POV

[ Insects chirping ] [ Insects continue chirping ] [ Gentle music plays ] [ Cattle mooing ] [ Goats bleating ] [ Gentle music continues ] [ Washing line whirring ] -Hello.

-Good morning.

-How has Lily been?

-Oh, she's doing well.

-Any concerns?

-Not other than her spitting up.

She still spits up a lot.

-Hey, baby girl.

How are you doing?

Aw.

[ Lily cries ] Hi, pumpkin.

Can I take a look at you?

Lily.

Are you feeling ticklish?

Your belly feels nice and soft.

[ Gentle music plays ] -The U.S.

maternal mortality rate continues to steadily increase.

This new report found 36% of U.S.

counties are maternity-care deserts, places with no OB/GYN doctors, hospitals providing obstetric care, birth centers, or certified nurse-midwives.

These figures have worsened over the past two years, with the number of maternity care deserts increasing.

-Oh, today is baby day.

I... [ Chuckles ] Working on number three for today, so... -Oh.

[ Laughs ] Full moon, you know?

So... Okay.

[ Phone ringing ] -Hi.

-Yes, this is Joe calling, and she wasn't sure if you were at home.

-No.

Well, you'll probably beat me down there.

-Alrighty.

Probably be ready when you get there, the way it looks.

-Oh, boy.

Okay.

Bye.

-Bye.

-[Bleep] [ Dramatic music plays ] All right.

They're already inside.

[ Dramatic music plays ] [ Car door slams ] [ Birthing parent moans ] I'm here.

I need -- Oh, okay.

Maybe I can just check and see what's going on real quick.

-The water just broke.

It's gonna come.

-Okay.

All right.

Go ahead.

[ Birthing parent moaning ] Breathe into that pressure.

[ Birthing parent groans ] That's it.

[ Birthing parent groans ] There you go.

[ Chuckles ] There.

You got a little boy.

[ Baby crying ] -Thank God you came.

[ Melissa laughing ] [ Baby crying ] [ Siren wailing in distance ] -A Penn Yan woman is in jail for illegally working as a midwife.

53-year-old Elizabeth Catlin is accused of unauthorized practice of the profession.

-We heard a very loud pounding on the door.

[ Door banging ] I just opened the door, and he flashed a badge, and he slapped the cuffs on.

[ Cuffs clack ] -The first thing I thought was, "Wow.

They're actually arresting a midwife for helping people have babies?"

[ Siren wailing ] -"Why are you doing this?"

There's not enough midwives.

And then the ones we do have, what?

Let's arrest 'em?

[ Siren wailing ] [ Indistinct conversations ] -Hi, Liz.

-When Liz was arrested, it actually made me feel angry.

It was a shock.

For her to be treated that way, it was very hard for me to accept.

Everybody loved her, and she was such a good midwife.

-Thank you.

-Praying for you.

-Thank you.

-Case number two on the calendar -- The People vs.

Elizabeth Catlin.

-I believe I've delivered close to 500.

I was at 480-something before I was arrested.

[ Cart rattling ] [ Buggy rattling ] [ Parent chuckles ] [ Parent speaking in Pennsylvania Dutch ] -There you go.

[ Community member speaking in Pennsylvania Dutch ] ] [ Parent speaking in Pennsylvania Dutch [ Community members chattering ] -Hello, young man.

No?

[ Laughs ] Hi, sweetheart.

[ Tongue clicking ] [ Elizabeth laughs ] [ Parent speaking in Pennsylvania Dutch ] -Thank you for coming to the basket auction.

As you know, we are coming together to help raise money for Liz's legal fees.

And for all the people that didn't bring money, after you go home, you can send your money to Liz.

[ Community members chattering ] -I just saw this other one.

"My other name is Mom."

-Uh-huh.

[ Community members laughing and chattering ] -How are you doing?

-Good.

I'm -- -Good.

You -- -I'm pregnant again.

-You are?!

-Yes!

-Congratulations.

So -- -You're not doing any births.

-Not yet.

Not now.

I can't.

-I know.

-Sorry.

Who are you getting?

-Oh, nobody yet, but... [ Laughs ] -Being a midwife definitely is a calling.

The mother reaches down, pulls the baby to her, and that's just, that's just amazing.

There's no other feeling like it, to know that I was part of that process.

Oh, my word.

Look at you.

[ Clicking tongue ] [ Kisses smacking ] Once I became a home-birth midwife, I started getting calls.

And I'll never forget the first time I got a call from a Mennonite woman.

She asked if I was available to attend her next birth.

And then more women started calling, and they kept calling.

-It's been a shock for your community to all those ladies that were already pregnant and didn't know how it was gonna go or what was gonna happen, or how they were gonna -- where they were going to be or who could be with them.

That's -- that's hard.

-Yeah.

Uh-huh.

-When Liz was arrested and she had to stop practicing, I was retired, but I was able to say, "I'll come and do some births," when there were people falling through the cracks.

-You know, the people had been talking about you, that you filled in, and I said, "Oh, I never met you, so..." -It's very hard for the Mennonite families to accept that they don't have the right to have Liz.

-Hey, girls, look this way.

Children.

[ Laughs ] -Children!

-Babies!

-She evolved in this community as a midwife, and she provided what they were looking for.

[ Gentle music plays ] [ Hooves clopping ] -The Mennonites say... [ Speaks in Pennsylvania Dutch ] ...which means "staying apart from the world."

We drive horse and buggy.

We don't have a lot of technology.

We're friendly with everybody, but we stay in our own cultures, our own homes, and our own churches, our own small world.

[ Alma speaking in Pennsylvania Dutch ] The most important work that we have to do in our life is raising our children, even if some days you wish you wouldn't have 'em.

[ Laughs ] [ Alma chuffing ] Home birth is just another thing that has been passed down from generation to generation.

My mom did it, my grandma did it, my aunts did it, my cousins did it.

Everybody just had their babies at home, and all of a sudden we're not being allowed to have a midwife of our choice.

