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Catonsville Midwife Awaits Final Hearing on License

License suspension comes as home births are on the rise in Maryland.

A well-known Catonsville midwife is awaiting a final ruling from the Maryland Board of Nursing to find out if her license to practice in Maryland will be revoked.

Patricia Noble, executive director of the Board of Nursing, said the board has not made a final ruling but said the date of midwife Evelyn Muhlhan's hearing is not public.

Muhlhan's license by the Board of Nursing in October after several complaints were filed with the board. Her supporters have argued that none of the complaints were made by clients but instead by health professionals. The original investigation document is attached to this article.

Muhlhan runs Alternative Birth Choices, a Catonsville-based practice that provides midwife, doula and OBGYN services to expectant mothers. She has been performing home births for 30 years.

The investigation by the board comes as home births are on the rise in Maryland and also at a time when several advocacy groups are pushing for expansion in the number of midwives licensed to provide home births in the state.

According to an article from Maryland Reporter, the number has increased from 291 in 2001 to 409 in 2010.

The state Department of Mental Health and Hygiene said that despite the increase, home births still account for less than 1 percent of births in Maryland.

The department has issued a joint statement on planned home births in Maryland endorsing the following practices:

  • A pregnant woman considering a home birth should consult with a licensed physician or certified nurse midwife to determine if she is a good candidate for home birth.
  • All planned home births should be attended by a licensed physician or a license certified nurse midwife.
  • It is illegal for a physician or midwife to practice without a license in Maryland.

The Board of Nursing has 208 licensed certified nurse midwives in Maryland out of more than 300,000 licenses in Maryland, Noble said.

At least one home birth advocacy group is advocating for another level of midwifery to be made legal in Maryland.

Maryland Families for Safe Birth is advocating for the approval of a certified professional midwife, which is a type of certification in many other states.

President Jeremy Galvan declined to comment specifically on Muhlhan's case. He said there is a need for midwives who do homebirths in Maryland.

"As many as 50 women who planned to have a home birth now have to make alternative arrangements last minute," he said, with the suspension of her license.

While the number of certified nurse midwives is high, the number who will perform a birth at home is much smaller, Galvan said.

"Clearly the nurse midwives are not interested in providing home birth services," he said.

He said his organization is concerned with allowing women more choices in the way births progress that he said they have in hospitals.

In the case of Muhlhan, complaints stemmed from births where there were complications and the mother and baby were delivered to the hospital.

The board said that Muhlhan was not approved to deliver babies outside of her practice and she was also practicing without a backup physician. In the investigation, Muhlhan said that she did not have such a physician, though it is required.

Hospitals need to make an effort to partner more with midwives, Galvan said.

Erin Wright, a certified nurse midwife and chairwoman of the Maryland Chapter of the American College of Nurse-Midwives, is one of those midwives who works in a hospital.

Wright said regulations that require a collaborative plan and a backup plan have only been in place since 2010 and are a marked improvement over previous regulations, which allowed less autonomy for midwives.

Wright practices at the University of Maryland Medical Center and said that 96 percent of nurse midwives nationwide deliver in hospitals.

She said homebirths can be great for families, if the mother is a low-risk candidate. The new regulations allow for a collaborative practice between doctors and midwives, she said.

"I think it's great if women are choosing this and they are appropriate candidates," she said.

