Yates County Public Health officials say 151 of the 319 babies born to Yates County residents during 2017 were born to Mennonite families. Many of those babies were likely born in their family homes, and it’s highly likely under the watch of Elizabeth Catlin — the woman facing criminal charges for practicing midwifery without the education and training required by New York State. Neither the New York State Police Investigator nor the New York State Education Department Investigator will provide details about the investigation or the source that led them to levy the charges against Catlin, a Certified Professional Midwife, a status recognized in up to 30 other states.
More women who have used Catlin’s services have spoken out to protest action taken by the investigators who took Catlin into custody in November. Their voices have been joined by Ivan Martin, a patriarch in the Mennonite community who moved to Yates County in 1977, and has helped others in the area understand the Mennonite culture.
Speaking out so forcefully and publicly about an issue is uncommon for Mennonite women, and Martin says while the Mennonite culture has a biblical injunction to not sue over disputes, they would certainly plead their case if given an opportunity to speak to elected representatives.
Martin stresses the practice of using a birth assistant for in-home births is not a religious matter, but it is a cultural matter. The father of 13 children — 12 which were born in the family home, and three of those delivered in home by a medical doctor — says women are more comfortable being cared for by a woman in their own home, rather than a birthing center or hospital, perhaps by a man.
“It’s not as though we just invented a really high risk procedure,” says Martin, later adding, “I don’t believe the medical establishments are evil, but medical professionals are also being victimized by the state.”
Kate T Finn, MS, LM, a midwife whose practice is based in the Ithaca area, says there are not enough N.Y.S. licensed midwives to provide the specialized care in a home setting statewide. She says she knows of one or two who practice in homes between Ithaca and Rochester, and the cost of traveling from her area to serve women in Yates County makes that option infeasible.
Wayne Strouse M.D., who practices Family Medicine in Penn Yan, offers his perspective in a letter to the editor on page 4. He says nurse midwives play a vital role in providing quality obstetrical care and the state’s obligation is to ensure that they have been properly trained, are competent, and have kept up their skills by continuing their education.
“No one is saying that home delivery should not be allowed, or that nurse midwives should not be allowed to practice their craft,” he writes, later adding that the state’s obligation is to ensure that all pregnant women have competent care, not just the ones who are having routine, normal deliveries.
All of the women who have sent letters to the editor in support of Catlin and in-home birthing have said they want to have all their babies in their homes. At least one of the women is currently pregnant, and she’s unsure what options she and her family might have in the coming months. They all said they would want to have Catlin assist with their delivery.
While there are roughly 700 Mennonite families in Yates County, and the ratio of births here continues to tip toward a majority of Mennonites, no facility within the county is equipped for maternity services, even if the women were receptive to having babies outside the home. Infant mortality rates show Yates County is tied for the second lowest infant mortality rate in the Rochester region. Wyoming County’s rate is 2.5.
The closest facilities are F.F. Thompson Hospital in Canandaigua, Newark Wayne Hospital in Newark, Cayuga Health System in Ithaca, and Arnot Medical Center in Elmira.
Licensed Midwives are on the staff of each of those facilities, but their services are limited to their offices and birthing centers.
In an attempt to shed more light on the availability of licensed professionals, The Chronicle-Express requested a listing of Licensed Nurse Midwives from the State Education Department on Nov. 28, but a reply to the Freedom of Information request will not be available until about Jan. 2 according to an email received Dec. 3.
Yates County Public Health Director Deb Minor, R.N. MPN, sees no short term solution that will satisfy the state officials, medical professionals who have raised concerns, and the families seeking in-home delivery support unless a N.Y.S. licensed midwife who will perform in-home deliveries can be recruited to move to the area.
Minor says the Public Health Department does not provide pre-natal care, but they can help individuals find a provider. She adds, “As a public health professional, I can’t advocate for someone who is unlicensed.”
Finn says the solution should be up to the local Mennonite community. “They have a wisdom in their community.”
She recommends the community make the determination about their care and the legal structure should be built to support that. “The alternative is less access to care,” she says.
Martin feels the safest way to resolve the situation would be for New York State officials to modify their stance with some kind of cultural exemption that would allow Catlin or others with similar education and experience to serve clients in their homes without penalty.