Certified Professional Midwives (CPMs) can’t get licenses in Pennsylvania, but they thought they were protected from prosecution by a sort of legal grey area. A recent fine levied against Diane Goslin, a CPM who served a mostly-Amish clientelle, suggests that the state belongs on the list with 11 others where home-birth midwives are criminalized.

Goslin, who had practiced for 25 years and became a CPM in 1998, was fined $11,000 by the state board of medicine last week and ordered to “cease and desist” attending women in childbirth. The board told Goslin that she was practicing midwifery without a license and practicing medicine without a license. “Her violations of the law are grave because her conduct puts women and their newborn infants at risk,” the board said in its ruling. (Read this AP story for more details.)

There is no evidence that it is less safe to be attended by a CPM at home if you are an otherwise healthy women expecting an uncomplicated delivery, while there is evidence that having such care is more likely to result in a normal, vaginal delivery. The medical board displayed no awareness of this evidence, particularly when it said, “The harm that unlicensed unqualified persons can do to people who they purport to care for is obvious.”