Appeals holding that midwifery constitutes the practice of medicine and is subject to sanction if unlicensed. (Smith v. State ex rel. Medical Licensing Bd., 459 N.E.2d 401 (Ind. App. 1984)).
May 26th, 2006 09:52
The law is pretty clear, but probably not being enforced unless a death or injury occurs.
Don’t want to sterotype too much, but in a college town such as Bloomington, there may be several “midwives” who are not licensed RN’s but have thus far operated under the radar because they have been fortunate enough to have no problems with deliveries and are not loudly advertizing their services.
May 27th, 2006 12:02
Pila is simply mistaken about the law being “pretty clear”–and apparently in the same way as the government lawyers in this state. No one has looked at the law of midwifery in Indiana in any detail in 22 years, during which time the law has changed considerably.
Of course, a licensure bill has passed the Indiana House at least twice–and by overwhelming margins. The last time around, I believe the vote was something like 84-16. But every time the bill dies, because it arrives in Pat Miller’s senate committee, and Pat Miller won’t give it a hearing.
When I have a minute, I’ll put a link to the complaint against the AG up on my blog. The complaint asks for a wide variety of things, and I expect that it will be joined, presently, by 50 or so additional plaintiffs. Only a small fraction, I believe, are from anywhere near Bloomington, although it might be a larger fraction than I recall off the top of my head.
May 29th, 2006 18:47
Mr. Ausbrook:
Gee, I’m just a small-town girl and have been taken to task on two different blogs in the last couple of days!
I’m not familiar with the details of your case, but I did live in Bloomington at one time and am aware that there are a number of people in that area who prefer homebirths with midwives to going to a hospital. I did not say that there was no demand for midwife services elsewhere in the state.
As far as I knew, the law on licensure of nurse midwives in Indiana was pretty clear. Perhaps I am mistaken Perhaps in your review of the statutes you have found that they are not clear. Fair enough. I’m interested in seeing what happens with your case.
June 10th, 2006 17:05
The law is not “pretty clear”. While Indiana has a regulatory scheme for licensing nurse-midwives (CNMs) it does not have any statutes or regulations concerning direct-entry midwives. The two are completely different animals.
June 15th, 2006 10:38
[...] As an update to this post, the Indy Star reports today that the midwife (Jennifer Williams) has decide to accept a plea: Jennifer Louisa Williams, 54, Bloomington, will not go to prison, but instead agreed to a year’s probation and to not practice midwifery or medcine during that year, according to Shelby County Prosecutor R. Kent Apsley. [...]
June 15th, 2006 15:23
Sorry to be dense, but are direct-entry midwives not covered by the current law at all because “direct entry midwife” is a term of art? Is regulation implied but not explicit in current law? If current law regulates nurse midwives, does that mean that no other midwives are allowed to legally work in the state of Indiana?
My understanding was that the only way to legally operate as any kind of midwife in Indiana was to follow the regulations as set forth in current statute(s)–period. Please understand, I’m neither a nurse midwife nor a prosecutor.
Are you saying that if there is no regulatory scheme for “direct entry midwives” then is it okay to function as one and assume that you cannot or should not be prosecuted for violating the current statute(s) on nurse midwives?
I don’t mean to attack you and hope that your situation works out. This is a topic about which I am curious, however. Maybe the current law needs to be amended.
June 16th, 2006 03:38
Pila - you write:
“Sorry to be dense, but are direct-entry midwives not covered by the current law at all because ‘direct entry midwife’ is a term of art? Is regulation implied but not explicit in current law? If current law regulates nurse midwives, does that mean that no other midwives are allowed to legally work in the state of Indiana?”
That is exactly the question. Supporters of direct-entry midwifery will argue that the law regulates nurse-midwives only, and that there is no regulation in place for direct-entry miwifery. In some states, this argument has been sucessful. The state will, I’m sure, argue that by licensing nurse-midwives, Indiana intended to regulate the practice of any type of midwifery, rendering the practice of midwifery by those who are not CNMs illegal.
If no regulation exists, does that make the practice of midwifery illegal? Since the practice of midwifery has been in existence for thousands of years longer than either the United States or the state of Indiana, some would argue that the government has no right to regulate midwifery. I don’t necessesarily agree, but it is an interesting argument.
Most states which regulate direct-entry midwifery do so separately from nurse-midwifery. In Texas, I believe, CNMs are regulated by a division of the medical board, while LMs (licensed midwives) are regulated by a separate stand-alone board.
You might find the following resource helpful:
http://www.fromcallingtocourtroom.net/
June 16th, 2006 09:02
Thanks for the answer. Sorry to pepper you with questions.
Maybe the legislative history of the Indiana statute would provide some clues.
Also, at first I thought you were Mr. Ausbrook’s client. Sorry for the mistake.
June 16th, 2006 11:11
[...] There is an interesting discussion in the comments to my midwife posts (read here and this post) about the legal status of unlicensed midwives in Indiana. So called "direct entry" midwives practice arts aiding women in traditions that go back before written history. Many feel that the government has no role in regulating the activities of these midwives, but not how government works. [...]
November 27th, 2008 01:24
IMO Kent Apsley is a petty tyrant of shelby county, he regularly tries to eliminate all black and brown potential jurors from the jury.
Additionally his cohort Brad Labdwerlen wins his cases by losing “brady” evidence i.e. exculpatory evidence.