-The Mennonite community have been just wonderful.

I've been receiving cards and letters daily.

[ Letterbox squeaks ] But, emotionally, it's been hard.

I did sell my house to pay my attorney.

[ Paper rustling ] "We all know you're not guilty of those things they blamed you with.

We all know you did all you could for us.

Don't give up, Liz.

Sometimes the darkest hour is just before dawn."

[ Pensive music plays ] I got a call from my attorney, and he said the grand jury had convened.

"They've indicted you on 95 felony counts.

They are charging you with the death of that baby," and I just... I couldn't believe it.

-Your name Elizabeth Catlin?

-Yes.

-Court notes your charges, 95 counts.

Count one, criminally negligent homicide in the County of Yates.

The defendant caused the death of Joseph E. Martin.

Count two, the crime of unauthorized practice of the profession of midwifery.

All right, Ms.

Catlin, court now inquires, how do you plead to the charges set forth in the indictment?

Guilty or not guilty?

-Not guilty.

-So noted.

Mr.

Casella, as the district attorney, have you done all that is required to bring this case to a point where it may be tried?

-Yes, sir.

-All rise.

Remain in place till court convenes.

-It'll be a complex jury trial 'cause the jury's gonna have to analyze all the evidence and try to apply it to 95 separate charges.

Normally we have indictments one, two, three counts, four counts.

So this is an unusual set of circumstances.

Okay.

Thank you.

-Thank you.

-Have a nice day, everybody.

-Thanks.

-Well, we seem prepared.

My training is not recognized by the state, but I know I'm not guilty of the death of that baby.

[ Wind whooshing ] -Hi, everybody.

Welcome to NRP and BLSCPR today.

My name's Jennifer Nelson.

I am a midwife from the Pittsburgh, PA, area.

So, today, we are gonna work on how to resuscitate a baby that needs a little extra help transitioning from womb to world, 'cause one out of every 10 babies will.

Everybody can come on in.

Okay.

I am a VBAC mom.

I've been in labor for 36 hours.

-Oh, geez.

-Ruptured for 23.

And I've been pushing for 2 1/2 hours and I finally birthed baby's head, and we've got a big baby.

-Okay.

-Oh, here comes baby.

Melissa, can you grab the blankets here?

-Oh, I did it.

-You did it.

Go ahead, pick this leg up and sit yourself right back down here.

-Right here?

-We can do a look at baby.

-Oh, boy.

I birthed a person out of that.

-Do you want suction?

-You sure did.

Sure, yeah.

Let's get some suction.

-Hi, baby.

-We have a little meconium.

What do we got for respirations and heart rate?

-Nothing.

Nothing here.

-We have a limp, blue, floppy baby -- -Oh, we're gonna need some suction on this.

-With some bruising to their face.

-You keep talking to your baby.

-Hi, baby.

-He knows your voice.

-Hi, baby.

-Recognize there.

Let's go ahead and give him a breath.

-Hi.

-He still hasn't responded.

-Look.

-Breathe, one, two, breathe, one, two.

Come on, baby, you can do it.

What do we have here now?

Any response from baby?

-Nothing.

No changes.

-No.

Listen.

Let's take a listen.

-Thunk, thunk.

-Not very good.

Yep.

-Chest compressions?

-One and two and three, and breathe.

One, two, and three, and breathe.

-Go ahead and get a heart rate.

-Okay.

Let's check this out again.

[ Cellphone rings ] -Someone else is in labor.

-Okay, now let's try this heart rate again.

-Thunk, thunk, thunk, thunk, thunk, thunk.

-Oh, we got a good baby here, Mom.

I think you're gonna be fine.

There we go.

Now you keep this baby... -Thank you.

-...right up with you.

-Keep talking to it.

-Oh, good.

Hi, baby.

-Because we want her to stay with us.

-Hi.

-There you go.

Good job, baby.

-My goodness.

That was hard work for me, too.

-We'll keep her nice and warm.

-Oh, my.

-Yeah, it was hard work for both of us, right?

-Yeah.

Well, you guys are all doing a fantastic job at neonatal resuscitation.

Is there anything that anybody has any questions on in regards to NRP?

-Yeah, I think our biggest problem in resuscitation is not being licensed, it's being who I am and be able to tell people that come, like, if you have to call 911, do you say, "I'm a midwife?"

-Yes.

-I don't think I would.

I might say, "I'm a nurse.

I live down the road," or some stupid scenario.

-Are you in New York?

-Yes.

-We all are.

-Okay.

Okay.

-Yeah, we're all in New York.

-No, it's a terrible situation.

-So I would probably just say, "I was their birth attendant.

I'm trained in NRP.

My card is current", and, "This is the difference between NRP and CPR.

It's one breath to three compressions," and teach them, and then they're gonna be a lot less likely to throw you under the bus when they know you have more education than they have.

-I was in the closet.

I taught someone to hold on to the mom's uterus 'cause she was really bleeding and had to go.

And I was in the closet when the ambulance came.

-Wow.

-I know you've got that fear in you, though.

-Yeah.

-And even if it all goes perfectly on the scene with the ambulance people and everything and they get to the hospital and they tell them how perfectly it all went with this midwife that knew what she was doing, and they turn around and turn you in.

-Elizabeth, today we're going to officially advise the judge that you're not going to accept a negotiated offer.

-So, the deal on the table that Liz is rejecting, what was the nature of the deal?

-To plead guilty to criminally negligent homicide, unauthorized practice.

You'd have three felonies.

The alternative, obviously, if you proceed to trial, that, you know, you could theoretically be looking at much more jail time if you're convicted.

Okay?

Michael, any questions about anything?

-I'm good.

There were a number of midwives in New York who I had worked with over years, and they brought the case to my attention.

And the discussion revolved around how midwifery needed to be changed in New York.

What ended up happening was a tragic event, but Liz Catlin is a certified professional midwife.

She is someone who has gone through both the education, the testing, the on-the-job training over many years, which qualifies her to be attending women in this function.

