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Why is this decision so important?
Your freedom is under attack
The Pennsylvania Board of Medicine wants to put an end to out-of-hospital births.
Their recent attack on Diane Goslin marks a change in the Board of Medicine’s
handling of cases regarding non-licensed midwives in the State of Pennsylvania. In
several previous cases, the Board has withdrawn charges it brought against homebirth
midwives, largely because the midwives successfully argued that the Medical Practice
Act of 1985 (MPA) does not directly prohibit homebirth midwifery.
Although the Board has chosen to directly target Diane Goslin, they are taking aim at all
homebirth, or direct-entry, midwives in the state. This is a test case. The Board
intends to establish a legal precedent. They want to be able to prosecute future cases
against midwives under the MPA by extending its regulation of nurse midwives to
include anyone assisting in an out-of-hospital birth.
With this recent action, they have removed the legal barrier that, until now, has keep
them from putting all homebirth midwives in Pennsylvania out of business.
Their intent is clear – the Board of Medicine wants to criminalize home birth midwifery
and eliminate home birth in the state of Pennsylvania. While the Board contends that
there are plenty of licensed Certified Nurse-Midwives (CNMs) available to provide
services to the families desiring homebirth, this is simply not the case. CNMs are
required to practice under the supervision of a doctor. Doctors who are willing to
provide medical back-up for out-of-hospital births are becoming rare.
Make no mistake – your freedom to birth your children at home with the attendants
of your choice is under attack in Pennsylvania.
Your freedom is under attack
The Pennsylvania Board of Medicine wants to put an end to out-of-hospital births.
Their recent attack on Diane Goslin marks a change in the Board of Medicine’s
handling of cases regarding non-licensed midwives in the State of Pennsylvania. In
several previous cases, the Board has withdrawn charges it brought against homebirth
midwives, largely because the midwives successfully argued that the Medical Practice
Act of 1985 (MPA) does not directly prohibit homebirth midwifery.
Although the Board has chosen to directly target Diane Goslin, they are taking aim at all
homebirth, or direct-entry, midwives in the state. This is a test case. The Board
intends to establish a legal precedent. They want to be able to prosecute future cases
against midwives under the MPA by extending its regulation of nurse midwives to
include anyone assisting in an out-of-hospital birth.
With this recent action, they have removed the legal barrier that, until now, has keep
them from putting all homebirth midwives in Pennsylvania out of business.
Their intent is clear – the Board of Medicine wants to criminalize home birth midwifery
and eliminate home birth in the state of Pennsylvania. While the Board contends that
there are plenty of licensed Certified Nurse-Midwives (CNMs) available to provide
services to the families desiring homebirth, this is simply not the case. CNMs are
required to practice under the supervision of a doctor. Doctors who are willing to
provide medical back-up for out-of-hospital births are becoming rare.
Make no mistake – your freedom to birth your children at home with the attendants
of your choice is under attack in Pennsylvania.
In an unusually aggressive move Wednesday, September 26, the
Pennsylvania Board of Medicine began a campaign to end homebirth in
Pennsylvania.
Board of Medicine Decision Press Release
HARRISBURG, PENNSYLVANIA -
SEPTEMBER 27, 2007
HOMEBIRTH MIDWIFE IS ORDERED TO CEASE AND DESIST BY THE STATE BOARD OF
MEDICINE
The State Board of Medicine today ordered Diane Goslin, a Pennsylvania midwife who attends the
hombirths of the Amish and Plain communities, to "cease and desist from the practice of medicine
and midwifery." Additionally, she was fined $11,000.
Goslin, a Certified Professional Midwife, who attended over 5,000 successful homebirths and trained
many professional midwives, received her certification from NARM (North American Registry of
Midwives) in 1998. Accordingly, she has received appropriate training and education, demonstrated
competent midwifery skill levels as affirmed by peer-review and successfully passed nationally
standardized examinations. Although 23 States grant midwifery licenses to midwives who achieve
NARM certification, Pennsylvania does not.
While homebirth attended by a midwife has been a traditional practice within Pennsylvania Amish
and Plain communities, this less costly practice has recently been under attack from the state
medical board. The number of families choosing homebirth continues to increase as medical
research demonstrates its safety and cost effectiveness
The CDC recently released a report that shows national maternal mortality rates (Aug, 2007 National
Health Statistics) are the highest they have been in decades. One of the factors, they say, is the
rising Cesarean birth rate.
In an effort to achieve a safe and satisfying birth, women are beginning to choose homebirth as an
option. "The system is broken," said Dr. Marsden Wagner, the former director of Women and
Children's Health at the World Health Organization. "The United States has the second worst
newborn mortality rate in the developed world, despite the fact that it's one of the most expensive
maternity care systems."
