This summit was a joint collaboration between Human Rights in Childbirth and Midwifery Today. On April 2, 2013, legal professionals, activists, midwives and other healthcare providers came together with maternity care consumers to discuss the legal treatment of midwives as a human rights issue. The intention for the meeting was to gain clarity on the legal treatment of Out-Of-Hospital (OOH) midwives and doctors across the United States, and to gather some of the people actively working to promote women’s human rights in childbirth. The focus was centered on collaborative fact finding and brainstorming, rather than the determination of solutions.
An introductory session started the day with Midwifery Today founder Jan Tritten speaking about her experience as a center of the global midwifery community, and her impression that the legal treatment of midwives is getting harsher. Hermine Hayes-Klein spoke about the role of midwifery in the criminal prosecution of “witchcraft” over centuries in Europe, and the connection between that history, the development of obstetrics, and modern maternity care. Finally, Katie McCall, midwife and researcher, gave an overview of the legal status of midwifery in different U.S. states, and about the collaborative establishment of the group “Sisters in Chains,” which exists to support birth providers and mothers who are sanctioned for non-mainstream birth choices.
Panel 1: Midwives
Medical anthropologist Robbie Davis-Floyd moderated a panel of 9 birth professionals, from different jurisdictions, who faced legal sanction for providing support for out-of-hospital childbirth. Silke Akerson, president of the Oregon Midwifery Council, spoke about the stress and impact of individual cases of persecution on all midwives in that community and on the profession as a whole. The panel contained certified nurse-midwives, certified professional midwives, and unlicensed community midwives, with different accents and different backgrounds, whose stories shared a common thread: each had faced legal sanction on charges that amounted to, “This birth should have been in a hospital, and it’s your fault that it wasn’t.” Each faced sanction that was severe enough to have a predictable disincentivizing effect on the provision of OOH services. Even if the births over which the midwives faced sanction had involved a perinatal death or “bad outcome,” the legal treatment of the midwives was incomparable to the legal treatment of doctors with bad outcomes in the same jurisdiction.
Midwives from states where there are no legal “midwives” described home raids and handcuffs for “practicing medicine without a license.” Midwives who remained unlicensed in states where licensure restricted their ability to show up for women carrying twins, breech, or having previous cesarean surgery, described similar treatment. A gentle, religious, grandmother midwife, whose experience and knowledge of childbirth probably surpassed most of the doctors in her county, described the day she was paraded in handcuffs before her neighbors, while tears streamed down her face. A licensed midwife who attended a friend’s breech birth described the effect on her husband and young children of the day that the police raided their home. An ObGyn discussed the sanction he has faced from the Medical Board in his state for supporting women’s choices to birth outside of the hospital. Dr./Midwife Agnes Gereb joined by skype to give a message of hope from her home in Hungary, where she is in her third year of house arrest sentence for attending home birth. Other midwives in the audience rose to share their stories. Patterns were identified. Tears were shed.
Panel 2: Mothers
This panel consisted of “maternity care consumers” whose experiences and/or concerns around childbirth motivated them to become activists for the fundamental human rights of birthing women. Panelists spoke about the effect that the legal treatment of birth providers has on birthing women and their babies. Because each of these women hears and reads many stories from other women, they were able to speak to issues including continuity of care, the bullying and abuse that can occur when women have nowhere to turn, and problems of misinformation and meaningful consent. The discussion expanded to include the use of law on birthing women directly for their reproductive choices, including the use of Child Protective Services to threaten and punish women for failing to comply with hospital staff.
Lexi Abeln, a mother of seven, labor and delivery nurse, doula, birth educator and birth community activist. Lexi is the founder of Birthlight, a support group for women who have experienced trauma in childbirth.
Farah Diaz-Tello, a mother and lawyer with the US National Advocates for Pregnant Women.
Jen Kamel, a mother and former commercial real estate research manager. Jen Kamel brought her focus to post-cesarean birth options after her cesarean for footling breech and founded the website VBAC Facts.
Gena Kirby, a mother, consumer activist, and founder of Progressive Parenting, a popular radio program.
Ana Paula Markel, a mother, doula, advocate and owner of Bini Birth in Los Angeles.
Roanna Rosewood, a mother, consumer activist, and author of Cut, Stapled and Mended: When One Women Reclaimed her Body and Gave Birth on her Own Terms
Nekole Malia Shapiro, a mother, activist, doula, massage practitioner, peer counseling educator, embodiment coach and the creatrix of Embodied Birth.
Dawn Thompson, a mother, consumer activist, and leader of ImprovingBirth.org.
Moderator: Hermine Hayes-Klein, mother, advocate, activist, HRiC.
Panel 3: Lawyers
The day concluded with a panel of legal professionals from the US and Europe who advocate for the legal rights of birthing women.. The panel members joined from around the world and all had experience providing defense and counsel to those facing sanctions. The panel was moderated by Rebecca Spence, lawyer and bioethicist and the founder of Legal Advocates for Birth Options and Rights (LABOR). The panel included:
Ernst van Bemmelen van Gent, a Dutch human rights lawyer who defends midwives.
Carol Downer, an American reproductive rights lawyer, who was herself charged with “practicing medicine without a license” in California in 1972, for showing women how they could treat vaginal infections with yogurt.
Stefania Kapronczay, director of the Hungarian Civil Liberties Union and a member of the legal team behind the European Court of Human Rights case of Ternovszky v. Hungary.
Indra Lusero, reproductive and transgender rights attorney, founding member of LABOR and the HRiC US Legal Advocacy Network.
Laura Fine Moro, a criminal defense attorney in Oregon, who discussed constitutional defenses to the unequal application of criminal charging practices between midwives and medical professionals.
Elizabeth Prochaska, a British human rights lawyer and the founder of BirthRights.co.uk.
Cyd Ropp, a legal scholar and the author of “The Rhetoric of Childbirth,” an analysis of winning and losing arguments in midwifery trials.