midwife2Nearly 100 people were seen protesting outside the LaGrange County, Indiana Courthouse on Monday, April 9th. Ireena Keeslar was arrested March 31st on a felony charge of practicing midwifery without a license.

Indiana is one of fifteen states that prohibits Certified Professional Midwives (CPMs) from delivering babies and generally prevents women from choosing mid-wife assisted home births. In Indiana, to legally practice midwifery one must qualify as a certified nurse-midwife (CNM), meaning they are a registered nurse (bachelor’s degree in nursing) and have obtained a master’s degree from a national accredited school of midwifery. This standard is significantly higher than that of other states, as a CNM has specialized education and training in both nursing and midwifery.

LaGrange County prosecutor’s investigator said Keeslar had been a licensed nurse but let her license lapse, making her ineligible under Indiana law to perform midwifery services.

CNMs usually practice under the supervision of obstetricians and generally only assist in deliveries conducted in hospitals or clinic environments. Additionally, unlike many states, Indiana courts have held that the administration of extensive prenatal care and the performance of deliveries do constitute the practice of medicine, and thus only doctors and CNMs may legally conduct these procedures.

Due to the recognition of midwifery as the practice of medicine, it is unlawful to practice without a license and both felony criminal charges and medical malpractice actions can be brought against unlicensed midwifes. Many hospitals do not support the practice of midwifery because the malpractice insurance rates may be higher in order to cover midwives.

Advocates in favor of home-births argue that states should recognize CPMs and do away with the stricter CNM requirement for practicing midwifery. These arguments are based on a woman’s constitutional right to choose among birthing options, women’s right to privacy and the significant public health and economic benefits that result from greater access to midwife care.

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