A court victory for lay midwifery
Lancaster New Era

Published: May 28, 2008
13:27 EST

By The Editors
A Commonwealth Court ruling allows lay midwife Diane Goslin to resume providing home-birth services to Amish and Mennonite families, as she has done for many years.

The appellate court, in a 5-2 ruling, disagreed with state Board of Medicine officials, who had claimed Goslin was practicing medicine without a state license.

The ruling is welcome, but does not resolve the long-standing debate between lay (unlicensed) midwifery and state certified nurse-midwifery in Pennsylvania.

Commonwealth Court may have just kicked the can farther down the road &tstr; to the state Supreme Court, which would get the case, if the state chooses to appeal.

A lay midwife differs from a state certified nurse-midwife in a number of important ways.

Lay midwives assist women in home births. They favor a non-intrusive approach to pregnancy, and are more likely to use herbal remedies to treat pregnancy-related conditions.

Nurse midwives, on the other hand, are more likely to deliver babies in hospitals, and their state license allows them to prescribe medicine and order laboratory tests.

Lay midwives receive training, but not the level required to become a state certified nurse-midwife (Goslin is certified by the North American Registry of Midwives, but the designation is not recognized by the State of Pennsylvania).

While Plain sect women here use both lay midwives and nurse-midwives, they prefer to give birth at home, and that's the lay midwife's specialty.

The case against Goslin, of Providence Township, began in 2005 after she participated in the delivery that ended with the death of a newborn.

The state did not claim negligence by Goslin, but concluded she was putting women and babies at risk and ordered her to stop.

Goslin appealed, setting the stage for last week's decision by Commonwealth Court, which found that the state incorrectly concluded she was making medical and surgical decisions as part of the birthing services she provides.

The court's decision may not be the last word, but it's an important win for Goslin, who has participated in some 5,000 successful births over the past 28 years.

The state could halt further court action, but a better remedy would be to accept lay midwifery for what it is: a form of health care similar to, but different from, licensed nurse-midwifery.

This may ultimately require legislative action &tstr; not unheard of in cases such as this.

In 2004, Congress approved a bill sponsored by Rep. Joe Pitts that permits Amish children, ages 14-18, to work in woodworking and carpentry shops.

Pitts introduced the measure after hearing complaints that Amish employers were being fined thousands of dollars by the U.S. Department of Labor for violating federal child-labor laws.

As in the Goslin case, the government cited safety concerns, but ignored the impact the regulations were having on traditional Amish life.

Pitts' bill addressed the safety concerns, and his measure was approved by lawmakers and signed by President Bush.

The state Legislature could craft a bill addressing midwifery in Pennsylvania, resolving the question once and for all.

Until then, Goslin can resume her work and hope for continued success in the courts.
PS- the legislators should be doing something.. they ain't!