Lesson #3 - Legality of Midwifery: Difficult Choices for Midwives
For more information, please read the document titled, The History and Legalities of Midwifery in Alabama.
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If an independent
midwife attends a family at their birth in Alabama, she is at risk
of being charged with practicing nurse-midwifery without a license
due to the judicial precedent that was established in Toni Kimpel’s
case and reaffirmed against Karen Brock. Conviction carries with it
a Class C misdemeanor, including a fine and possible jail time.
According to judicial precedent, it does not matter if the midwife
is compensated for her services; if she is performing actions that
are within the legal scope of nurse-midwifery according to the Code
of Alabama, it is possible that she could be prosecuted.
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The reality in
Alabama is that a midwife is usually only prosecuted if she
provides continuity-of-care when a transfer to a hospital is
required, or if there is a difficult outcome involving the
well-being of mother or infant. Due to medicolegal concerns, it is
difficult for most physicians to form collaborative relationships
with out-of-hospital care providers. Infrequently, a midwife has
been able to secure a positive relationship with a physician within
her community. It is because midwives value continuity-of-care that
ALMA is actively seeking legalization for midwifery in Alabama.
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Each midwife in
Alabama must decide the scope of her midwifery practice in light of
the current legal situation. Some midwives choose to obtain
out-of-state licensure and their clients plan to birth across state
lines. Other midwives choose to continue attending births in their
communities within Alabama. ALMA respects each midwife’s choice
while encouraging all midwives to be open and accountable to both
the families they serve and to one another.
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