But in New York, that's disallowed.

[ Dramatic music plays ] -Hi.

This is Elizabeth Catlin.

I'm from Penn Yan.

-Hi, I'm Nubia Martin.

I'm co-president of NYCPM.

I am a community birth worker in Yonkers.

-My name is Gayle Eckey.

I am a founding board member of NYCPM.

-My name is Carmen Mojica.

I am one of -- also one of the founding members of NYCPM.

-I'm Melissa Carmen.

I am a CPM.

And Liz being arrested, there's, like, such a sense of urgency because there's rumors going around that there's more CPMs that are being targeted.

-Hi.

My name is SeQuoia Kemp in Syracuse, New York.

People are looking for, you know, Black midwives, Black home-birth midwives, and there are none in our community.

-I'm Linda Schutt.

I'm a licensed midwife and I was on the board of midwifery for many, many years.

Over the last 30 years, what's acceptable in New York has become narrower and narrower, and we've lost a pathway for out-of-hospital midwives.

And the outcomes have gotten poorer.

-In New York, Black women are dying 8 to 12 times more.

I believe that's directly connected to the fact that we are one of the only states that does not recognize the CPM credential.

-I've seen a great exodus of midwives from New York specifically because it's really difficult to practice here.

No matter where a midwife works, we're not seen as valuable in the healthcare system.

And we keep changing the laws and we keep changing the requirements.

In the beginning, direct-entry midwife was just fine, then it became you needed to become a nurse first, then it became you have to have a master's.

How many more times are we going to increase the cost of education so that people that look like me or people within their community can't afford to become midwives?

-My job as the prosecutor, my oath that I swore is to enforce the laws.

And the law in New York says you must be a registered nurse-midwife.

The United States is a unique country in that the states are given a lot of authority to pass laws they feel are appropriate.

This isn't an insignificant event, childbirth.

It can mean the life or death of the mother and/or the child.

And the state of New York has said certain requirements are required for it, and I don't find that to be unreasonable.

[ Water running ] [ Water continues running ] -Let me grab this side, pull this down, and we'll kind a get the bed ready.

I have a feeling she'll be pushing soon.

Go ahead and fluff that one.

[ Water running ] [ Faucet squeaking ] Just nice, slow breathing.

She's doing so great.

-Can she have, like, right in the water?

-She can have right in the water, yeah.

-Really?

-Really, really.

[ Heartbeat thumping ] Baby's excited to meet you.

[ Water splashing ] Get us another one.

[ Chuckles ] [ Clara moaning ] [ Water splashing ] [ Attendant faintly speaking ] [ Clara moaning ] [ Water splashing ] -Good job.

That's the way.

[ Water splashing ] Nice and easy.

[ Clara moaning ] [ Clara deeply exhales ] Nice job, Clara.

[ Clara moaning ] Head's out.

Just keep this down.

Keep this down.

Good job.

Good job.

[ Water splashing ] There.

Hold on.

You're tangled.

-There you go.

-Yeah.

There's your baby.

[ Baby crying ] Yeah.

Great job.

[ Baby crying ] [ Baby continues crying ] What do you think you're gonna name your little boy?

-I think we might name him Leroy.

-Leroy?

Aw.

How much do you think he weighs?

Felt like 20 pounds, right?

No, not that bad.

[ Laughs ] -Not as big as I think.

[ Baby crying ] -Ooh, maybe 8.

[ Baby crying ] Eight, four.

[ Baby crying ] Yeah.

Okay.

You got your legs straight for me.

I appreciate that.

20 1/4.

[ Baby crying ] 14 1/4.

[ Baby crying ] [ Water running ] [ Baby crying ] [ Water running ] [ Water continues running ] [ Gentle music plays ] [ Lively music plays ] I'm a certified professional midwife.

I've delivered probably between 750 to 800 babies.

After I started school, they changed the rules and regulations.

The state said, "You do not have the education that we want you to have, so therefore you are not allowed to work in New York state anymore."

Knock, knock.

-Come on in.

-Oh, my goodness.

Let's see.

[ Baby crying ] How has everything been with a baby?

-Very good.

Lots of messy diapers.

-Okay.

They're probably yellow by now, right?

-Yes.

-Yeah.

Did your milk come in plenty?

-Mm-hmm.

Is it -- like, his belly right here, is it normal to be, like, bloody?

It's been -- -Oh, sure.

You can use a little just alcohol to kinda clean around.

-I've been using alcohol and the corn starch, you know, to keep it dry.

-Sure.

What drives me to do what I'm doing is there are hundreds and hundreds of women that need to be served, so what do we do?

[ Gentle music plays ] [ Buggy rattling ] -It's very pretty for summer.

A little tighter than the Liverpool pink, and it doesn't stretch quite as much.

-Yes.

-Yeah.

-Yeah.

-All set?

[ Children faintly chattering ] -Brandon, I'm gonna let you cut 'em up.

Cut them apart.

Yeah, just cut it out.

[ Child speaks in Pennsylvania Dutch ] [ Kathleen speaking in Pennsylvania Dutch ] -Tristan, you can carry all the jars over here.

[ Child speaks in Pennsylvania Dutch ] Get them out of the rack and carry them over to the table.

With having had eight, I had some scary moments, but I'm not scared of childbirth.

With my last child, she was a big baby.

And I chose to go into the hospital and do an ultrasound, and that really opened my eyes to what I had with the midwife and just the commercial type of birthing in there.

You kind of get fearful of not being in control or made to feel like you don't have any choices.

It was not for me.

[ Laughs ] Do you remember what Grandma used to do with the peaches, with the peels?

-I can put more in.

-No.

-She used to make peach pie with them.

You put the peels in a pie and eat the peels too.

[ Chuckles ] With home birth, the mother is kind of intuitive to what she feels she needs.

One each.

Can you count them?

-One, eight, four.

-And I know even the health benefits that the baby gets from being allowed to be birthed in a slow and easy way.