In the UK, homebirth was recently adopted as an option for birthing women by the National Health
Dept., which stated in 2006, "We are committed to offering all women the choice of how and where
they give birth." In April 2007, The Royal College of Obstetricians and Gynecologists (the UK
equivalent to the US ACOG), released a joint statement with the Royal College of Midwives stating
their support for home birth.
"A recommendation made by the Georgia Study commission on Midwifery is applicable to
Pennsylvania," said Ida Darragh, Director of NARM. "When a state has an underground network of
health caare providers, it needs to deal with the situation responsibly through regulation rather than
prosecution."
Pennsylvania Board of Medicine began a campaign to end homebirth in
Pennsylvania.
Board of Medicine Decision Press Release
HARRISBURG, PENNSYLVANIA -
SEPTEMBER 27, 2007
HOMEBIRTH MIDWIFE IS ORDERED TO CEASE AND DESIST BY THE STATE BOARD OF
MEDICINE
The State Board of Medicine today ordered Diane Goslin, a Pennsylvania midwife who attends the
hombirths of the Amish and Plain communities, to "cease and desist from the practice of medicine
and midwifery." Additionally, she was fined $11,000.
Goslin, a Certified Professional Midwife, who attended over 5,000 successful homebirths and trained
many professional midwives, received her certification from NARM (North American Registry of
Midwives) in 1998. Accordingly, she has received appropriate training and education, demonstrated
competent midwifery skill levels as affirmed by peer-review and successfully passed nationally
standardized examinations. Although 23 States grant midwifery licenses to midwives who achieve
NARM certification, Pennsylvania does not.
While homebirth attended by a midwife has been a traditional practice within Pennsylvania Amish
and Plain communities, this less costly practice has recently been under attack from the state
medical board. The number of families choosing homebirth continues to increase as medical
research demonstrates its safety and cost effectiveness
The CDC recently released a report that shows national maternal mortality rates (Aug, 2007 National
Health Statistics) are the highest they have been in decades. One of the factors, they say, is the
rising Cesarean birth rate.
In an effort to achieve a safe and satisfying birth, women are beginning to choose homebirth as an
option. "The system is broken," said Dr. Marsden Wagner, the former director of Women and
Children's Health at the World Health Organization. "The United States has the second worst
newborn mortality rate in the developed world, despite the fact that it's one of the most expensive
maternity care systems."
In the UK, homebirth was recently adopted as an option for birthing women by the National Health
Dept., which stated in 2006, "We are committed to offering all women the choice of how and where
they give birth." In April 2007, The Royal College of Obstetricians and Gynecologists (the UK
equivalent to the US ACOG), released a joint statement with the Royal College of Midwives stating
their support for home birth.
"A recommendation made by the Georgia Study commission on Midwifery is applicable to
Pennsylvania," said Ida Darragh, Director of NARM. "When a state has an underground network of
health caare providers, it needs to deal with the situation responsibly through regulation rather than
prosecution."
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Amish Auction a Huge Success
Quarryville, December 8, 2007
In spite of an icy drizzle, hundreds made their way to the
Hoffman Building at Solanco Fairgrounds for the first
Annual Auction for Homebirth Midwifery. People bid on
woodcrafts, toys, appliances, artwork, quilts, handmade
clothing, and numerous other items while consuming
piles of homemade donuts and soft pretzels, sausages,
sandwiches, mouth-watering barbecued chicken, and
gallons of chicken corn soup.
Daniel King, owner and operator of the Bartville Store and
Food Locker, planned the auction. Amish friends and
neighbors contributed time and donated a wonderful
variety of crafts and handmade items.
At the end of the day, the auction had earned about
$15,000 to help Diane Goslin in her legal battle against
the PA Board of Medicine.
Quarryville, December 8, 2007
In spite of an icy drizzle, hundreds made their way to the
Hoffman Building at Solanco Fairgrounds for the first
Annual Auction for Homebirth Midwifery. People bid on
woodcrafts, toys, appliances, artwork, quilts, handmade
clothing, and numerous other items while consuming
piles of homemade donuts and soft pretzels, sausages,
sandwiches, mouth-watering barbecued chicken, and
gallons of chicken corn soup.
Daniel King, owner and operator of the Bartville Store and
Food Locker, planned the auction. Amish friends and
neighbors contributed time and donated a wonderful
variety of crafts and handmade items.
At the end of the day, the auction had earned about
$15,000 to help Diane Goslin in her legal battle against
the PA Board of Medicine.
