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01/12/88 the People of the State of v. Margaret Jihan

January 12, 1988





519 N.E.2d 22, 165 Ill. App. 3d 507, 116 Ill. Dec. 432 1988.IL.19

Appeal from the Circuit Court of Jackson County; the Hon. Bill F. Green, Judge, presiding.


PRESIDING JUSTICE HARRISON delivered the opinion of the court. LEWIS and CALVO, JJ., concur.


In this appeal from a criminal conviction for practicing midwifery without a license, defendant, Margaret Jihan, contends the statute under which she was convicted is unconstitutionally vague because the term midwifery is not defined. We agree with defendant's contention and reverse the judgment of conviction and sentence for the reasons which follow.

Defendant was charged by indictment with involuntary manslaughter and practicing midwifery without a license. The circuit court of Jackson County subsequently dismissed the charge of involuntary manslaughter, and defendant was tried before the court on the remaining charge. The trial court convicted defendant of practicing midwifery without a license, and sentenced her to one year of probation and ordered her to serve six months of "electronic home confinement" from 10 p.m. until noon six days per week as a condition of probation.

The State's primary witness at trial was Lynn Trella, a detective with the Carbondale police department. Detective Trella testified that she interviewed defendant on May 21, 1985, and her testimony consisted primarily of what defendant told her in that interview. Detective Trella testified that defendant told her she was in graduate school taking courses in health education. Defendant had been a midwife for approximately five years. She had spent seven years in informal training in the field of childbirth. A woman named Hanizah Hashim, who was expecting her first child, had planned to deliver the baby at a new birthing center, but the center was not scheduled to open by Mrs. Hashim's due date, so a doctor referred her to defendant so that Mrs. Hashim could deliver at home. Mrs. Hashim contacted defendant six to eight weeks prior to giving birth, and defendant later met with Mrs. Hashim and her husband for purposes of "education and awareness."

On May 16, 1985, Mrs. Hashim telephoned defendant and reported that her "bag of waters" had ruptured. Defendant advised Mrs. Hashim regarding methods of inducing labor, including "breast stimulation, long walks, and hot showers." Defendant went to Mrs. Hashim's apartment on May 16 to check on her condition and returned again on May 17. Defendant was at Mrs. Hashim's apartment "on and off all day" on May 17, and spent the night there, observing the progress of her labor and monitoring the child's heartbeat. At 8 a.m. on May 18, Mrs. Hashim began active labor. Defendant continued to monitor the baby's heartbeat and the progress of the labor. At approximately 7 p.m. on May 18, Mrs. Hashim passed a bloody discharge, and meconium was present in the discharge. Meconium is fecal material coming from the infant. The two women discussed whether Mrs. Hashim should consider going to the hospital, but Mrs. Hashim expressed her desire to remain at home. Defendant then conducted an internal exam, determining that Mrs. Hashim's cervix was dilated eight centimeters. Defendant checked the baby's heartbeat every 15 minutes until the child was born.

Defendant was present during the delivery. The baby's head was delivered first. Defendant observed meconium on the child, a boy, and wiped his face and began suctioning his nose using a ball syringe. Then the remainder of the child was delivered. Defendant continued the suctioning and began massaging the baby, then placed him on his mother. Defendant wiped more meconium from the infant, then clamped and cut the umbilical cord. She instructed an assistant to begin massaging Mrs. Hashim's abdomen. The record does not reveal the identity of this assistant. Defendant then took the baby into the bathroom and turned on the hot water in the shower to create steam. The baby became unresponsive, so defendant began cardiopulmonary resuscitation. At some point during these events, defendant had told someone present to call for an ambulance. Defendant carried the baby outside to meet the ambulance crew. She gave the emergency personnel a brief history of the birth, and after they left with the baby, defendant went back into the apartment to check on Mrs. Hashim. The assistant had failed to do the massage which defendant had requested, and Mrs. Hashim was bleeding. Defendant also saw that the placenta would not expel, so she called for another ambulance to take Mrs. Hashim to the hospital.

Detective Trella also testified that she asked defendant during the interview whether she charged a fee for her services, and defendant replied that she generally received from $2 to $5 an hour. On cross-examination, the detective testified that defendant told her that her role at births was as a patient advocate and labor coach.

The State also introduced into evidence a release signed by Mrs. Hashim and her husband releasing defendant "from any responsibility associated with any complications which may come up, or be apparent, at any time in connection with the birth of our child." The release states they asked defendant to be present at the birth "as a midwife." It further states: "We further realize that Maggie Jihan does not have a license as a midwife, and that Illinois does not license midwives. We understand that Maggie Jihan does not hold herself out to the public as a midwife, but is only agreeing to attend our birth because she feels she could be of help to us."

The parties stipulated that if called to testify, Dave Meiners, a member of the ambulance crew which attended to the Hashim baby, would testify that when he arrived at the apartment, defendant was outside holding a newborn male infant. Defendant told him the child had been born seven minutes prior to the arrival of the ambulance and had never breathed after birth. After taking the baby to the hospital, Meiners returned to the apartment to find a mother who apparently had just given birth and transported her to the hospital.

The State also presented certificates from the Department of Registration and Education which state that defendant has not made application to practice as a physician, surgeon, chiropractor, midwife, or registered professional nurse, and does not hold a license under either the Medical Practice Act (Act) (Ill. Rev. Stat. 1985, ch. 111, par. 4401 ...

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