Thursday, July 24, 2008

The Amish defend midwife Diane Goslin

The Christian Science Monitor recently published a story, Laboring To Save Home Birth, about a midwife who serves the Pennsylvania Amish and the political battles over her right to practice.

What surprised me the most was how many births the midwife attends each year: 200 to 300. Most home birth midwives limit their practice to around 40 or 50 births per year. This is in part due to the relative scarcity of midwives, which means they spend a lot of their time traveling to and from their clients' houses. I wonder how she manages such a large load. I have read the the Amish generally do a lot less prenatal care, which would definitely cut down on the midwife's time demands. Her practice is 65% Amish.

A few paragraphs from the article:
Midwife Diane Goslin’s farmhouse office bustles with activity this summer morning. Horse drawn buggies line the driveway, while pregnant women line the waiting room inside – their hair tucked into bonnets, their dark dresses covered by black aprons.

A mother expecting her 11th child arrives with her daughter, who is expecting her first. Women do mending as toddlers scoot around their ankles. Childhood friends reunite, chattering in Pennsylvania Dutch. Sisters shriek with laughter at the unexpected sight of their expectant aunt.

Outside, on the porch – in a waiting room of his own – a lone, straw-hatted man rocks, amused, pretending not to overhear the women.

The Amish here in Lancaster County may go to the hospital if they break an arm or need surgery, but when it’s time to give birth they stay home. Usually, they deliver their babies with the aid of a midwife, and the women in this waiting room half-joke that if Ms. Goslin goes out of business, they are through with childbearing.
Read the rest of the story...

11 comments:

  1. Now Rixa you know I am not a huge fan of homebirth. But I am a huge fan of civil liberties. I agree that woman should have the choice. Also there are some places like Nantucket Island where you probably are not doing much better in the hospital than at home. I spoke with a Lay Midwife who works Nantucket and she was very knowledgeable.

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  2. There are about a dozen nurse-midwives attending home births in Lancaster County, just FYI. Few CNMs or CPMs in PA support Goslin, because she allegedly pretty much refuses to go to the hospital for anything -- twins, breeches, mothers pushing five hours, etc. There are rumors of a lot of bad outcomes. That said, I support EVERY woman's right to choose her care provider no matter what.

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  3. mommandoula:

    rumors are generally unfounded though. Just because she doesn't transfer after mom pushes for 5 hours, or for breech, or multiples, doesn't mean that her outcome is going to be bad. There are mothers who have these sort of situations and birth ALONE! It's not impossible. I am personally looking at a twin UC this time around (I'll know for sure next week after I see my midwife friend.) Charges wouldn't be dropped and she wouldn't be serving the community the way she does if her outcomes were so bad. The point is that she is NOT a nurse midwife and the people she serves still trust her experience and knowledge despite the state mandate that she not "practice medicine" (pshaw...it's NOT medicine...) and no one has been able to say she has done a bad job, been negligent, etc. so they haven't been able to take away her from the community.

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  4. oh! womon in the woods is me, Tasha, btw, Rixa....I forgot I was signed in under that email addy...lol!

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  5. Tasha...soooo, you're pregnant if I read your comment right? So happy for you!

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  6. i enjoyed this article. made me want to be in that waiting room!

    as far as the not going to the hospital, perhaps it is the mothers who wish not to transfer. there are people in the world who want nature to take its course, whatever course that may be. i doubt that i am one of them (havent been in such a situation really) but i respect those who are.

    i would love to meet a midwife who would truly listen to the mother, overcoming her own fears & prejudices. much like the 'husband epidural' there is the 'midwife transfer'.

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  7. I know about the Goslin case, but I haven't been following it too closely. I can't speak to her character or vouch for the safety of her practice. But mommandoula... 'rumors of bad outcomes'? What good is it to repeat unsubstantiated rumors about a midwife who is charged simply for practicing without license, something that can happen to any CPM in PA, and with the same breath declare that you support every woman's right to choose her care provider no matter what? I am pretty sure you're not saying let those plain women choose the midwife you just accused of being dangerous. I am hoping you're not implying that Goslin had it coming to her, with all those higher risk births, she was bound to have bad outcomes and/or get investigated. That is not a good strategy for supporters of birth choices... If you can back up your rumors, that might be important information to share... Otherwise, I can't see how it helps anyone involved?

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  8. Rixa,

    yep yep. 22 weeks tomorrow. my Iowa midwife friend is going to palpate me next week at a Pagan festival we both go to to see if she thinks I am carrying 2 babies! YAY! I am a lot bigger than I have been in the past for 22 weeks here is my flickr:

    http://www.flickr.com/photos/gaiasrose/

    tell me what you think....

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  9. This tool looks as though it will be perfect. Thanks so much for the suggestion!

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  10. I just want to say that as a client of Diane and her practice, she is extremely safe and will go to the hospital if need be. We discovered I had a clotting issue and while she gave me some very good ways to bring up my platelet numbers, she told me if they weren't up by the time I was in labour, I couldn't stay home. She is all about safety. She listens to her clients and does her very best to give them what they want.

    And many people do support her. She has personal relationships with doctors at hospitals in case someone needs to transfer. These doctors know the situation and realize that these women want to birth at home. I went for a consult with one - after discovering my platelet problem - and she was extremely understanding of my situation and my desire to be home. She fully supported me and all of Diane's other clients who go there for consults. So she has plenty of supporters in the medical community as well as the general public.

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