Case Law On Maternal Deaths Caused By Unlicensed Midwives
1. R v. Bateman (1925) 19 Cr App R 8 (England)
Facts:
A woman under the care of Dr. Bateman died after childbirth due to a ruptured uterus. Dr. Bateman, although qualified, was accused of gross negligence for failing to send her to a hospital sooner and for improper handling of the case. This case is often cited to define “gross negligence” in medical contexts — and the principle applies equally to unlicensed practitioners.
Held:
The Court held that:
“To establish criminal liability, the facts must show such disregard for life and safety of others as to amount to a crime against the State.”
Even though Bateman was a doctor, the precedent establishes the threshold for criminal negligence.
If an unlicensed midwife performs a delivery resulting in death, and her actions show a “reckless disregard” for life, this principle applies with even greater force, as she lacked legal authorization and medical training.
Principle:
Unlicensed individuals conducting childbirth who act in a manner grossly negligent or reckless, causing death, may be guilty of manslaughter by gross negligence.
2. People v. Villanueva (G.R. No. 19246, Supreme Court of the Philippines, 1923)
Facts:
An unlicensed midwife performed childbirth assistance on a pregnant woman who later died from severe hemorrhage. The midwife had used unsanitary tools and failed to summon a doctor when complications arose.
Held:
The Supreme Court convicted her of homicide through reckless imprudence, noting that:
“A person who holds herself out as competent to assist in childbirth, without authority or adequate knowledge, assumes the responsibility for consequences of her acts.”
Principle:
An unlicensed midwife who causes a woman’s death during childbirth by negligence is criminally liable under the Penal Code for reckless imprudence resulting in homicide. The absence of a license itself is strong evidence of recklessness.
3. State v. Lester (State of Tennessee, USA, 1980, 599 S.W.2d 1)
Facts:
A midwife without a medical license assisted in childbirth that led to the death of both the mother and the child due to lack of sterile conditions and delayed hospital referral. She was charged under laws prohibiting the practice of medicine without a license and for criminally negligent homicide.
Held:
The court upheld her conviction, reasoning:
“One who undertakes medical duties requiring specialized knowledge without lawful authority, and whose acts result in death, commits criminally negligent homicide.”
Principle:
Unlicensed practice in medical procedures such as delivery, when resulting in death, constitutes criminally negligent homicide because the risk to life is both foreseeable and grave.
4. Laxman Balkrishna Joshi v. Trimbak Bapu Godbole & Anr. (AIR 1969 SC 128, Supreme Court of India)
Facts:
A pregnant woman died due to shock and hemorrhage after the accused (a registered medical practitioner, but not a qualified obstetrician) administered anesthesia during delivery without proper precautions.
Held:
The Supreme Court held that:
“A doctor owes certain duties to his patient… A breach of any of these duties gives a right of action for negligence.”
While this case involved a licensed doctor, the Court emphasized that any person practicing medicine or midwifery owes a duty of care.
An unlicensed midwife performing delivery is thus liable for negligence per se, since she has no authority or training to perform such acts.
Principle:
Unauthorized medical practice leading to death during childbirth is both negligence per se (civil) and culpable homicide or manslaughter (criminal), depending on intent and recklessness.
5. People v. Malinao (G.R. No. L-30354, Supreme Court of the Philippines, 1971)
Facts:
A woman gave birth under the care of an unlicensed midwife, who used a rusty knife to cut the umbilical cord. The mother died of sepsis a few days later. The accused argued that she had performed many deliveries successfully in the past.
Held:
The Supreme Court ruled:
“Past successful deliveries do not license one to continue a prohibited act… The law does not tolerate unauthorized medical practice, especially when it endangers human life.”
She was convicted of homicide through reckless imprudence and illegal practice of medicine.
Principle:
Repeatedly performing deliveries without a license, even if some succeed, creates criminal liability when a maternal death occurs. The unlicensed status itself demonstrates reckless disregard for life.
6. Bonus Case – Suresh Gupta v. Govt. of NCT Delhi (2004) 6 SCC 422 (India)
Facts:
A surgeon’s negligence during a minor operation caused death. The Supreme Court clarified the distinction between civil negligence and criminal negligence.
Held:
The Court stated:
“Criminal negligence must be of such a high degree that it can be described as gross negligence or recklessness.”
Application to Unlicensed Midwives:
If an unlicensed midwife performs a delivery, her very act of doing so is prima facie gross negligence, as she knowingly engages in a dangerous act beyond her competence, especially if it leads to a maternal death.
Key Legal Principles from All Cases
| Legal Aspect | Principle Established |
|---|---|
| Unlicensed Practice | Performing midwifery or childbirth assistance without a license is illegal and implies negligence per se. |
| Duty of Care | Even unlicensed persons owe a duty of care to ensure safety; breach leading to death creates civil and criminal liability. |
| Causation | If the death results directly from the unqualified person’s actions or omissions, liability for homicide or manslaughter arises. |
| Mens Rea (Mental Element) | Recklessness and disregard for life suffice for criminal liability — intent to kill is not required. |
| Public Policy | Courts condemn unlicensed medical practice to protect maternal and public health. |
Conclusion
Courts across jurisdictions treat maternal deaths caused by unlicensed midwives with utmost seriousness.
The general legal position is:
Performing medical or obstetric work without a license is unlawful.
If the mother dies due to negligence or recklessness, the unlicensed midwife can be convicted of culpable homicide, manslaughter, or criminal negligence.
Even if intent to kill is absent, gross imprudence or lack of skill that results in death is sufficient for conviction.
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