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Jennifer Block

The Criminalization of the American Midwife

Illustration by Ellice Weaver

Jennifer Block  |  March 2020  |  32 minutes (8,025 words)

Elizabeth Catlin had just stepped out of the shower when she heard banging on the door. It was around 10 a.m. on a chilly November Wednesday in Penn Yan, New York, about an hour southeast of Rochester. She asked her youngest child, Keziah, age 9, to answer while she threw on jeans and a sweatshirt. “There’s a man at the door,” Keziah told her mom.

“He said, ‘I’d like to question you,” Caitlin tells me. A woman also stood near the steps leading up to her front door; neither were in uniform. “I said, ‘About what?’” The man flashed a badge, but she wasn’t sure who he was. “He said, ‘About you pretending to be a midwife.’”

Catlin, a home-birth midwife, was open about her increasingly busy practice. She’d send birth announcements for her Mennonite clientele to the local paper. When she was pulled over for speeding, she’d tell the cop she was on her way to a birth. “I’ve babysat half of the state troopers,” she says.

It was 30 degrees. Catlin, 53, was barefoot. Her hair was wet. “Can I get my coat?” she asked. No. Boots? She wasn’t allowed to go back inside. Her older daughter shoved an old pair of boots, two sizes too big, through the doorway; Catlin stepped into them and followed the officer and woman to the car. At the state trooper barracks, she sat on a bench with one arm chained to the wall. There were fingerprints, mug shots, a state-issue uniform, lock-up. At 7:30 p.m. she was finally arraigned in a hearing room next to the jail, her wrists and ankles in chains, on the charge of practicing midwifery without a license. Local news quoted a joint investigation by state police and the Office of Professional Discipline that Catlin had been “posing as a midwife” and “exploiting pregnant women within the Mennonite community, in and around the Penn Yan area.”

Catlin’s apparent connection with a local OB-GYN practice, through which she had opened a lab account, would prompt a second arrest in December, the Friday before Christmas, and more felony charges: identity theft, falsifying business records, and second-degree criminal possession of a forged instrument. That time, she spent the night in jail watching the Hallmark Channel. When she walked into the hearing room at 8:00 a.m., again in chains, she was met by dozens of women in grey-and-blue dresses and white bonnets. The judge set bail at $15,000 (the state had asked for $30,000). Her supporters had it: Word of her arrest had quickly passed through the tech-free community, and in 12 hours they had collected nearly $8,000 for bail; Catlin’s mother made up the difference. She was free to go, but not free to be a midwife.

Several years back, a respected senior midwife faced felony charges in Indiana, and the county prosecutor allowed that although a baby she’d recently delivered had not survived, she had done nothing medically wrong — but she needed state approval for her work. The case, the New York Times wrote, “was not unlike one against a trucker caught driving without a license.” As prosecutor R. Kent Apsley told the paper, “He may be doing an awfully fine job of driving his truck. But the state requires him to go through training, have his license and be subject to review.”

But what if the state won’t recognize the training or grant a license? 

Catlin is a skilled, respected, credentialed midwife. She serves a rural, underserved, uninsured population. She’s everything the state would want in a care provider. But owing to a decades-old political fight over who can be licensed as a midwife, she’s breaking the law.  Read more…