PHOENIX — As demand for home births increases, ABC15 is helping moms find the best care for themselves and their babies by providing an interactive database with information on all Arizona midwives.
Below you will find a first-of-its-kind online tool that families can search, combining information from the Arizona Department of Health Services and the Arizona Board of Nursing. Both agencies regulate midwives, although each has different rules for midwife training, scope of practice, and oversight.
In the search bar, you can find the names of 400 midwives with active licenses, the agency that licenses them, the type of license they have, when they were initially licensed in Arizona, and whether regulators have fined, cited, or disciplined them. In the “Regulatory Actions” column, you can click on the link if there are any regulatory records.
Having trouble viewing the database? Click here.
***NOTE: ABC15 is committed to providing up-to-date information about midwives. This dataset is current as of June 27, 2024. Please email investigators@abc15.com with questions or comments.
ABC15 gathered information for the database through several methods. In June, the Arizona Board of Nursing provided a list of hundreds of nurse midwives, which we narrowed to those who have “active” licenses. We then searched each of the nearly 340 names in the agency’s license verification portal. For ADHS-licensed midwives, we searched on AZCareCheck, which electronically provided the names and three-year enforcement histories of nearly 100 non-nurse midwives.
ABC15 dataset users are encouraged to also research midwives and their credentials using the AZ Board of Nursing and ADHS websites.
Tragedy prompts project
“This has been the hardest thing I've ever had to live through,” said Joie Haralson.
Haralson is a grandmother from Graham County in southeast Arizona. Her daughter, Jordan Terry, died of a uterine rupture after a home birth last December. Her grandson, Mack Terry, was stillborn. Jordan died of a uterine rupture, a dangerous complication of a vaginal birth after cesarean [VBAC], which she was attempting at home with the help of an ADHS-licensed midwife.
“I'm a pretty strong person, but this has torn our family apart,” Haralson said.
Haralson said her daughter hired her midwife, Sarah Kankiewicz, based on recommendations from other new moms in the area.
Jordan’s family told ABC15 they didn’t know state regulators had found deficiencies in the care Kankiewicz provided during two previous births, and the midwife had been fined five times for failing to turn in reports on time.
"After the fact, family started researching,” Haralson said. “What I've learned is [there were] so many violations, so many citations.”
Three years before Jordan Terry died, Heather Flowers hired that same midwife.
“I really trusted that she had my health, my safety - that’s what she was there to monitor,” Flowers said. “All these red flags were ignored.”
According to an ADHS report, Kankiewicz didn’t check vital signs as often as required by health regulations. After a lengthy labor, Karina was born weighing 11 pounds. Flowers said her daughter was initially purple and not responsive. Luckily, she was revived.
Meanwhile, Flowers experienced a severe tear which, according to a state report, Kankiewicz was required to seek consultation for a higher level of care, but she did not. Flowers said Kankiewicz tried to suture the tear, but she later needed corrective surgery.
“Every day of my life, I have a consequence from the tear,” Flowers said. “There has not been one day in the last four years that have gone by that I have not suffered some.”
Flowers wanted to warn others about the midwife, but she said it was hard to figure out the process to file a complaint.
“I wasn't going to give up making sure the report [was] finished and was complete, Flowers said. “It took quite a long time.”
Flowers ended up submitting her complaint to the Arizona Department of Health Services. ADHS licenses nearly 100 midwives, including Kankiewicz, who agreed to stop practicing in Arizona last month.
The same group of ADHS regulators also supervise funeral homes, audiologists, laser techs, and several other health professions and facilities. Flowers questions the regulators' depth of knowledge about midwifery.
“I thought to myself, 'how are these people going to address this issue or even understand what actually happened here?'” Flowers said.
In Flowers’ case, ADHS issued a statement of deficiencies to Kankiewicz, citing her for 5 violations of state health rules, but her license was not suspended at that point.
When ABC15 reached Kankiewicz by phone in May she declined comment, which she said was based on the advice of her lawyer. She did not respond to subsequent calls or texts.
What the midwife data revealed
Several families told ABC15 they blame confusion about midwife qualifications and regulations on Arizona having two separate licensing agencies that license three different types of midwives.
