The police have said that Ms. Catlin, 53, crossed a line, misrepresenting herself as a licensed midwife, defrauding clients and endangering them. She faces up to seven years in prison if convicted of the charges that include unauthorized practice of a profession.

picture: supporters for Elizabeth Catlin

PENN YAN, N.Y. — For a generation of Mennonite women, Elizabeth Catlin was integral to the most joyous occasions of their lives: the births of their children.

Ms. Catlin was a second mother, they said, a birthing attendant who helped them with prenatal care and then caught their babies during hundreds of natural childbirth deliveries at their homes.

So it was incomprehensible to them that on a recent winter day they were in a courtroom to support Ms. Catlin, who in December had been arrested and charged with four felonies for practicing midwifery in a county about an hour southeast of Rochester.

It was Ms. Catlin’s second arrest: She had been charged the month before in a neighboring county, where the State Police wereinvestigating her possible role in a newborn’s death.

The police have said that Ms. Catlin, 53, crossed a line, misrepresenting herself as a licensed midwife, defrauding clients and endangering them. She faces up to seven years in prison if convicted of the charges that include unauthorized practice of a profession.

“Elizabeth Catlin went far beyond acting as a birthing attendant by creating her own medical practice, seeing patients on a regular basis, providing medical advice, conducting medical procedures and by being paid for her services,” Mark Eifert, a State Police investigator, said in a statement.This is your last free article.Subscribe to The Times

Ms. Catlin maintains that she served only as a birth attendant because New York does not recognize her midwifery certification. She has pleaded not guilty to all charges.

“My life is ground to a halt,” Ms. Catlin said. “My passion has been taken away.”

Her clients also reject the charge that she distorted her training, andthey are making rare public overtures of support, like the courtroom appearance.

“Normally the Mennonites do not speak out — and especially the women don’t — because we’re kind of taught the men are the leaders,” said Kathleen Zimmerman, a 37-year-old mother of eightchildren, four of whom Ms. Catlin helped to deliver.

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The women’s show of solidarity underscores what is at stake for the Mennonites, a conservative Christian denomination. They shuntechnology, and the majority do not drive cars or have health insurance. Because they mostly avoid hospitals, natural home births are a way of life.

More broadly, their feelings about Ms. Catlin, who is not a Mennonite, help to reveal the lack of maternal care in rural areas. The Mennonites in New York largely live in counties where there is a shortage of licensed midwives and obstetricians, experts say.CreditLibby March for The New York Times

The New York Times

On a recent morning, seven Mennonite mothers gathered in Alma Rissler’s living room inPenn Yan and spoke in grave terms of a future without Ms. Catlin’s services.

“If we sit back and don’t speak up, our daughters will not have the options that we have,” Ms. Rissler, 27, said.

As children waddled around the house, the women spent over an hour recounting painful memories — miscarriages, stillbirths, difficulties conceiving. The common thread was Ms. Catlin’s role in helping them through it all.

The women have written to the local newspaper in support of Ms. Catlin, raised money for her legal fees and sent her care packages. Ms. Catlin’s initial court appearance marked the first time that many had set foot in a courthouse.

“If nobody talks, what’s going to happen?” said Sharon Zimmerman, a 25-year-old mother of two and a cousin of Kathleen Zimmerman.

Ms. Catlin was born in Penn Yan and home-schooled her 14 children here. For the past 25 years, she said, she has helped women with prenatal care and delivery. Her career sprang from her own experience: She moved to home births after having her first four children in a hospital.

“I just love the women I work with, and I love to teach them how to birth well,” Ms. Catlin said. “I’m just a friend to them. They feel free to ask me any questions about marriage. Being a birth attendant is just a natural progression of all of that.”

In recent years, Ms. Catlin said she has been present at about 70 of the approximately 200 Mennonite births each year. A midwife who was licensed by the state delivered many of the other babies in the community until she died in February.

“The care that she gave was like a mother,” Kaylene Hoover, 25, said. “She knew exactly how you felt.”

The circumstances that led to Ms. Catlin’s first arrest also particularly alarmed the women. According to court documents, staff members at F.F. Thompson Hospital in Canandaigua, N.Y., reported Ms. Catlin to the authorities after she brought a woman to the hospital. Officials said the woman gave birth there, but the baby, who had sepsis, later died.

Ms. Catlin’s lawyer, David Morabito, said she was not involved in the delivery.

“She does not take unnecessary risks,” said Ms. Rissler, who hired Ms. Catlin to help deliver two of her threechildren. “She goes to the hospital when it’s necessary. But if it’s a routine birth, there’s really no reason to go.”

