The Practice of Midwifery in Maryland

In spring 2011, a midwife based in Maryland pleaded guilty in Virginia to two felonies stemming from the death of a baby after a home birth.  That event spurred this series “The Practice of Midwifery in Maryland.”

Midwifery in Maryland
Aired May 11, 2011

Karen Carr, a midwife based in Baltimore, pled guilty in spring 2011 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 was asked 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 (or CPM), 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.

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.

A Setting for Birth
Aired June 8, 2011

In the U. S., the majority of midwife-attended births take place in hospitals…but many people still associate midwives with births that take place outside the hospital—at home, or in a free-standing birth center.

According to data from the Centers for Disease Control, in 2006, fewer than 1 percent of all births in Maryland took place outside of a hospital—though that number is rising.  The CDC found that the number of mothers opting for out-of-hospital birth had risen by 35 percent from three years prior.

In this segment, we hear perspectives from those who are familiar with midwife-attended births– at home, in birth centers, and in hospitals–and we discuss the possible problems when a direct-entry midwife (who may not be licensed) must transfer care to a physician at a hospital.

We hear from Brigitte Jacobson is a former Navy pilot who gave birth to her second child at her home in Baltimore, Ann Sober a nurse and the director of a birth center in Arnold, north of Annapolis, called “Special Beginnings Birth and Women’s Center,”  and Erin Wright, a certified nurse-midwife who practices at a hospital through the University of Maryland, and president of the Maryland Chapter of the American College of Nurse-Midwives.

The Future of Midwifery in Maryland
Aired June 10, 2011

Karen Carr is a certified professional midwife–a form of midwifery not licensed in Maryland, though it is recognized in 26 states.   In Maryland– and throughout the country–the majority of midwife-attended births are attended by certified nurse midwives—they’re trained in both nursing and midwifery.   The consumer group Citizens for Midwifery does a good job of detailing the differences between the two groups.

We discuss those differences on air with Karen Fennell, a policy consultant and lobbyist for the American Association of Birth Centers.  She’s working to  gain licensure for certified professional midwives in Maryland. We also hear from Larry Fogelson, an obstetrician who’s the head of Women’s Health Associates at St. Joseph’s Medical Center in Towson.  He works with the certified nurse-midwives who practice there.

Please share your story with us.

We welcome your comments about these segments.  We’d also like to hear about your own birth experiences, whether they took place at home, in a hospital, with a midwife or a doctor – leave us a comment, email us at, or give us a call at 410-881-3162.

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