Pregnancy

Utah midwife gets jail in death of premature twin

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A Utah midwife convicted in the death of a premature twin baby marks a rare criminal case that comes as out-of-hospital births grow in popularity in the U.S. and more states move to license midwives.

Vickie Sorensen, 57, was sentenced to six months in jail Tuesday for manslaughter by a judge who called it one of the most difficult cases he'd ever presided over.

Prosecutors said the lay midwife in southern Utah had reassured the parents that she could deliver the twins safely at a birth center in 2012, but when one baby was born purple and unable to breathe she tried to treat him with outdated techniques and too-large equipment rather than going to the hospital right away.

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Sorensen, though, told the judge that she'd delivered thousands of healthy babies, including twins, safely over the years, but she didn't initially think the woman was in labor and snowy roads later kept her from reaching the hospital, the Spectrum newspaper in St. George reported. The courtroom was packed with about 40 people who came to support the Cedar City woman who was also ordered never to practice as a midwife again.

The charged case comes as a growing number of people around the country choose have babies at home or in a birthing center rather than a hospital.

The rate of out-of-hospital births nationwide grew 29 percent between 2004 and 2009, according to the Centers for Disease Control and Prevention. In Utah, it doubled between 1990 and 2012.

Parents often appreciate a less clinical setting, and movies like Ricki Lake's "The Business of Being Born" have helped raise awareness of the rate of cesarean sections in U.S. hospitals among other things, said Lisa Kane Low, president of the American College of Nurse Midwives.

Home births, though, can carry slightly elevated risks for women who have higher-risk pregnancies, like twins or breech babies, Low said. Many of those mothers deliver at hospitals where they can get specialized care. Still, the vast majority of home births go well, Low said.

When cases are filed against midwives, many end with a plea deal rather than a trial.

Criminal cases against health care workers in general are rare, said Kelly Dineen, an assistant professor at St. Louis University School of Law who studies bioethics and health law. When doctors face malpractice allegations, for example, the first stop might be a licensure board rather than a criminal investigation. But midwives are different.

"The reason manslaughter charges become the route to pursue is you don't have licensure," Low said. Utah has a licensure program, but it isn't required to practice.

Nationally, there are different types of midwives, ranging from certified nurses with advanced degrees who deliver at hospitals to lay midwives, some of whom have no formal training but years of experience — a range that can be confusing for women sorting through options for prenatal care and childbirth.

Though the increasing moves toward regulating the professional have sparked debate as some midwives worry that rules could limit access to care more than half of states have licensure systems most others have some effort underway, according to the nonprofit Big Push for Midwives.