HARRISBURG - In a case that touched on whether women have the right to give birth where and with whom they want, a Commonwealth Court panel of judges ruled yesterday that a Lancaster County midwife could resume her work delivering babies for the Amish.
Diane Goslin, 50, had been under a cease-and-desist order from the Pennsylvania State Board of Medicine, which had charged her with practicing medicine and midwifery without a license.
But the Commonwealth Court panel, in a 5-2 decision, nixed that order yesterday.
"I am very excited," Goslin, from New Providence, said shortly after she learned of the decision. "This is such an encouraging day of victory for women and families."
The state had charged Goslin because she is not a nurse-midwife, that is, someone with a nursing degree who specializes in childbirth. State officials have argued that in Pennsylvania, a woman must be a nurse-midwife to practice midwifery.
Goslin is not a nurse-midwife. She is a certified professional midwife, having obtained certification through the North American Registry of Midwives 12 years ago. Twenty-two states, including New Jersey, recognize the certification in their licensing and regulatory requirements.
"Our only interest in this is to make sure that those providing care to the people of Pennsylvania are licensed, know what they're doing, and do so safely," said Gerald Smith, senior counsel for Department of State, which is the administrative agency for the state's Board of Medicine.
Smith yesterday said the state has not decided yet whether to appeal the decision to the state Supreme Court. That could affect whether Goslin can immediately return to her midwifery practice.
In their decision, the Commonwealth Court judges found that the medical board incorrectly concluded that Goslin was practicing medicine as part of her midwife duties.
But it did not address the more fundamental question of whether it is necessary to be a nurse-midwife in order to practice midwifery in Pennsylvania.
The state maintains it is necessary.
Goslin's attorney, James J. Kutz, had argued that although state law licenses nurse-midwives and permits them to perform diagnoses and dispense drugs, it still allows "conventional" midwives to carry out functions associated with the natural development of childbirth. Those include ensuring labor progresses normally and "catching" a baby when it is born.
Yesterday, Kutz said he believes the court left the door open to allowing for two classes of midwives, including non-nurse midwives.
"Is my client's education adequate," for her to practice as a non-nurse midwife, Kutz asked. "We believe it is."
Goslin has attracted an array of allies - including Amish families and advocates of home-birthing - who believe her case is fundamentally about whether a woman has the right to give birth where she wants, attended by whom she wants.
Goslin, who is not Amish or Mennonite, delivered babies mostly to women in Lancaster County's "plain" communities, where home birth is a tradition closely tied to their religious beliefs.
She believes women should have the ability to give birth at home, without drugs, surrounded by family and friends.
(Some nurse-midwives do attend home births, although the majority work in hospitals. Because they collaborate with obstetricians, they are subject to restrictions, many dictated by malpractice concerns.)
Goslin's supporters had argued that all women, Amish or not, should be able to give birth at home, attended to by the person of their choice.
"This is about respecting women's choices," said Jody Ward, cofounder of
, a Web site dedicated to home birth and its benefits. "And if that choice is to birth quietly at home, they should be able to do that."