That stuff is really important to me.

I think we feel the medical world is kind of infringing on the edge of the community... ...with stuff that has always worked for us.

-Women have been helping women birth their babies since the beginning of time.

There was hands-on skill and knowledge that was passed on.

Many of the early midwives in this country were enslaved granny midwives, and they were the holders of that knowledge.

But in the early 1900s, with the modernization of medicine and medical schools teaching, predominantly white male, privileged individuals, birth was moved out of the home and into the hospital.

The perception that birth needed interventions took over, and there was a public campaign to discredit midwives.

Midwives were seen as undesirable, dangerous, dirty.

They were just the dog out on the doorstep.

Even today, there's a perception that the midwife has no education, no ability to help if things go wrong, but their outcomes are equal, if not better, than hospital.

However, the health business is, like any business, looking to make a profit.

There's an economic incentive for medicine to keep control of birth and to keep midwifery shut down.

We need birth in all settings.

Women should have the right to choose the type of birth that is safest and best for them.

[ Keys clacking ] -I've worked at the paper off and on since the 1980s, so for most part of 30 years.

I've never seen anyone charged with 95 felony charges in this community before.

I first heard about her arrest from the press release that the state police put out.

I was really surprised when that came across my desk.

And, frankly, I called a couple people that I knew knew Liz, and they were as shocked as I was.

I mean, why go after a midwife?

-95 felonies.

That's more than any midwife has ever been charged with in the history of the world.

It was like, "Okay, they're after us now.

They're gonna everything they can to shut down midwifery in New York state."

I'm like, "Oh, boy, I'm like one degree of separation.

It's just gonna be a matter of time before they get me."

[ Lively dramatic music plays ] -No one is saying that a woman can't choose to hire a cab and have that cabby drive her around while she's in her third trimester on her due date because she wants a cabby to deliver the baby.

The problem isn't the woman choosing who gives birth to the child.

The problem is a person hanging a shingle and advertising and providing a service who's not legally authorized to do it.

That's the problem.

-If I was unable to practice right now, the community would be in dire straits.

So we had to make a drastic move to get here to Pennsylvania, just 5 miles over the Pennsylvania-New York border, so that way, they can continue being served.

So we decided on two lights?

-We got two lights on the outside.

One down there, one up here.

-Okay.

One up here, okay.

-We're gonna change all the boxes to single boxes.

-Okay.

-I think you got some insulation you oughta change.

-Okay.

-Back here, this drywall was moist when we took it off.

-What is the most immediate thing?

Like, the electrical outlet thing?

-Yes, that's gonna be our top-shelf priority.

-I gotta try to cut costs where I can.

There's so much money I've gotta sink into this house, and it's a little overwhelming right now financially.

This has been a huge hit for us.

I've invested everything I have for this project down here.

It just weighs very, very heavy.

There's so much to do in so little time.

I'm under the gun because I guarantee the cops will be outside the door waiting for an Amish person to walk in my house, and they'll arrest me on the spot.

[ Gentle music plays ] [ ATV engine revving ] [ Sheep bleating ] -Here, chick, chick, chick, chick.

In our communities, Mennonite and Amish, I'll say plain communities, somebody's always having a baby -- [ Laughs ] -- and, oftentimes, two or three at once.

So I've probably delivered around 600 or 700 babies.

[ Chickens clucking ] Collect eggs here.

I got one chicken trying to sit.

After Melissa moved, people were frantic 'cause the community she serves now drives three hours to see her.

There was a woman who had her baby in the car.

There was people who had their babies alone, with no one there.

I just took care of a woman that said she has gone over to her neighbor, and if I'm not available, she'll do that again.

There's only so many people I can care for.

Baby's moving well for you?

-Very well.

-Very well?

Good.

Any Braxton Hicks?

-Not aggressive, but it's moving.

-Active.

Good.

That's what we like to hear.

I was a little nervous to be working in New York without a license, without being legal.

But I've always been told that even without a license, someone working as a plain-community person in their own community, people don't bother you because you are trained in your own ways.

All right.

Let's go take a listen to this baby.

So, a girl or a boy?

-Roy is very confident that it's a girl.

It just couldn't be a boy.

-Well, we have a head down there, back over here.

Feet up here in this corner.

That's good.

I guess I've always been the type of person that doesn't like to sit around and let the grass grow.

We usually stop school at eighth grade.

But I always loved school, and so I decided to get my GED.

30 centimeters.

Excellent.

And then I went to the National College of Midwifery.

That was associate's degree.

Heart rate sounds excellent, mostly in the 130s and 40s.

[ Heartbeat thumping ] That's great.

I got my CPM credential at the end of 2010, and I actually had plans to do whatever I needed to do to get the licensure, but at the time, I had six children.

With our farm, me going away to school, spending that kind of money, there was no way we could have done it.

[ Tractor engine droning ] [ Cart rattling ] [ Birds chirping ] [ Calm music plays ] [ Lawn mower droning ] [ Birds chirping ] [ Paper rustling ] -The children came out and helped me move.

I sure couldn't have done it without them.

All these memories.

I have 14 children.

The oldest is 35, the youngest is 9.

My daughter Grace thought she was Mennonite when she was growing up.

She was really ripped off when she found out we weren't Mennonite.

[ Chuckles ] This is Grace.

She's expecting her third.

She's just not even a week from delivery in this picture.

This is my, I think, 19th grandchild.

[ Reflective music plays ] There he is.

[ Laughs ] When my daughter started getting married, they said, "You know, Mom, we're gonna want you to catch our babies."

I've caught all my grandchildren, and now I have another one due.

I can't do it.

The judge told me I couldn't do anything medical to a pregnant woman or a newborn.

I still feel called to help these women.

But I'm 54 years old right now.

If I were convicted, I would be 94 years old before I got out.

I don't think about spending 40 years in jail.

I mean, it's a possibility, but I can't take myself there.

I think I'd sink.

Good morning.

