Midwife faces court date in 'confusing' case

September 25, 1994|By Jackie Powder | Jackie Powder,Sun Staff Writer

In her 15 years as a midwife in Pennsylvania, Judy Mentzer has delivered nearly 1,000 babies.

She's proud of her record: 876 normal births, 24 breech births, 13 sets of twins and 13 Caesarean sections. There have been eight stillborn babies, but no maternal deaths.

But those statistics haven't impressed the Maryland Board of Nursing. Ms. Mentzer is scheduled to appear in Carroll County Circuit Court on Tuesday to face charges of practicing nursing without a license and misrepresenting herself as a nurse.

Ms. Mentzer was charged in March after the nursing board learned that she had attended a birth in Finksburg.

Under state law, only certified nurse midwives may practice in Maryland. Ms. Mentzer is not a nurse and says she has never claimed to be one, although she has delivered about 45 babies in Maryland.

If convicted, she could be sentenced to a year in jail and fined $5,000 on each of the two counts.

"A criminal is somebody who hurts you or steals from you, and I've done neither," said Ms. Mentzer, 46. "I haven't even lied, yet I'm in a criminal court. It's very confusing."

The Maryland Board of Nursing doesn't see it that way.

"She's evidently had no problems that we're aware of, but it's our belief that in order to practice as a midwife in the state you have to be a certified nurse midwife," said Donna Dorsey, executive director of the nursing board.

Certified nurse midwives can legally attend home births, but lay midwives say that only one in Maryland is willing to do so.

As a result, lay midwives say, women in Maryland who want to give birth at home are faced with giving birth unattended or hiring an illegal health care provider -- the non-nurse or lay midwife.

That's what got Ms. Mentzer into trouble. She said Maryland women sought her out to attend their home births and that she didn't have the heart to turn them down.

"It's not right that I can't choose who delivers my baby," said Carol Rhein, who has delivered two children at her Finksburg home with Ms. Mentzer.

Thorny issues

The nursing board's action against Ms. Mentzer illustrates the issues surrounding the role of nurse vs. midwife, midwife vs. obstetrician and a woman's right to choose who delivers her baby and where.

Several of Ms. Mentzer's clients and non-nurse midwives in Maryland, all of whom practice illegally, have come to her defense. About 40 supporters showed up at the Westminster courthouse last month for her trial, which was postponed. They plan to be there for her rescheduled court appearance Tuesday.

Anne Thompson, a certified nurse midwife and head of the Maryland chapter of the American College of Nurse Midwives, supports national licensing and certification for lay midwives so that they can practice legally.

Ms. Mentzer "had been practicing safely for a very long time and was targeted and used as a scapegoat for something the state wasn't sure how to handle," said Ms. Thompson, who practices at the Baltimore Birthing Center.

While waiting for her court date, Ms. Mentzer continues to practice midwifery in Pennsylvania.

Midwifery is based on the theory that childbirth, in most cases, is a natural process that doesn't require medical intervention.

Midwives vs. obstetricians

Midwives say that obstetricians, fearful of malpractice suits, are too willing to interrupt the normal birth process with surgery, high-technology equipment or drugs.

Pregnant women under the care of midwives are encouraged to play an active role in their prenatal care, labor and delivery. Midwives say they can offer much more personal attention than obstetricians can.

"The midwife's responsibility is to make sure the client has the birth she wants as safely as possible," Ms. Mentzer said.

Supporters of midwifery also say it offers a less costly alternative to birth in a hospital.

Although certified nurse midwives are gaining increasing acceptance in the health care field, obstetricians are generally critical of lay midwifery.

"To ensure quality, one needs adequate training and preparation, and the only way to quantify that is through certification," said Dr. Hal Lawrence, a North Carolina obstetrician/gynecologist and co-chairman of the American College of Obstetricians and Gynecologists' collaborative practice group.

Certified nurse midwives are legal in all states. In 13 states, including Maryland, lay midwifery is illegal. At least 14 states have statutes that provide for licensing or some form of legal recognition of lay midwives.

In the remaining states, the profession falls into a legal gray area in which midwives are not regulated but also aren't prosecuted.

In Pennsylvania, where Ms. Mentzer is based, a judge found in a 1989 ruling that state law was ambiguous regarding midwifery. The judge dismissed charges against a lay midwife accused of delivering a baby without a license.

Ms. Mentzer came to the attention of the Maryland Board of Nursing through birth certificates she had filed for her Maryland clients.

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