When Regulation Hurts: Two Midwives Challenge NARM’s Accountability in Court

In a profession rooted in compassion, trust, and deep responsibility, midwives are expected to uphold high standards of care. But what happens when the organizations tasked with certifying and regulating midwifery themselves fall short of fairness and transparency?

This is the heart of a courageous legal battle being waged by two American midwives, Sandy Glenn and Carolyn Greenfield, against the North American Registry of Midwives (NARM)—the credentialing body for Certified Professional Midwives (CPMs) in the United States.

In a deeply personal and eye-opening conversation facilitated by maternal health advocate Paul Golden, the midwives outline a troubling breakdown in professional oversight that has left their careers disrupted and their reputations damaged—all without a fair opportunity to defend themselves.

NARM student midwives face new challenges while getting their credential.

Midwives Sanctioned Without Due Process

Sandy and Carolyn describe how NARM removed their professional credentials without offering proper hearings or written justification. Sandy never received a hearing at all. Carolyn, who did face a grievance panel, was denied legal representation, forbidden from cross-examining witnesses, and ultimately stripped of her credential.

“They didn’t allow me to go work in another practice... I couldn’t find a supervising midwife, so they revoked my CPM and posted it on their website,” Carolyn shares.

The issue, as the midwives explain, is not just about two individual cases—it’s about a lack of due process, the fundamental right to a fair and impartial hearing. In legal terms, this includes the right to understand accusations, respond with evidence, have representation, and appeal decisions.

An Accountability Vacuum

Despite being an accredited body, NARM has allegedly acted without oversight, operating in a legal gray area. When the midwives appealed to the Institute for Credentialing Excellence (ICE) and its credentialing division, NCCA, the situation only became murkier.

“After collecting evidence for over a year, NCCA sent a generic rejection letter—one that didn’t even apply to our actual credentials,” Sandy reveals.

Shockingly, the NCCA later stated that NARM is not credentialed to authorize preceptors, yet NARM had sanctioned Sandy as a preceptor. This contradiction raises serious concerns about the legitimacy of the sanctions and the credibility of the systems behind them.

The Impact on Midwifery, Clients, and the Public

Beyond the personal and professional toll on Sandy and Carolyn, the ripple effect of these decisions is felt most keenly by pregnant families and aspiring midwives.

“We’ve had to pause the training of new midwives, which leaves our communities with fewer options—especially for home birth,” Sandy explains.

Carolyn adds that since her name appeared on NARM’s sanctions list, she has experienced a steep decline in clientele and public smearing among colleagues, despite maintaining her license in another state.

“I’ve been practicing ethically and legally, but NARM’s post has deeply affected my livelihood and reputation,” she says.

A Legal Stand for Fairness and Reform

The midwives, representing themselves in court, are pursuing legal remedies including reinstatement of credentials, removal from the public citation list, and systemic policy changes. Their court case may ultimately test whether private credentialing bodies like NARM are bound by due process principles when making career-altering decisions.

“We’re not just fighting for ourselves,” Sandy says. “We’re fighting for all midwives who need a fair, accountable regulatory system.”

What Can Other Midwives Learn from This?

This case underscores the importance of transparency, legal safeguards, and political advocacy within the profession. Sandy encourages midwives to become involved in local legislative efforts, noting how powerful it is to simply show up and speak to lawmakers.

“You’d be amazed how many legislators are quietly supportive of midwifery—some were even born at home,” she notes.

Carolyn reminds others that it is possible to take legal action, even without a lawyer.

“We filed this ourselves, and we’re still standing,” she says.

Conclusion: The Fight for Just Oversight

The regulation of midwifery must strike a careful balance—ensuring safety without stifling practice, enforcing standards without silencing professionals. The NARM case raises vital questions: Who holds the regulators accountable? What processes must they follow when lives and careers are at stake?

As this case unfolds, midwives around the world should be paying close attention. Whether in the United States or beyond, this is a reminder that regulation without accountability becomes repression. And when that happens, it’s not only midwives who suffer—but the families who depend on their care.

🛠 Takeaway for Midwives:

• Know your rights: Even private organizations must follow fair practices.

• Get involved legislatively: Change often begins locally.

• Support one another: Community advocacy can protect midwifery’s future.

• Demand transparency: Credentialing bodies must operate with clarity and fairness.

Many thanks to Paul Golden, Midwife Mediator, for his tireless efforts supporting global midwifery.