[ Congregation chattering ] [ Congregation continues chattering ] If I have to go through this for the truth to come out, I just pray something good comes out of it.

-You wanna turn your Bibles to Matthew 5?

"Blessed are the poor in spirit, for theirs is the kingdom of God, the kingdom of heaven.

Blessed are those who mourn, for they shall be comforted."

-I do not believe I am guilty.

When I think back on it, I wouldn't have done anything differently.

[ Suspenseful music plays ] I got a call at about 9:30 in the morning, and Wilma said that her water had broke early that morning.

I went over to check on her.

She didn't have really much going on, and so I left.

She tried to sleep.

I went back the next morning, and by the time I got there, she was in labor.

So I just took her vitals.

Everything looked fine.

And I had her try pushing.

And when she would push, the baby's heart rate would go up.

We had tried that a couple different times.

Every time, the heart rate would go up.

And I said, "It's time to go in.

We need to get this baby born."

She got her dress on.

I drove them in the van.

We got to the hospital.

They had her start pushing, and the baby's heart rate, like, really shot up.

Finally, the doctor, she said, "I will do the vacuum because I'm pretty sure you don't want a C-section, right?"

And I'm thinking, "Yes, you need a C-section," but I don't say it, I don't speak up.

When I arrive at the hospital, I am completely out of it.

I don't have anything to do with the decision-making process.

She just got the vacuum ready.

And it was through two pushes and two pulls that the baby was born.

When I left the hospital, I thought the baby was fine.

And then about 2: 00 in the morning, the doctor called me and she said, "I just want to let you know that the baby died."

I was shocked.

I'm thinking, "What happened?

What happened?

Why?"

And she said, "Now is not the time to discuss it."

[ Suspenseful music plays ] [ Papers rustling ] -I was reading records and becoming baffled, because when you read the medical records, you start not being able to put it together.

In the particular case, there was a failure to progress, and Liz came to the conclusion that more medical intervention is necessary.

Part of midwifery training is to discern when that's the case and to move the person to an appropriate setting to deal with that.

So, the mother comes to the hospital with the baby inside of her,, and the hospital doesn't say, "This is an emergent situation.

Look at the heart rate, look at this, look at that."

None of that happens.

Several hours pass where the woman is allowed to continue to birth, which is exactly what Liz was doing.

[ Dogs barking ] Hello.

What I came to understand was that, in conversations with family members who were inquiring as to what went on, the doctors, in essence, said, "I should have done a C-section when she came in."

-I was in shock.

-In other words, acknowledging some situation that required intervention.

What later became the mantra was that the midwife had failed.

-If I speak with my brother and his wife about the death of baby Joseph, who is my nephew, they say that it was God's will to take the baby -- God needed a rosebud, and he took Joseph.

Um... But we also have a lot of questions.

They never blamed Liz, never.

They are not blaming anybody, but they do wish that the doctors at the hospital would tell the truth.

They wish the truth would be told.

[ Gentle music plays ] [ Carriages rattling ] -No midwife or OB would ever wanna lose a mom or a baby.

But when an OB has a death, the OB isn't carted off to jail in their slippers, and there has been very, very severe unnecessary deaths that have happened because of negligent care.

[ Lively music plays ] -Morning.

[ Door creaking ] -So, how are you feeling?

-Oh, I actually thought I might have to call you up in the night, but stuff sort of fizzled out, so I'm not sure.

-Okay.

-Yeah.

-Crampy or...?

-I felt very crampy.

And then contractions, I had a bunch, too.

-Okay.

When I was in my 20s, I wanted to be in OB.

Any other concerns that you have going on?

But I could not believe, over and over and over again, what I saw in the hospital -- the abuse, particularly towards women of color.

Horrible.

Can I have you kinda shift your center?

There you go.

Doctors coming in and just shoving their fingers into a woman's vagina -- "I'm going to break your water."

"What?

Why?

And why aren't you asking if it's okay?

[ Gentle music plays ] All right.

Well, keep me posted on today if you feel like something's brewing.

[ Gentle music plays ] This battle, this isn't just about childbirth.

This is about a war against the right for bodily autonomy.

History has proven that criminalizing women's choices has never produced the outcome they want.

You can outlaw abortion and say, "You cannot have an abortion," then they'll go back to hiding in alleys.

There's a woman who wants an abortion, she will get one, and it's the same thing for childbirth.

If a woman does not wanna go to the hospital, she won't.

Hi.

How are you?

-A lot of labor has been donated for the property.

We took the carpet up, finished the floors, put a new bathroom in.

We're willing to help Melissa out as much as possible because she's such a good midwife.

-That looks nice.

[ Hammers banging ] -Was it last week sometime?

I worked for Vern Yoder.

And over lunchtime, we seen him, he's over there on the porch with two guys standing there, pretty official guys.

And he spent some time talking to them.

And when he came over, he said, "Those were private investigators..." -No.

-Asking after you.

-"...asking about Melissa Carman."

[ Melissa gasp ] -When was this?

-Less than two weeks ago.

-What did he say?

-He's like, "Those guys were very nice."

-Yeah, they will act super, super nice.

They're like, "Oh, no one's in trouble here.

No problems."

Wow.

Have they been around at anyone else's house that you know of?

-I haven't heard of anybody else.

Not in our community that I've heard of.

-Mm-hmm.

Oh, boy.

[ Phone ringing ] -You've reached Defazio.

-Hey, it's Melissa Carman.

How are you?

I have some Mennonites that are working down here in Pennsylvania on the new place, and one of them just told me that two investigators were up in the Lyndonville area asking questions about me.

You know, they're going to their houses.

-Yeah, okay.

-Why'd they write me a check, I'm sure, you know, what did I do.

-I don't know if there's other people that they're looking at, too.

I don't know.

I'm not familiar with the community, but, you know, it seems like they were on some kind of a, won't say a witch hunt, but... -Ugh.

-It's for us to be aware of what's coming down the pike.

All right.

-All right.

Thank you.