Judge Proclaims State has Overriding Control
of Your Birth Choices
On October 31 Judge James Colins denied the request of Diane Goslin for a stay or
supersedeas of the cease and desist order given by the Pennsylvania Board of
Medicine on September 26. In his opinion, Judge Colins wrote,"...while we recognize
the distinct interest of future parents to make decisions regarding the manner by which
their children may be delivered, we believe that the Commonwealth has a paramount
interest in ensuring that the lives of unborn fetuses are medically protected."
This was the decision reached by Colins even after he stated that, "...the record reveals
- and the Board does not contest - that Goslin has an exceptional degree of experience
and certification from a highly regarded national midwife organization, North American
Registry of Midwives." He further stated that, "The Board has not asserted that Goslin
has ever practiced in a negligent or dangerous manner."
In her declaration submitted on Goslin's behalf, social scientist and midwife Betty-Ann
Daviss wrote, "Ms. Goslin's results are impeccable; her client satisfaction is
excellent...It is highly unusual that this Cease and Desist Order is coming twenty-six
(26) years after Ms. Goslin began to practice...There must be some kind of appeal to
common sense if not common law that a citizen exercising her profession in a
community for this amount of time cannot merely be thrown out at the whim of a few
people who may have a vested interest in establishing their profession over hers."
Daviss, who co-authored the landmark study , "Outcomes of planned home births with
certified professional midwives", published in the British Medical Journal in 2005, and
who knows Goslin's work well concluded her statement by saying, " It is ironic that
one of the very midwives whom I chose to visit precisely because of her unusually
high level of experience should receive a Cease and Desist Order the month after I
visited her."
of Your Birth Choices
On October 31 Judge James Colins denied the request of Diane Goslin for a stay or
supersedeas of the cease and desist order given by the Pennsylvania Board of
Medicine on September 26. In his opinion, Judge Colins wrote,"...while we recognize
the distinct interest of future parents to make decisions regarding the manner by which
their children may be delivered, we believe that the Commonwealth has a paramount
interest in ensuring that the lives of unborn fetuses are medically protected."
This was the decision reached by Colins even after he stated that, "...the record reveals
- and the Board does not contest - that Goslin has an exceptional degree of experience
and certification from a highly regarded national midwife organization, North American
Registry of Midwives." He further stated that, "The Board has not asserted that Goslin
has ever practiced in a negligent or dangerous manner."
In her declaration submitted on Goslin's behalf, social scientist and midwife Betty-Ann
Daviss wrote, "Ms. Goslin's results are impeccable; her client satisfaction is
excellent...It is highly unusual that this Cease and Desist Order is coming twenty-six
(26) years after Ms. Goslin began to practice...There must be some kind of appeal to
common sense if not common law that a citizen exercising her profession in a
community for this amount of time cannot merely be thrown out at the whim of a few
people who may have a vested interest in establishing their profession over hers."
Daviss, who co-authored the landmark study , "Outcomes of planned home births with
certified professional midwives", published in the British Medical Journal in 2005, and
who knows Goslin's work well concluded her statement by saying, " It is ironic that
one of the very midwives whom I chose to visit precisely because of her unusually
high level of experience should receive a Cease and Desist Order the month after I
visited her."
| Did Diane Break the Law? Is there a law against homebirth? In short, no. There is no Pennsylvania law that precludes the practice of homebirth midwifery or home birth. Then why has Diane been ordered to cease and desist from the practice of midwifery? The PA Board of Medicine has fined Diane for practicing midwifery without a license. They argue that she is in violation of the Medical Practice Act (MPA) of 1985. However, the MPA does not say anything about the licensure of homebirth midwives who are not nurses. Rather, it regulates the practice of Certified Nurse Midwives. This is a matter of legal interpretation, and the Board has interpreted the law to apply to anyone who attends a woman in childbirth. If the MPA became law 22 years ago, why hasn't this been an issue before? In fact, this has come up before. In 1989 identical charges were brought against a Mercer County midwife by the Board of Medicine. The court decided that since the MPA did not prohibit homebirth midwifery by non-nurses, the Board could not put an end to her practice under that Act. |
COMMONWEALTH COURT WILL
DECIDE FATE OF PA MIDWIVES
Wednesday, April 9, 2008 Nearly 1,000 people gathered at the State Capitol today in
support of Lancaster County midwife, Diane Goslin, who was appealing a cease and
desist order from the PA Board of Medicine handed down last September.
The Board of Medicine found Mrs. Goslin in violation of the Medical Practice Act of 1985
for "practicing medicine without a license."
