Midwives Challenge Georgia’s Restrictive Laws, Citing Maternal Health Crisis and Lack of Options

In a significant legal challenge that underscores the escalating maternal health crisis in the United States, a group of midwives and advocates have filed a lawsuit against the state of Georgia. The action targets some of the nation’s most stringent midwifery regulations, which plaintiffs argue severely restrict the practice of midwives, limit patient choice, and exacerbate existing disparities in maternal care, particularly for Black women and those in rural areas. The lawsuit was announced on April 2, 2026, outside the Georgia State Capitol, coinciding with the final day of the state’s legislative session, a day after lawmakers failed to pass House Bill 520, legislation that aimed to decriminalize and expand midwifery practices.

Background: The Deepening Maternal Health Crisis

The United States faces a stark and persistent maternal mortality crisis, with rates significantly higher than those of other high-income nations. Compounding this national emergency is a growing scarcity of accessible maternity care providers. Across the country, an increasing number of hospitals are closing their labor and delivery units, and freestanding birth centers are facing financial pressures that lead to their closure. This trend has created vast "maternity care deserts," leaving over one-third of U.S. counties without a single birthing facility or obstetric clinician.

Georgia, in particular, has been identified as a state with a critical shortage of maternal health services and some of the most restrictive laws governing midwifery. This environment has contributed to dire health outcomes for pregnant individuals. The closure of Georgia’s oldest freestanding birth center in February 2026, leaving only three such facilities statewide, serves as a potent symbol of this crisis. Furthermore, data from August 2025 indicated that only 36% of Georgia’s rural hospitals were providing labor and delivery services, highlighting the limited options available to a significant portion of the state’s population.

The Lawsuit: Challenging Legislative Barriers

The lawsuit, filed by the Center for Reproductive Rights, Covington & Burling LLP, and Mitchell Shapiro Greenamyre & Funt LLP, names Jamarah Amani, LM; Tamara Taitt, MS, LMFT, LM; and Sarah Stokely, CNM, as plaintiffs. They contend that Georgia’s laws prohibit midwives with expertise in home and birth center births from practicing and prevent certified nurse midwives (CNMs) from practicing to the full extent of their training and expertise. These regulations, the plaintiffs assert, are not only outdated but actively harmful, creating unnecessary barriers to essential healthcare.

Specifically, the lawsuit challenges a regulatory framework that:

• Prohibits Traditional Midwifery: Georgia law effectively criminalizes the practice of traditional midwives who may not hold specific state licenses or certifications, despite possessing generations of inherited knowledge and community trust.
• Restricts Certified Nurse Midwives: Certified Nurse Midwives, despite their rigorous training and proven ability to provide safe and effective care, are often required to enter into restrictive and costly collaborative agreements with physicians, limiting their autonomy and scope of practice. This "physician babysitting" requirement, as described by one plaintiff, adds an insurmountable financial burden and administrative hurdle.
• Fails to Recognize Apprenticeship Models: The state’s legal framework does not adequately recognize or license midwives trained through established apprenticeship models, a vital pathway for many seeking to enter the profession, particularly within marginalized communities.

The timing of the lawsuit’s announcement is strategic, occurring on the final day of the legislative session. The failure of HB520 to pass means that the legal avenue for challenging these restrictions through legislative reform has been temporarily closed, necessitating judicial intervention.

The Impact of Midwifery Care: Evidence-Based Benefits

Extensive research supports the positive impact of increased access to midwives on maternal and infant health outcomes. Studies consistently show that individuals receiving midwifery care are less likely to experience interventions such as Cesarean sections, episiotomies, epidural anesthesia, and induced labor. These procedures, while sometimes medically necessary, are associated with increased costs, potential health complications, and longer recovery times.

Crucially, evidence suggests that midwifery care is particularly beneficial for marginalized populations, including people of color and those with lower incomes. Midwives often prioritize personalized care, foster trusting relationships with their clients, and are skilled at identifying and managing risks, knowing when to involve physicians in complex cases. This patient-centered approach is precisely what many are seeking amidst the current healthcare landscape.

Voices from the Front Lines: Plaintiff Testimonies

The plaintiffs in the lawsuit represent a spectrum of midwifery practice and personal experiences, all unified by their commitment to expanding access to care.