All right.

Bye.

[ Phone beeps ] [ Melissa sighs ] [ Suspenseful music plays ] The state troopers called me and asked me to come in to arrest me for unlawful practice of a profession.

I told my daughter that I was gonna be arrested, and she was crying.

And usually I'm the type of person who can keep my composure, but my hands were shaking.

I was scared.

-Not guilty, Your Honor.

-In Liz's case, there was too many references to me when we read the discovery documents.

It's as exactly as we suspected -- text messages.

-Yeah.

-Yeah.

They're charging me with the one felony of unlawful practice of a profession, and then the other one, the misdemeanor, is because I warned you -- according to this, I warned you about an investigation.

[ Paper rustling ] There are a lot of text messages back and forth.

And Liz told me that the police were gonna be called, you know, regarding her case.

So I texted her, "Get rid of any evidence of past records.

Delete text messages.

Hide things off site."

And it wasn't a serious text message.

It was a gut-punch reaction to what she said about the cops being called.

And they've offered me a plea.

I don't believe I can stand in court and say that I'm guilty of a felony and a misdemeanor knowing that, at the end of the day, all of this was only to benefit a community that has no resources.

And I feel like I have to take this as far as it'll go.

[ Spray hissing ] [ Phone ringing ] Oh, boy.

My attorney.

Hey.

-Hey, how you doing?

I'm on my way up.

-Okay, great.

-One last thing I wanted to tell you.

You understand that I'm in a position where I'm confident we can win the case if we had to go to trial, but I'm also, on the other hand, I think you should take the offer?

I look at it from a risk perspective and that you could -- I know you could also be convicted.

-Sure.

-I'd just hate you to lose everything 'cause I never know what's gonna happen with a jury.

-Right.

Um...okay.

All right.

And -- -I just wanted to tell you that before you have made your decision.

And I'll see you at court after 1:00, all right?

-Okay.

Sounds great.

I'll see you then.

-Bye.

-Bye.

If it only stayed like that forever.

Okay.

[ Elevator bell dings ] Hello.

-How you doing?

[ Melissa laughs ] What are you gonna do?

-I'm not gonna take the plea.

-You are or you're not?

-Not.

-Okay.

All right, you're gonna be... They're gonna put it on the record.

We're going to trial.

And, you know, it's anything from 1/3 to 4 to probation if you're convicted.

And then the misdemeanors are just, you know, the same, okay?

-Okay.

I'm probably gonna end up getting a three to five.

[ Patricia laughs ] -Parole?

-Getting a... I'll be at the center -- -No, no.

Don't even think that, much less say it out loud.

-Well, are they really gonna put me in jail?

-No.

No.

Well, reasonable people wouldn't.

But this is our concern, that we're not always dealing with reasonable people.

-This is what upsets me about this whole thing, is that when you walk in there, it's all men... -Oh, yeah.

-Yeah.

-...determining the outcomes for women in this state.

-You can go in.

The court is in short recess, but you can go in.

-Okay.

We're next?

-Yep.

-Perfect.

[ Door clicks and creaks ] [ Attendee faintly speaking ] -Well...that was interesting.

-How are you feeling?

-Uh, disgusted.

Disgusted that Todd Casella and his little counterpart, they don't give a crap.

They don't give a crap about any of this, and it just makes me sick, so... Right now, I'm thinking if I had pled, just saying guilty to that felony and to that misdemeanor... I would've wanted to kill him.

Not literally.

[ Laughs ] with my thoughts.

Next thing you'll know, I'll be on trial for murder.

[ Melissa sighs ] [ Dramatic music plays ] -Hello.

How are yous today?

Oh, it sure is cold outdoors.

-Yeah.

Hello.

[ Lissa speaking in Pennsylvania Dutch ] -Oh.

We are growing.

-If you say so.

Hello.

-Yes.

[ Lissa speaking in Pennsylvania Dutch ] -He is.

[ Lissa speaking in Pennsylvania Dutch ] -Okay.

You want her over on the table or...?

[ Lissa speaking in Pennsylvania Dutch ] -After Melissa got arrested, I was like, "This isn't good.

They are seriously going after anyone helping people have babies at home."

All right.

She's been eating well for you?

-Sometimes when she gets started, she's clicking her tongue.

-I see.

There is a huge community of people, and if they're always scared that their midwife is gonna be taken away because she's not legal, what kind of care does that leave people?

And I'll just have you lie on the bed here, and I'll check your uterus out.

Just go ahead and do a little sit-up for me.

We'll check your muscles... -Oh, dear.

-...on your stomach, muscles.

-Oh, dear.

[ Laughs ] -There we go.

Eh, could use a little work.

[ Both laugh ] Well, can't we all?

Very good.

-Liz was arrested, and Melissa was arrested.

Lissa's way overcrowded.

The options are almost nil.

It kind of sent me in a penny about how far they would actually go.

[ Crowd chattering ] [ Gentle music plays ] [ Auctioneer chanting ] [ Auctioneer continues ] -Steven.

[ Auctioneer chanting ] -I didn't really feel I was being watched until the Yates County Sheriff's Department called and started asking me questions if I'm practicing midwifery, which I said I'd never identified myself as a midwife to anyone.

And he asked what I call myself, and I said a birth attendant or a labor assistant.

And then he said, "Well, we'll let the evidence speak for itself.

You're under investigation."

[ Phone beeping ] -Hello, Carolyn?

Yeah, this is Doris.

[ Doris speaking in Pennsylvania Dutch ] And 10:00 is the Lissa Horning arraignment, the one in the courthouse.

-Courthouse.

-Yeah, she just kind of suddenly got a call on Friday telling her, so that means they're going to go ahead with pressing charges.

Yeah, guess you have to be there and sit up front and cry and... [ Laughs ] [ Carolyn faintly speaking ] Yeah.

[ Laughing ] And go into labor right there.

[ Laughs ] Oh, yeah.

[ Laughs ] Maybe it would soften somebody's heart.

