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Medical board reprimands area midwife

Multiple violations published online in previous board orders, notice from Department of Health Professions

By Sally Voth

A midwife has received a reprimand from the Virginia Board of Medicine.

Peggy Lee Franklin, of Gainesville, was reprimanded, according to a post dated Wednesday on the Virginia Department of Health Professions' website.

A document related to the case was classified as "pending" on the site, and not yet available through the Practitioner Information website.

However, previous board orders and a notice that describes multiple violations were published online, as was a reprimand from last year.

According to an April 26, 2011, notice to Franklin from Virginia Board of Health Executive Director Dr. William L. Harp, she was to appear before an informal board conference last summer.

The notice identifies her as a licensed midwife and certified professional midwife.

It states Franklin may have violated board regulations by either not providing a 30-year-old patient with a written disclosure explaining her qualifications, experience and training; whether she had hospital privileges; that midwives can't prescribe or administer controlled medications; midwifery qualifications; and that midwives aren't covered by the Virginia Birth-Related Neurological Injury Compensation Fund, among other requirements, or not getting the patient's signature saying the requirements had been explained to her.

Franklin also neglected to tell her patient her options regarding referral to a doctor or to provide "evidence-based information regarding the health risks associated with birth of a child outside of a hospital or birthing center in the case of vaginal birth after a prior cesarean section," the notice states.

Additionally, Franklin didn't get the medical report about the patient's C-section, and therefore, didn't know what type of incision was used, it states.

Franklin also allowed the woman to remain at home despite the fact she hadn't yet had contractions nearly two days after her water broke. She's accused of either not talking with the patient, or not documenting such a discussion, about the increased risk of infection that can result from going more than 24 hours without labor after the rupture of membranes.

The patient showed up at Franklin's office about 26 hours after her water broke, the notice says.

"Although Patient A was still not in labor at that time, you did not recognize the critical and unsafe nature of the situation for Patient A and her infant if delivery was further delayed, and failed to recommend or effect transfer of Patient A to the hospital or other appropriate healthcare professional," the notice says.

Contractions didn't start until more than 46 hours after the woman's water broke, and Franklin went to her home about five hours after that, according to the notice. An hour-and-a-half later, the woman was taken to the hospital asking for an epidural, it states.

A bit more than an hour later, she delivered via emergency C-section a floppy baby that needed to be resuscitated due to respiratory distress, according to the notice.

It accuses Franklin of talking to the patient about lying to doctors about the length of time that had passed since her membranes had ruptured.

Franklin documented what happened before the patient went to the hospital, according to the notice.

"We discussed that it wasn't 'politically correct' to have [rupture of membranes] over 24 hours with OB standard of care vs. midwifery model of expectant management despite what the studies show...I asked what time they wanted to say the water broke and they suggested midnight, just 24 hours prior," the notice quotes Franklin's record. "This seemed reasonable to me, enough to ensure the staff would be aware of the prolonged rupture in their assessment of care and possibly enough to spare them (and me) of unnecessary criticism upon admission."

The notice goes on to state that Franklin never alerted the attending physician to the length of time since the patient's membranes broke.

According to an order from last August, the midwife told a special conference committee midwifery calls for giving mothers options and their risks, and then letting the mother decide what action to take.

She said the reason for deceiving hospital staff was to let them know the woman's water had been broken "for a long time," but to possibly still make a vaginal birth possible, according to the order.

"Ms. Franklin stated it is unlikely she would handle this situation the same way in the future," the order states. "She also stated that her patients will not be allowed to go over 24 hours with ruptured membranes."

The committee reprimanded Franklin, and required her to get continuing education in professional ethics for health care workers, the order states.

A Jan. 30 order states that Franklin had complied with the board's order, and fully reinstated her license to practice.

Franklin's Facebook page has numerous pictures of newborns and their parents, and says she owns Birth by Design in Chantilly, although the business' website was not accessible Friday evening.

Franklin is also licensed as a registered nurse, according to the Virginia Department of Health Professions' website.

Several years ago, the General Assembly amended the Code of Virginia regarding the regulation of midwifery. Midwives were then required to inform patients of added risks for vaginal home births after a c-section, breech births, high-risk pregnancies and multiple babies.

Franklin did not return a phone call Friday evening.