The New York Times spoke to a dozen women about the two decades Ms. Catlin has worked in the area, and none had complaints about her.

Ms. Catlin had never been in legal trouble before her arrests, the police said. But, they said, her work with the Mennonites broke the law, and put women and newborns at risk.Ms. Catlin’s supporters listened to her lawyer explain the legal process after the Penn Yan court hearing.CreditLibby March for The New York Times

Ms. Catlin’s supporters listened to her lawyer explain the legal process after the Penn Yan court hearing.CreditLibby March for The New York Times

Searching for affordable farmland, Mennonite families first arrived in Penn Yan from Lancaster, Pa.in 1973. Ms. Catlin was in elementary school.

The community now lives in at least four upstate New York counties, where seven churches and 38 schools support more than 700 families. Most of the Mennonites rely on horses and buggies to travel short distances. In other instances, they call taxis. The majority of them do not have televisions, cellphones or internet access.

Their church discourages the use of family planning and birth control, and families often have upward of eight children.

“We feel that it is our God-given duty for the husband to be the breadwinner, and the mom to be the homemaker,” said Ms. Hoover, who has two children.

Still, the women said, they felt compelled to speak about the accusations against Ms. Catlin.

“The men could not sit here and explain it,” Ms. Rissler said. “They’re involved, but they don’t know” what it is like to give birth.

Ms. Catlin said she was overwhelmed by the efforts.

“They wouldn’t do this if they didn’t feel strongly,” she said, adding that “they’re taught to be quiet.”Kathleen Zimmerman, a Mennonite, holding her daughter Kimbria. “Normally the Mennonites do not speak out,” Ms. Zimmerman said.CreditLibby March for The New York Times

Kathleen Zimmerman, a Mennonite, holding her daughter Kimbria. “Normally the Mennonites do not speak out,” Ms. Zimmerman said.CreditLibby March for The New York Times

Whether Ms. Catlin was acting as a birth attendant or midwife is likely to be at the heart of her criminal trial. Mr. Eifert, of the State Police, said such an attendant — a relative or a close friend, for example — can help deliver the baby but should not perform any procedures that require “any sort of medical skills.”

Ms. Catlin said she only worked in that capacity, even though she is credentialed as a certified professional midwife — known as a C.P.M. — by the North American Registry of Midwives. That qualification is recognized by more than 30 states, but not New York. Here, midwives must pass an exam by the American Midwifery Certification Board, have a master’s degree and meet other qualifications.

Ms. Catlin’s arrest has mobilized midwives nationwide who argue that New York’s licensing rules are exclusionary. Hilary Schlinger, the director of a midwifery program in Wisconsin, said the rules disproportionately impact upstate New York because no schools north of New York City meet the state’s requirements.

One set of midwives does not have outcomes “that are superior to the other,” added Ms. Schlinger, who used to practice midwifery in New York.

Dr. Amy Tuteur, a retired obstetrician gynecologist in Boston, vehemently disagreed, saying it is problematic that people with C.P.M. certification are not required to take formal classes.

“They’re trying to pass themselves off as equivalent to other midwives when they’re really only lay people,” she said.

Ida Darragh, the executive director of the North American Registry of Midwives, called her organization’s training “a very formal apprenticeship.”

“It’s not a lack of education,” she added. “It’s just not in a classroom.”

As Ms. Catlin’s case winds through the legal system, dozensof Mennonites are pregnant, and many hope to be soon. They want home births so much so that several recently delivered children without a birth attendant of any kind.

A few said they were considering hospital births, but were pondering where to go and how to get there. The nearest hospital to many of the Mennonites in Penn Yan does not offer obstetrics.

Even if it did, Dr. Eva Pressman, the chairwoman of the obstetrics and gynecology department at the University of Rochester Medical Center, said the bigger issue for the Mennonites is that they prefer to avoid hospital deliveries. “They’re not looking for birth to be a medical experience,” Dr. Pressman said.

After Ms. Catlin was arrested, Dorothy Newswanger, 31 and pregnant, had worried about her next labor. Ms. Catlin had helped to deliver her first three children at home.

Ms. Newswanger and her husband ultimately decided to travel to the home of another birth attendant who lives an hour away.

She delivered twins on Sunday in a difficult breech birth.

Three hours later, she spent an hour driving home in a minivan.

“This was our second-best option,” Ms. Newswanger said on Monday.

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Kazan- Kazan National Research Technical University Казанский национальный исследовательский технический университет имени А. Н. Туполева he graduated in Economics in 1982

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