Oh, dear.

This is so nuts.

[ Dramatic music plays ] -The Yates County Sheriff's Department called again, and he said, "We need to serve you with an arrest paper for unauthorized practice of a profession."

If they tell me I can't practice anymore, it would be a big hole in my life.

I feel like that's my God-given talent, to work with babies and moms.

[ Group chattering ] -Who's going to help all these people?

Sue and I are pretty old to take it on.

[ Group laughing ] -Especially me.

[ Linda laughs ] -It was so senseless trying to figure out, "Well, okay.

He says, 'We the people,' and then, well, we're sitting right behind them.

He's talking for us?"

[ Rain pattering ] -Thank you all for coming today, especially in the rain.

Thank you for coming.

My name's Linda Hamilton.

I was involved in a case with midwife Diane Goslin several years ago when she was charged by the state of Pennsylvania for practicing midwifery.

And I want you to know that the reason Diane won and the reason things are the way they are in Pennsylvania, now giving freedom to home-birth midwives, is because people like you came out and stood up for her.

I really want to get feedback from you all.

What can we do to work together to make this happen here in New York?

-We are realizing that if we don't step out and say what we want, we're going to lose home birth altogether.

-Yeah, I'll take some more and pass 'em out to others, too.

-I will take at least 10.

[ Dramatic music plays ] -The Bible says to be separate from the world, but I do feel that we should be helping and not sitting back and let them take the punishment all by themselves.

[ Dramatic music plays ] -The reason the Amish is showing up at the courthouse is to show the judge how important midwifery is to the Amish and the plain communities.

-The way we've been showing support so far is by going to court, raising money, writing letters to newspapers, and just, in general talking about it, talking to people we meet, answering their questions.

I think it's a fight with words.

-So I guess what we wanna do is just write your story on the back just to let other people know what we desire.

-It's gonna feel boring writing the same thing over and over.

I have to give all my 101 reasons on every different postcard.

-Oh, yeah.

And keep it simple.

Yeah.

[ Group laughing ] I think my biggest thing is, I really want this for my daughters, too, because, I mean, you know how fun it is to come down the stairs and hear Dad say... What did he tell you?

-Yeah, "We have a surprise for you."

That was for Brandon, I think.

And then, we were trying to guess what it was.

We guessed a trampoline and a pony and a goat and... [ Group laughing ] Well, we wanted a trampoline badly.

We never imagined it was a baby.

[ Group laughing ] It was just a sister.

-Just a sister.

[ Group laughing ] -It is very rare that the Mennonites will write letters to the editor, but in this case it was just a flood of letters that came across my desk.

The most striking aspect is that they felt they had no choice but to come out and speak so publicly.

This is from Kathleen Zimmerman of Geneva.

"We desire quiet home births with little outside intrusion..." -...with someone who understands our culture, with someone who has gifts and talents in coaching the birthing process.

Catlin's case is not exclusively a Mennonite issue.

The future of midwifery in New York is at stake.

Thank you, Medical Group, for you are there when our bodies need your help, but set us free when we can do it on our own."

May the Lord give wisdom to all those making decisions in this matter.

Kathleen Zimmerman.

[ Phone ringing ] -Hello.

My name is Lissa Horning, and I was reaching out to your office about being supportive of a CPM bill which is now titled as the Community Midwifery Bill, and it's under Article 140 A. I have responded to this basically with rolling my sleeves up and getting busy with legislative stuff.

I've contacted President Biden many times.

It's very uncommon for women to be -- even men, I mean, plain community, in general -- to be involved in politics so much.

But when it really came down to that they are actually gonna arrest me, I decided, "Why would we sit around and let these guys run the show when we could potentially have things differently?"

-Hi.

Good afternoon.

-Hello.

-Hi, Lissa.

-I did it this time.

-So, Lissa, if you want to start... Leah, it says Susan Derby, but that's Lissa Horning.

-Okay.

-And she's running the meeting, so... -We are asking legislators to be aware that there is a bill out there.

It's called the United Midwifery Practice Act.

We really need this bill because right now in New York, we are, like, 30th ranking for maternity healthcare, and that's even worse than some third-world countries.

-I'm all fogged up.

[ Melissa and Lissa laugh ] -Oh, well.

-Make sure I don't bang into something, okay?

-Yeah, right.

-This is a bill that will expand midwifery in the state of New York to include the certified professional midwife, and we're super, super excited about it.

This has been a long time coming.

-Oh, my husband wants to know, "Are you in New York City?"

-Yes.

-Yes.

-But it really sounds like it's an even bigger concern for our rural communities even more so than New York City.

-But in New York City, I think one of the issues that is paramount is the fact that Black and Brown women are dying 8 to 12 times that of white women in the state, and they also have poor access to care.

-There have been so many studies done everywhere, all across the country, New York state's Maternal Task Force, everybody is saying, "We need more midwives."

[ Dramatic music plays ] [ Dramatic music fades ] -Are you speaking today?

-Yes.

-Yes, we are.

-Can I have copies of your testimony, please?

-Um, I have the original along, but they told me I don't have to do the copy thing.

Do you have a copier here if you need it?

Yeah.

-I'll make a copy and get it right back to you.

-Okay.

Thank you.

-Good morning, everyone.

I'm very delighted to be here today to hear these testimonies, and hopefully we can turn them into legislations and policies that we can take into action, in terms of providing care for our expectant mothers.

-This has been a topic that I have been interested in for a long time.

I would be curious from the people who are testifying to tie in the high level of maternal mortality to New York state as we go along.

Thank you so much.

-The United States is facing a maternal mortality crisis.

-Closures of hospital birth centers and labor and delivery units have led to deserts of care.

-The system is broken, and it makes it much harder than it ought to be to provide care for pregnant people and their newborns.

-Everyone knows that obstetrics, labor, and delivery is a fast, money-making opportunity for any hospital, but yet this is the medical model that we're under.

[ Attendees faintly speaking ] -Hello.

