5-11-11: Midwifery in Maryland

May 11, 2011 at 2:00 pm 9 comments


Karen Carr, a midwife based in Baltimore, pled guilty last week to two felonies in Virginia, child en­dan­ger­ment and perform­ing an invasive procedure with­out a license.  The charges stemmed from the death of a baby after a home birth she performed in Alexandria.  According to prosecutors, the baby’s head was stuck in the birth canal for 20 minutes, and Carr tried to resuscitate him for 13 minutes before calling for emergency help.

Carr agreed to do the birth after a licensed birthing center in Virginia said they would not deliver the child because the baby was in the breech position.  Breech babies (in which the fetus is feet-first) are usually delivered by Caesarean section, because the risk of complications is increased.  Carr is to pay a $5,000 fine, and return the $3,200 fee she charged the boy’s parents.   All but 5 days of her two 4-year sentences were suspended.

Karen Carr is a certified professional midwife, a certification which is recognized in 26 states, but not in Maryland.  So, while it’s been reported that she was practicing without a license in Virginia, she’s also been practicing illegally in Maryland.  Carr said she chose to pursue certification as a CPM, as opposed to certification as a nurse-midwife (recognized in all 50 states), because she wanted to practice outside of the medical system.

“I wanted to do it that way because I know people looking for home births want an unmedicalized birth,” said Carr.   “They want their birth to be a family event.  So I decided not to allow myself to be influenced in that way.”

Despite the lack of a license, the original charges against Carr—involuntary manslaughter and child abuse—sparked an outpouring of support, both verbal and financial, from some of the 1200 families whose babies she has delivered.  She has been a midwife for 18 years, and specializes in delivering children at home.

In light of all this–we want to look at the practice of midwifery in Maryland.  Karen Carr agreed to speak with us and answer questions not involving the Virginia case.  We also speak with Erin Wright, a licensed nurse-midwife and the president of the Maryland affiliate of the American College of Nurse Midwives.

We also want to hear from you — what are your experiences with midwifery, or home birth?  Let us know at 410-881-3162, email us at mdmorning@wypr.org, or leave a comment below.

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9 Comments Add your own

  • 1. Susan Jenkins  |  May 11, 2011 at 3:46 pm

    It would be a good idea to talk with some midwives or consumers in Maryland who want to work for laws that will license and regulate midwives. There is a growing movement all across the country to make sure that midwives who provide out-of-hospital births are licensed and regulated. So far, laws have been passed in 27 states, including Virginia, but we still need this type of law in Maryland and D.C. There is no reason why CPMs like Karen Carr can’t be licensed and regulated just like any other kind of health professional. If you would like to be connected with someone who would be glad to be interviewed about this, contact us at The Big Push for Midwives (http://www.thebigpushformidwives.org) and we will put you in touch with someone.

    Reply
  • 2. Catherine M Salam  |  May 11, 2011 at 8:59 pm

    I thought your interview gave a balanced portrayal or the options for midwifery care in Maryland. However, there is an important distinction that delineates a client’s risk status. Home birth with either a CNM or a CMP should be an appropriate option for the low risk client. Transfer to a hospital setting for a higher level of care should be an option.
    I didn’t understand Dr. Gueckes’ comments…what do seat belts have to do with choices in birthing options?

    Reply
  • 3. Evelyn  |  May 12, 2011 at 12:35 am

    I have but one or two questions.Women and babies die in hospital under the supervision of obstetricians, licenced practitioners. Why then are they not brought up on feloney charges and advised not practice?

    Reply
  • 4. Kate Fisher  |  May 12, 2011 at 3:48 am

    When I got pregnant with my daughter I knew that the fast food “get em in get em out” style of the OBGyn I had seen over the years for well women care, was not going to cut it. did a lot of research and wanted home birth but my husband was leary of it. We compromised and went with a CNM (Certified Nurse Midwife) who delivers at a hospital. The are was outstanding! I now continue to see her for my well woman care and have never looked back or considered seeing an OBGyn again! With a midwife I feel like a woman with valid concerns instead of a billablle customer who has “too many questions”.

    Reply
  • 5. Kate Fisher  |  May 12, 2011 at 3:51 am

    *The care was outstanding

    Reply
  • 6. Mimi  |  June 7, 2011 at 12:07 pm

    This person was operating outside of the law and knew it. She does not help midwifery. She may be responsible for the death of that child. It astounds me that she fails to accept greater responsibility. ACNM should support lawful midwifery practice only and recognize all other practice for what it is: dangerous and punishable by law. There is absolutely no excuse to operate outside of the laws of the land and no reason to take chances with someone’s life. Midwifery should not turn away from modern medicine but offer a complementary practice.

    Reply
  • 7. Paula, CNM  |  June 9, 2011 at 7:26 pm

    CPMs SHOULD be licensed and regulated. They would be subject to providing the same standard of care given by any other obstetric provider, which in this case, would be to not offer a home birth (or for that matter, birth center birth) to a client with a fetus in breech presentation.

    Reply
  • 8. Yatta S. K. Elsar  |  December 1, 2011 at 9:25 pm

    If CPMs are regulated, they can serve as a legal, economical, privately secure means for many families.

    Reply
  • 9. gwen  |  May 3, 2012 at 6:32 pm

    My first birth was in a hospital. I had wanted it in a birthing center, but insurance didn’t cover that. I had a negative experience. I was given drugs I had insisted i didn’t want. I was attended by strangers, before my nurse-midwife decided to come in for the last hour. My baby couldn’t breathe when he came out becauseof one of the drugs the stranger attendant had given me. For my second and third births I used lay midwives, and I was comfortable, at home. I would like a midwife for my fourth birth now, but I live in maryland, and apparently they aren’t legal here. I have no desire to repeat my negative hospital birth experience.

    Reply

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