ADHS oversees midwives who, generally, don’t have formal medical training. They mostly practice in homes or at birthing centers.
ADHS-licensed certified professional midwives must have a high school diploma, pass a written test, complete an apprentice-type program, and become certified by a third-party group called the
North American Registry of Midwives (NARM).
ADHS also grandfathered in a handful of lay midwives who have been continuously licensed in Arizona since 1999 but do not have a certified professional midwife third-party credential. Those midwives are prohibited from accepting a client for VBAC, a fetus in a complete breech, or frank breech presentation.
Meanwhile, the Arizona State Board of Nursing licenses certified nurse midwives. These midwives have advanced college degrees, similar to nurse practitioners and can practice inside or outside of a hospital. Nurse midwives can also use more medication and medical interventions than ADHS midwives. There are more than 300 certified nurse midwives statewide.
“I wasn't aware of the certified [nurse] midwife versus the [ADHS] licensed midwife, lay midwives.” Haralson said. “I trusted that she would be safe regardless because this person is saying that they're professional.”
During ABC15’s review of ADHS records for 94 midwives, more than one-third faced discipline and/or fines in the last three years. Online ADHS midwife enforcement records only go back to 2021.
The records review also uncovered:
- Two certified professional midwives, including Kankiewicz, surrendered their licenses when facing possible revocation.
- Four additional ADHS-licensed midwives were suspended.
- Three more midwives received statements of deficiencies saying they violated state health rules, but their disciplinary files did not contain information showing whether the midwives made corrective actions or faced other fines or discipline.
- 33 ADHS-licensed midwives, including those who had higher levels of discipline, received civil penalties. Those fines were for failing to submit midwife reports within 30 days, as required. Those reports detail the care provided to each client and birth outcomes.
The Arizona Board of Nursing doesn’t require its midwives to submit client reports.
Overall, discipline for certified nurse midwives is rarer. ABC15 checked the histories of nearly 340 certified nurse midwives and found:
- Two nurse midwives had their licenses suspended in the last three years.
- At least eight other AZBN-licensed midwives had older disciplinary records. Unlike ADHS, AZBN’s online disciplinary records date back decades.
Midwives say demand is growing for their services because they can offer more patient-centered care and a more natural approach to pregnancy and childbirth.
“For the most part, they're excellent at what they do, and having an excellent skill provider at your birth increases the safety tenfold,” said Wendi Cleckner, an ADHS licensed certified professional midwife with decades of experience who does peer reviews. “So I think that doing your due diligence, if this is something that you want and want to pursue, that you absolutely should do your homework.”
Haralson urges expectant mothers to ask more questions.
“Try not to be sold on a fantasy,” she said. “Don't trust somebody that tells you that they have: A, B, C, and D in order. Make sure, for a fact, that's the case.”
She believes ABC15’s midwife database will help raise awareness so other moms can make informed decisions on care for themselves and their babies.
“Having it all in one area would be very beneficial to moms,” Haralson said. “I appreciate all that you guys have done.”
ABC15 has repeatedly requested an interview with ADHS about oversight and discipline of midwives licensed by the agency. Officials have yet to agree to an interview. An ADHS spokesperson said in an email last month that a document with information would be provided, but ABC15 has not received that document.
When asked about oversight and discipline, the Arizona State Board of Nursing replied with the following statement:
The Arizona State Board of Nursing's mission is: To protect and promote the welfare of the public by ensuring that each person holding a nursing license or certificate is competent to practice safely. Put simply, the Nursing Board's primary purpose is to protect the public and patients. When the Board receives credible information that a nurse's practice may be dangerous to patients, the Board initiates an expedited investigation. After due diligence and a complete investigation, and when necessary, the Board is able to take emergency action to protect patients through a summary suspension of the nurse midwife's certificate and license. This is a rare occurrence, as the vast majority of nurse midwives do not have complaints or disciplinary actions.
You can reach Senior Investigator Reporter Melissa Blasius by email at melissa.blasius@abc15.com or call 602-803-2506. Follow her on X (formerly Twitter) @MelissaBlasius or Facebook.