The Board based it's finding on the assertion that midwifery constitutes the practice of
medicine. Goslin has never been charged with negligence or endangerment.
Mrs. Goslin is a Certified Professional Midwife - a certification which is recognized in 23
other states. She has practiced midwifery in Pennsylvania for 25 years and has
attended over 5,000 births.
Goslin's appeal was heard by all seven judges of the Commonwealth Court in the
Supreme Court room of the Capitol. They will now decide whether or not the
Pennsylvania Board of Medicine correctly concluded that anyone assisting a women
in childbirth is practicing medicine. A decision is not expected for at least a week.
Goslin's attorney, James Kutz, said, "This is a case where your fundamental freedoms
run headlong into government regulation."
"The judges had some very important questions," said Betty-Anne Daviss, co-author of
the largest study ever conducted to assess the safety of homebirth. "Namely, they
wanted to know if a woman has a Constitutional right to birth her baby at home with
whom she wants." Daviss pointed out that governments in both Canada and Great
Britain are working to expand public access to midwives like Diane and, by so doing,
are seeing a decrease in maternal and infant mortality rates in those countries.
Goslin's lawyers argued in a courtroom packed with 250 supporters, according to
James Strickler, President of PA Families for Safe Birth.
"When I walked outside and saw the sea of people who had come out to support Diane
and homebirth freedom, I was overcome," said Faith Bucks, Chiropractor and co-
founder of SaveHomebirth.com. Amish and Plain men, women and babies had come
by the hundreds from across Pennsylvania to show their desire to maintain their
freedom to birth at home with the midwives of their choice.
*Pennsylvania Families for Safe Birth , a newly formed consumer organization, has begun the
process of creating legislation to license Certified Professional Midwives in Pennsylvania. PFSB's
mission is to "support families’ access to safe, appropriate, evidence-based care during pregnancy,
labor, birth and the postpartum period." For more information, please visit www.pasafebirth.org.
DECIDE FATE OF PA MIDWIVES
Wednesday, April 9, 2008 Nearly 1,000 people gathered at the State Capitol today in
support of Lancaster County midwife, Diane Goslin, who was appealing a cease and
desist order from the PA Board of Medicine handed down last September.
The Board of Medicine found Mrs. Goslin in violation of the Medical Practice Act of 1985
for "practicing medicine without a license."
The Board based it's finding on the assertion that midwifery constitutes the practice of
medicine. Goslin has never been charged with negligence or endangerment.
Mrs. Goslin is a Certified Professional Midwife - a certification which is recognized in 23
other states. She has practiced midwifery in Pennsylvania for 25 years and has
attended over 5,000 births.
Goslin's appeal was heard by all seven judges of the Commonwealth Court in the
Supreme Court room of the Capitol. They will now decide whether or not the
Pennsylvania Board of Medicine correctly concluded that anyone assisting a women
in childbirth is practicing medicine. A decision is not expected for at least a week.
Goslin's attorney, James Kutz, said, "This is a case where your fundamental freedoms
run headlong into government regulation."
"The judges had some very important questions," said Betty-Anne Daviss, co-author of
the largest study ever conducted to assess the safety of homebirth. "Namely, they
wanted to know if a woman has a Constitutional right to birth her baby at home with
whom she wants." Daviss pointed out that governments in both Canada and Great
Britain are working to expand public access to midwives like Diane and, by so doing,
are seeing a decrease in maternal and infant mortality rates in those countries.
Goslin's lawyers argued in a courtroom packed with 250 supporters, according to
James Strickler, President of PA Families for Safe Birth.
"When I walked outside and saw the sea of people who had come out to support Diane
and homebirth freedom, I was overcome," said Faith Bucks, Chiropractor and co-
founder of SaveHomebirth.com. Amish and Plain men, women and babies had come
by the hundreds from across Pennsylvania to show their desire to maintain their
freedom to birth at home with the midwives of their choice.
*Pennsylvania Families for Safe Birth , a newly formed consumer organization, has begun the
process of creating legislation to license Certified Professional Midwives in Pennsylvania. PFSB's
mission is to "support families’ access to safe, appropriate, evidence-based care during pregnancy,
labor, birth and the postpartum period." For more information, please visit www.pasafebirth.org.
Activists Initiate Big Push
in PA
Marsden Wagner decries the violation of
the sanctity of Pennsylvania's families
January 24, Harrisburg An enthusiastic crowd of
mothers, fathers, babies, midwives, and freedom-lovers
gathered in the state capitol today to celebrate the birth of
Pennsylvania Families for Safe Birth (PFSB.) The rally was
held in concert with other state rallies as part of The Big
Push for Midwives Campaign which is the first initiative of
the National Birth Policy Coalition. The NBPC is focused
on increasing access to the Midwives Model of Care in all
settings, as well as supporting legislative initiatives that
promote the autonomous practice of Certified Professional
Midwives and Certified Nurse-Midwives.
