Particularly in Pennsylvania, where thousands of Amish and other similar religionists shun modern medicine, lay midwives have become an important part of the birthing practices of many women. These midwives have no formal medical training, but are instead trained through an apprenticeship process. In Pennsylvania, however, only midwives with nursing degrees can be licensed. This makes the practice of lay midwifery illegal in some regulators' eyes, though state law doesn't specifically outlaw the practice. Since a lay midwife was accused of practicing medicine and nurse-midwifery without a license when an Amish baby she delivered in January 2005 died a day later, the issue has gotten more attention. The midwife, Diane Goslin, faces two charges from the Board of Medicine, each of which could lead to a $10,000 fine. No word has come down yet whether the state intends a further crackdown.
Concerned where this is leading, however, Amish people have been protesting, with about 200 rallying in Harrisburg late last month. Home-birth advocates have also expressed concern that without lay midwives, more home-birth deaths and baby injuries will occur. Meanwhile, the American College of Obstetricians and Gynecologists has come out against home birthing and lay midwifery.
To get more background on the lay midwife issue:
- read this Philadelphia Inquirer piece