My midwife is not a criminal

Yesterday, which just happened to be the International Day of the Midwife, midwife Karen Carr plead guilty to community endangerment and practicing medicine without a license, avoiding jailtime and a charge of involuntary manslaughter for attending a birth in Virginia. More than 50 supporters stood behind her in the courtroom on Wednesday, many of them wearing the babies that Karen caught in her trusted and experienced hands.

Those hands also caught one of my babies. My son Carter was born in 2007 in my little house in Washington, DC, as the morning sun shone into the window. Karen had been with me all night, and as dawn broke she was frantically calling other clients to rearrange appointments—I’d wave my arms and she’d put the phone down and come to my side, then return to the phone when my contraction ended. I was a first-time mom, shocked and terrified at the intensity of labor, and she guided me through the journey with grace and kindness.

Me and my baby boy September 12, 2007.
Karen Carr was my midwife when I was left out in the cold by DC licensing rules.

So this is personal for me. Washington, DC, licenses only Certified Nurse Midwives (CNMs) to attend births at home. Due to a series of events during my pregnancy, my original midwife was not able to attend my birth, and I was left at 6 months pregnant without a birth attendant. I’d heard about Karen through the grapevine and drove up to Baltimore to meet her. I’ll be honest—I’ve always been one to follow rules, and I was nervous about Karen, who is a CPM, attending my birth illegally in DC. But I knew a homebirth was a smart and educated decision for me, and I knew Karen had the experience to help me along my path.

She didn’t flinch at the idea of being unlicensed in DC. She’d attended hundreds of births in DC, Maryland, Virginia, and Pennsylvania, often serving women who were risked out of natural birth options in birth centers and hospitals (such as twins, VBACs, and breech births). Quite simply, she went where families needed her.

Very tragically, one of those families lost a baby. And the state of Virginia charged Karen with involuntary manslaughter and child endangerment, with a possible prison term of 30 years. Yesterday she plead the charges down, and will not serve any jail time. She still faces proceedings for a Cease and Desist order in DC, but the nightmare in Virginia is over. She will not practice again in Virginia.

This is all very complicated. It’s sparked a renewed debate about the safety of homebirth, the education and licensing of midwives, and how women should approach childbirth. I’ve struggled at finding ways to talk about this case to friends and family who are not active in the natural birth world; “Why didn’t she just get licensed?” they ask, or “If the baby was breech, why didn’t the mother just go to the hospital?”

Part of me just wants to scream and shake my fists, while the rest of me knows that if I want to spread a message that women have the right to make their own healthcare decisions, and that certifying midwives may not be the answer we seek, I have to take a breath and have these conversations, as difficult as they can be.

At Karen’s hearing, the prosecutor implied that the mother in this case—whose baby was breech—did not have the right to birth at home, given her status as high-risk. This kind of language certainly raises alarm bells, and tells us that we need to keep paying attention to these issues, because they are not going away.

Andrea Kimball (whose baby is pictured above) writes of Karen: "Each day as I cared for the four beautiful children she helped into this world, she was constantly in my thoughts. Her care for me, her compassion, her wisdom, her sacrifices ... so that I could have the choice to birth in the way I knew to be best, in the place I knew to best, and with the people I knew to be best. I would trust Karen with my life and the life of my children."
Photo by Emily Sopha

For more information about Karen’s case, visit In Service to Women. Founded by some of Karen’s supporters, In Service to Women set up a legal defense fund for Karen and other midwives facing prosecution. You can donate to this important organization and follow them on Facebook. 

And Karen, if you read this as the dust settles—Thank you. Your care and support has empowered me as a person, a woman, and a mother. For the gifts you gave to me, and hundreds of others, thank you.

-Sarah, SQUAT Editor