Watch the video.
Keynote speaker, Krystn Madrine, said, “We are part of
something that is much bigger than what you see here. All
across the country today people are coming together to
support the idea of midwives.” She reminded us that,
“(We) are part of the tapestry of the movement toward
having better birth.”
Marsden Wagner, former director of Women’s and
Children’s Health of the World Health Organization said,
“Pennsylvania is in a mess. You have a Medical Board
who is attacking midwives. You have obstetricians in this
state who say that homebirth is dangerous, that midwives
are dangerous.” Part of the mission of PFSB is to raise
awareness and support for families choosing an out-of
hospital birth as a safe, appropriate option. Dr. Wagner
reminded us that all of the evidence supports the claim that
midwife-attended birth is safe.
One of the goals of PFSB is
to support legislation that will
license Certified Professional
Midwives (CPMs) in
Pennsylvania, giving them
freedom to serve
Pennsylvania’s women.
“We are ready for, and demanding change,” said Salem,
Executive Director of Birth Without Boundaries,
International. “We need each one of you. We need our
midwives; regardless of what two letters come before the
‘M’. We need our midwives, period.”
“We are in the very early stages of our pregnancy,” said Ms.
Madrine. “Nobody can see. We aren’t showing yet. We’re
still having some morning sickness. We are still deciding
which vitamins to take.” But like the growing child, she
said, the movement toward childbirth freedom is living and
growing and swelling across the country. “So you can get
involved and have an impact. It has to come from you,” she
told the consumers, saying it is time for us to give back and
to stop the harassment of midwives.
“At the end of the day,” said Dr. Wagner, “this is all about
freedom. The families of Pennsylvania do not today have
freedom to choose the kind of birth they want where they
want it. The sanctity of all families has been taken away
from you. Pennsylvania families must get the truth,
because the truth will make them free.”
in PA
Marsden Wagner decries the violation of
the sanctity of Pennsylvania's families
January 24, Harrisburg An enthusiastic crowd of
mothers, fathers, babies, midwives, and freedom-lovers
gathered in the state capitol today to celebrate the birth of
Pennsylvania Families for Safe Birth (PFSB.) The rally was
held in concert with other state rallies as part of The Big
Push for Midwives Campaign which is the first initiative of
the National Birth Policy Coalition. The NBPC is focused
on increasing access to the Midwives Model of Care in all
settings, as well as supporting legislative initiatives that
promote the autonomous practice of Certified Professional
Midwives and Certified Nurse-Midwives.
Watch the video.
Keynote speaker, Krystn Madrine, said, “We are part of
something that is much bigger than what you see here. All
across the country today people are coming together to
support the idea of midwives.” She reminded us that,
“(We) are part of the tapestry of the movement toward
having better birth.”
Marsden Wagner, former director of Women’s and
Children’s Health of the World Health Organization said,
“Pennsylvania is in a mess. You have a Medical Board
who is attacking midwives. You have obstetricians in this
state who say that homebirth is dangerous, that midwives
are dangerous.” Part of the mission of PFSB is to raise
awareness and support for families choosing an out-of
hospital birth as a safe, appropriate option. Dr. Wagner
reminded us that all of the evidence supports the claim that
midwife-attended birth is safe.
One of the goals of PFSB is
to support legislation that will
license Certified Professional
Midwives (CPMs) in
Pennsylvania, giving them
freedom to serve
Pennsylvania’s women.
“We are ready for, and demanding change,” said Salem,
Executive Director of Birth Without Boundaries,
International. “We need each one of you. We need our
midwives; regardless of what two letters come before the
‘M’. We need our midwives, period.”
“We are in the very early stages of our pregnancy,” said Ms.
Madrine. “Nobody can see. We aren’t showing yet. We’re
still having some morning sickness. We are still deciding
which vitamins to take.” But like the growing child, she
said, the movement toward childbirth freedom is living and
growing and swelling across the country. “So you can get
involved and have an impact. It has to come from you,” she
told the consumers, saying it is time for us to give back and
to stop the harassment of midwives.
“At the end of the day,” said Dr. Wagner, “this is all about
freedom. The families of Pennsylvania do not today have
freedom to choose the kind of birth they want where they
want it. The sanctity of all families has been taken away
from you. Pennsylvania families must get the truth,
because the truth will make them free.”