My name is Lissa Horning.

I know it seems highly unlikely to people from downstate, but there really are large populations of people in upstate, also.

[ Attendees laughing ] -You mean the Bronx?

[ Attendees laughing ] -A study done in the Finger Lakes region communities in 2021 showed that 95% of women would choose home or birth-center birth above hospital.

I have had 10 babies with no complications.

None of them were in the hospital and none were attended by a New York state licensed provider.

Why?

Because New York state does not accept the education of my provider, yet her statistics far exceed any hospital for outcomes.

We have a critical lack of choices available in New York.

This could be helped by accepting and licensing the community midwife, who is currently criminalized, along with the families they serve, for their choice of birth.

-We have 90 people that we're targeting.

-So we each have 90?

-We each have 90.

Well, there's more.

-Okay.

-Okay?

Packs of 10.

-Okay.

-10, stamp 'em, rubber-band 'em.

10, stamp 'em, rubber-band 'em.

-Okay.

-We're targeting Senate and Assembly, but we need this to be a bipartisan bill.

-It's all pregnant women.

It doesn't matter what party they belong to or if they don't belong to anyone.

-Right.

We're targeting the senators, like, on Twitter and all that.

I said, "Do you hear this, New York State Assembly, New York State Democratic Senate?

NYCPM have a community midwifery bill that can change New York State's horrid maternal morbidity and mortality rate.

Say yes to A7898.

Say yes to S7078."

[ Gentle music plays ] -I don't like to put my name to things, but I think I did help get this bill put on the table and get a number moved forward.

If it's coming from the community who's using these services and said, "We want our midwives to be legal," it's different, and they listen.

-All right.

Good afternoon, everyone.

My name is SeQuoia Kemp.

Today, I am joined by my colleagues, members of the NYCPM Incorporated, midwives of Central New York, reproductive justice advocates, and families who are advocating for the legal recognition and licensing pathway for certified professional midwives in New York.

I wanna first welcome some of our lawmakers who have signed on this bill because they believe that midwives save lives.

Let's give them a warm welcome with our clap of hands.

[ Attendees applauding ] -Thank you.

I'm the assembly sponsor for the bill.

-Thank you.

[ Attendees cheering and applauding ] -Thank you very much for coming up here.

Thank you for doing what you do and supporting women through their birth.

It is critically important.

It's you who really help us get to a better birthing outcome for women in this state.

It's time to get the bill done, and I am very proud to be the assembly sponsor.

Thank you so much.

[ Attendees cheering and applauding ] -When I say, "Midwives," you say, "Save lives."

Midwives!

-Save lives!

-Midwives!

-Save lives!

-When I say, "Midwives," you say, "Save lives."

Midwives!

-Save lives!

-Midwives!

-Save lives!

[ Birds chirping ] [ Keys clacking ] -"...exciting to me."

Today, we are going to the plea hearing, which I am going to plead guilty to practicing midwifery without a license.

I guess there's no disputing that fact, but I've always come at it from the fact that it's legal to have a home birth in New York state.

A woman has a right to choose who she has there.

So, I don't know.

But I guess I was practicing midwifery without a license.

[ Birds chirping ] Thank you for coming.

-You're welcome.

-Oh, you're such -- -We said, "Well..." -True-blue friends.

-Today is, like, worth it to be here.

-Oh.

Absolutely.

-One last time?

-Yes.

Just this one last time.

-The prosecution agreed to drop all charges against Liz except for that of practicing midwifery without a license.

He came to understand that there was significant medical evidence that showed that Liz was not responsible for the baby's death.

-This is the beginning of the next phase, right?

-Now that you've gotten this far, this information can be used as power for the bill because -- -Well, that's what I want to make sure, that this is a catalyst.

-And the outrage that people have felt for, you know, three midwives getting arrested, you know, it's insane.

-Part of it, honestly, was our willingness to say, "Yes, we did illegally practice."

But there are explanations for what she did that, I think, gives a strong argument for mercy because she served many people as she broke the law.

[ Suspenseful music plays ] [ Attendees cheering and applauding ] -Okay, I'm gonna say it.

I'm Elizabeth Catlin, a certified professional midwife.

Whoo!

[ Attendees applauding ] I've never said that in public before because it's not legal here in New York state.

I wanna become like Finland and the Scandinavian countries, where midwives are revered, midwives are respected, and midwives... [ Attendees applauding ] Yeah.

[ Attendees applauding ] Midwives are considered the professionals in childbirth.

And with the Community Midwifery Bill, we finally have some language that protects us community midwives.

So let's stick with it.

We're almost there.

Be thankful that we can continue in this country to work for freedom.

Thank you, everybody.

I love you all.

[ Attendees applauding ] -Please, I would like to orchestrate one photo if I could, please.

Would any children born with Liz's help and would any mothers who were assisted by Liz, would you mind surrounding Liz and being photographed with her?

[ Elizabeth laughing ] And if children would come in front.

There we go.

[ Stirring music plays ] -Wow.

[ Gavel bangs ] -All rise.

Court is now reconvened.

[ Gentle music plays ] -Case number 8 -- The People vs.

Melissa Carman.

Has the jury agreed upon a verdict?

-Yes.

-How do you find in the People of the State of New York against the defendant, Melissa Carman, charging her with a crime of unauthorized practice of the profession of midwifery?

Guilty or not guilty?

-Guilty.

-And for tampering with physical... [ Reflective music plays ] -This is the primary birthing room.

It's all the babies that have been born here so far.

A lot.

-Lots of boys, yeah.

-Yeah, the boys are about two ahead on the girls, so... And then this room... this is the second birthing room here.

[ Lissa speaking in Pennsylvania Dutch ] -Hi, hi, puppy.

Hi, hi.

-Welcome.

I'm Liz Catlin.

I don't know if any of you know my story, but I'm a certified professional midwife, and I was working down in Penn Yan.

And three years ago, in October, I was charged with practicing midwifery without a license.

[ Lively music plays ]