Does Front Royal's very own "Mr. First Lady" support mid-wife Peggy Lee Franklin?

It is well known the Republicans are willing to do anything to control every aspect of a woman's private life, including but not limited to conception, birth control, menstruation, child birth, maidenhood, pregnancy, and menopause.

What reason would Matt Tederick have for becoming a chapter president of an association with these goals?



It's quite apparent you are in menopause with such a comment. Maybe the republicans can send you some meds to ease your fits of rage and bitterness.

Tesstickels you have it wrong. What republicans want is to not have to pay for a woman's desire to do whatever to her body. But as long as people like you insist on people like me paying for every aspect of a woman's life (like Obama's Julia) then get used to me wanting to have a say. You can't have it both ways.
And really... grow up, this article has nothing to do with politics.

so tell me, do you hold the same view toward male enhancement medications that allow a man to do whatever? Perhaps if republicans stopped the easy access to those medications women wouldn't need as much in the way of birth control, abortions or prenatal care


Thank you, kind sir, for clarifying what we may be allowed to say and what we can not say. We will be eternally grateful the world has you to safeguard us from those who do not know your rules for commenting. In your honor, my wife wants you to be the father of her next baby. She wants Matt to be the mid-wife.

No Bishop, YOU have it all wrong. You champion limited government yet you choose to make reproductive rights the business of government? You want it both ways?

You have not paid for my birth control. Do you pay for your boyfriends Viagra? Nobody is paying for women's desires, either.

LOL Tesstickles...I don't want the government involved in reproductive rights, but abortion is murder and as I understand it the government is supposed to stop murders before they happen...and as for the birthcontrol and viagra (lol) comment if you were on government aid then I would be paying for it because I am actually a tax payer. No medicine should be paid for by the government. Get government out of medicine and the prices would drop, but when the government allows them to charge anything they like then why not charge the most. You champion government control of every aspect of healthcare (except the murder of the pre born) and you're the one that brought politics into this converstaion...so please now tell me what does this article have to do with your assault on republicans?


Kim, you say if the government got out of medicine, the prices would drop and then you say that they dont control the price of medicine and so it's too high. Which is it?

I realize this thread has gotten off topic from what the original news article is about, but oh well-------.

That one sentence you wrote, Kim, is confusing. First you say if you get government out of medicine the prices would drop, but then you say "when government 'allows' them to charge anything they like, why not charge the most" which makes it sound like you advocate government to be involved!

To place all the blame on the involvement of government in medicine as to what caused the terrible rise in health care costs over the years is just plain wrong. There are numerous reasons, but I can tell you a MAJOR reason is when hospitals and doctors have to cover the cost of medical care for all the people who are not insured----and for which we all end up paying for in higher charges on our hospital bills. If someone is stabbed or shot, or in an accident, they will be cared for at a hospital even if they have no insurance and no matter how many thousands of dollars their care comes to. (Not to mention the high percentage of uninsured individuals who feel forced to use the hospital ER for minor things otherwise treated in a doctor's office.) And most of the time they (or their family if they do not make it out of the hospital after a serious event), can not or will not make an attempt to even try to pay down any part of the very high bill. The only way hospitals were able to stay solvent was to then charge those of us with insurance more-----i.e. the cost of $5.00 for a single aspirin in the hospital that shocked a friend of mine who requested an itemized bill after a hospital stay. This is exactly what Obamacare is trying to address in trying to get everyone covered with insurance. I don't agree with everything in Obamacare, but it is sure a step in the right direction if we want to control the cost of health care.

And as far as saying "-----when government allows them to charge anything they like------" that also is just incorrect! Take a look some time at your parent's or grandparent's paperwork from Medicare after a medical procedure or doctor visit. The doctor/hospital might charge a certain amount but if Medicare finds it to be an "over charge" they will pay only what is considered "reasonable and customary" for that particular service or procedure. Sounds to me like government (Medicare) is trying to keep costs reasonable!

I think a healthy watch that government is not getting too big and too controlling of our everyday lives is fine, but I think what we are seeing today are those on the extreme right of the political spectrum ( some Tea Party people) wanting to blame government for everything that is wrong and wanting to eliminate it to the extreme----except when it comes to the issues THEY think are important and want government to control!

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