Jamarah Amani, LM, a Florida-licensed midwife and co-founder of the National Black Midwives Alliance, shared her personal connection to the issue: "It should not be illegal to give birth at home with a midwife. Every pregnant person should be able to choose where they give birth and with whom. I was inspired to become a midwife after my own distressing birth experience in Georgia, where hospital staff would not let me give birth in the way I wanted – an all-too-common experience, especially for Black women. I trained in the tradition of legendary grand midwives who have helped Georgians give birth for generations. But because of Georgia law, I had to move to Florida to get my midwifery license and build my career. We’re bringing this case to get rid of these oppressive laws so I can serve families in Georgia, too."

Tamara Taitt, MS, LMFT, LM, executive director of Atlanta Birth Center, where she is currently unable to practice midwifery due to state restrictions, highlighted the urgency of the situation: "Georgia has a maternity care crisis, and the state continues to squander a workforce that could help change that. Currently, there are not enough maternal health care providers in Georgia. The solution is more midwives, and lawmakers need to let us practice. As the US continues to fall behind in maternal mortality and morbidity, the rest of the world employs the solution: more midwives. As a country and as a state, we are visibly failing pregnant people – especially Black women, rural families, and communities of color."

Sarah Stokely, CNM, a Georgia native who currently practices at a home birth practice in Tennessee due to state laws, articulated the practical challenges: "As a Georgia native, I want to use my midwifery license and skills to help families in my own state. But because of Georgia laws, I have to drive to Tennessee to practice my profession. In Georgia, I would need to pay a physician an insurmountable fee to babysit me. Many clients come to me because they’ve had traumatic hospital births, with procedures forced upon them. Our current medical system is not meeting the needs of pregnant people, and they deserve options. Midwives prioritize providing more personalized care and listening to the needs of our clients. We also know when to pull in a physician if certain risks arise."

Nancy Northup, President of the Center for Reproductive Rights, emphasized the legal and ethical dimensions of the case: "We cannot solve the maternal health crisis without midwives – they are a key part of the solution in Georgia and nationwide. Yet under Georgia law, midwives are treated like criminals. These extreme restrictions are exacerbating the maternity care crisis and infringing on the rights of pregnant women who want to give birth with midwives. We are suing the state because pregnant people should have the autonomy to decide who they give birth with, and taking away options while there is a glaring lack of providers is senseless. We must break down these legal barriers to improve maternal health care in this country."

A National Trend: Challenging Midwifery Restrictions

The lawsuit in Georgia is part of a growing national movement to challenge restrictive midwifery laws. Similar legal battles are underway in states such as Mississippi, Nebraska, and Alabama, all seeking to dismantle regulations that hinder midwives and birth centers. In a significant development for North Carolina, certified nurse midwives will no longer be required to enter into physician-led collaborative agreements starting in October 2026. Additionally, following a lawsuit filed by the Center for Reproductive Rights in 2024, Hawaii successfully expanded access to traditional and apprenticeship-trained midwives, demonstrating that legal challenges can yield positive policy changes.

Broader Implications: Reforming Maternal Care

The implications of this lawsuit extend beyond Georgia’s borders. It signifies a critical juncture in the ongoing effort to reform maternal healthcare in the United States. By challenging the legal framework that limits midwifery, advocates aim to:

• Increase Access to Care: Removing restrictive laws could open doors for more qualified midwives to practice, directly addressing the shortage of maternal health providers and reducing the prevalence of maternity care deserts.
• Improve Health Outcomes: Greater access to midwifery care, with its emphasis on individualized support and reduced intervention rates, has the potential to significantly improve maternal and infant health outcomes, particularly for vulnerable populations.
• Advance Reproductive Autonomy: The lawsuit champions the fundamental right of pregnant individuals to make informed decisions about their bodies and their birth experiences, including the choice of provider and birthplace.
• Reduce Health Disparities: By supporting models of care that are often more accessible and culturally attuned, this legal action could help to dismantle systemic inequalities in maternal healthcare.

The legal challenge in Georgia is poised to be a pivotal moment in the fight for comprehensive, accessible, and equitable maternal healthcare, potentially setting a precedent for other states grappling with similar restrictive laws and a worsening maternal health crisis. The outcome of this case will be closely watched by healthcare providers, policymakers, and expectant families across the nation.

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