Danielle Koontz January 12, 2012 at 12:29 PM
Penny thank you for continuing this conversation. I am anxious to see what the new year brings for women's birthing choices in Maryland.
Charity January 12, 2012 at 05:27 PM
I am one of the 50 women Evelyn was forced to abandon when her license was suddenly suspended w/o due process for an undetermined amount of time. I was 36 weeks pregnant & forced to scramble to find a new midwife; an OB practice wont accept anyone that late in the pregnancy; not that I wanted one. An otherwise perfectly smooth & complication free pregnancy was suddenly full of a high-level of stress that was unnecessary, unhealthy, & dangerous for me & my baby! The MD Board of Nurses are hipocrites who are being pressured by drs & hospitals fearing what the aforementioned increase in number of home births means for their bottom lines. Abandonment is also an illegal practice for health care practitioners but it seems they're willing overlook that to accommodate their witch hunt. The article also states, none of the complaints were made by patients; they were made by health care "professionals" who aren't willing to lose all that precious revenue as informed women/consumers exercise their right to explore other options & are not willing to patronize hospitals & OB practices who systematically perform inductions & cesareans for their own convenience. Transporting to the hospital during a home birth, demonstrates a midwife who knows the scope of her practice & is responsibly doing what is best for mom & baby. Unforseeable events happen in hospital births everyday! Clearly there is underlying motive for this investigation by her "peers;" none of whom are midwives.
Penny Riordan January 12, 2012 at 05:44 PM
Charity, thanks for commenting. I hope everything worked out for your birth. In case you didn't see, the attached PDF in the article (the second one), is the entire document from the Board of Nursing that outlines all the complaints.
Leimarie March 14, 2012 at 03:44 PM
[The MD Board of Nurses are hipocrites who are being pressured by drs & hospitals fearing what the aforementioned increase in number of home births means for their bottom lines. Abandonment is also an illegal practice for health care practitioners but it seems they're willing overlook that to accommodate their witch hunt. ] This couldn't be more false. Due to the exptremely low number of people that actually seek and look for the home birth option it is not even a "drop in the bucket" against their "bottom line". Believe it or not the bottom line is not the motivation saving moms and babies is. They've cleaned up enough "failed" home births to take notice. [Unforseeable events happen in hospital births everyday!] You're very right, and there are other experts available immediately to assist. That is not the case in a home birth situation, when every minute counts.
SirDen September 21, 2012 at 11:36 AM
Charity, having to change provider is not dangerous; being cared for at home by an incompetent, irresponsible care provider can, however, be extremely dangerous, and has, in the case of EM, resulted in at least one tragic (and avoidable) baby death, a severely brain damaged baby (again, avoidable), and traumatised mothers whose lives were also put at high risk. Thank goodness that doctors (who have to pick up the pieces when, due to incompetence and dangerous practices) have the courage to speak up for babies and their mothers; sadly, victims of dangerous practicians are often brainwashed into compliance and forced to support their midwife regardless of what horrors she has perpetrated upon them. Have you read the document that sets out the allegations against EM? Her licence was not suspended without due process; on the contrary, the terrible risks she posed to the public demanded immediate suspension. The board's action shows the immediacy of the danger to other pregnant women. Thank your lucky stars you had to find another provider, Charity!
SirDen September 21, 2012 at 11:40 AM
Why are homebirth advocates so hell-bent on defending dangerously incompetent midwives? If a car mechanic, due to carry out repairs on your car, was suspended due to grave incompetence and allegations of terrible injuries inflicted on innocent drivers and their child passengers, would people still feel aggrieved at being told to find a different mechanic? Would they see conspiracies everywhere, aimed at stamping out car mechanics in the community? Conspiracies to force all drivers to use large, centralised repair garages and remove freedom of choice? Why are people not grateful that the Board has taken appropriate action to REDUCE RISKS OF DEATH OR HORRIBLE INJURIES?? Aargh!!
erica thompson January 22, 2013 at 10:25 PM
Evelyn is an amazing midwife. She attended my 2010 homebirth and gave hme the compassionate care and attention I never received during my previous hospital births. I am just heartbroken that she is going through this. More women die in hospital births than anywhere else! Evelyn gave me the normal and beautiful birth I always dreamed of. We are behind you, Evelyn!
SirDen January 24, 2013 at 08:58 PM
So the mothers whose babies died due to EM's incompetence should just go, oh right, another woman was lucky enough to have a live, healthy baby (not because EM is anything but a menace and a disaster waiting to happen, but because she happened to have an uncomplicated birth), so we should just shut up and move on? How many preventable deaths must happen before these blinkered NCB fanatics wake up from to reality and stop supporting killer midwives? Have you no compassion for those whose babies are dead or brain damaged? In whose value system is it ok for incompetent midwives to cause needless death and suffering? And mothers hardly ever die in our hospitals; baby deaths are also very unusual, and term babies hardly ever die, except at the hands of midwives who are worse than useless.

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