Three certified nurse-midwives have filed a lawsuit against the state of Georgia, alleging that current laws create unnecessary barriers to their practice and negatively impact maternal healthcare access. The lawsuit, filed Thursday, argues that Georgia’s policies violate the state constitution and fail to adequately address the state’s growing maternity care crisis.

Georgia's Restrictive Midwifery Laws

Georgia law requires all nurse-midwives to maintain formal, written agreements with physicians outlining when physician intervention is necessary. These agreements often come with significant financial burdens, including monthly fees for physician time and liability insurance – reportedly around $500 per month, according to one plaintiff. Midwives without nursing degrees are prohibited from practicing in the state altogether.

Maternity Care Deserts and Maternal Mortality

The plaintiffs argue that easing restrictions on midwives could help address the significant lack of maternity care in Georgia. More than one-third of the state’s counties are considered “maternity care deserts,” lacking obstetric providers or birthing facilities, according to the nonprofit March of Dimes. Georgia also has a high maternal mortality rate, with 30 deaths per 100,000 births from pregnancy complications or within six weeks postpartum.

“There are some places in the state where there’s nowhere to give birth or access pregnancy care nearby,” said Hillary Schneller, senior counsel at the Center for Reproductive Rights and lead attorney for the plaintiffs. “We have midwives…ready and willing to fill that gap, and the state is treating them like criminals.”

Part of a National Trend

This lawsuit is part of a broader national movement challenging restrictions on midwifery practice. Similar cases have been filed in Mississippi and Alabama, arguing that midwives are crucial in addressing provider shortages, particularly as hospitals close obstetric units.

Recent Legal Challenges

  • Mississippi: The American College of Nurse-Midwives is suing over required physician collaborative agreements.
  • Alabama: A lawsuit challenges a regulation requiring birth centers to be licensed as hospitals. An appeals court recently reversed a lower court ruling in favor of the birth centers.

Sixteen states currently require some form of collaborative agreement between nurse-midwives and physicians. While proponents argue this ensures patient safety, midwives often report difficulty securing these agreements and a sense of distrust in their independent judgment.

Impact on Midwives and Patients

The plaintiffs – Sarah Stokely, Jamarah Amani, and Tamara Taitt – all face challenges due to Georgia’s regulations. Stokely frequently travels to Tennessee to practice, while Taitt struggles with limited staffing at her Atlanta birth center due to the restriction on hiring non-nurse midwives. Amani, a former Georgia resident, ultimately chose to relocate to Florida due to the state’s limitations.

“If you are invested in solving the problem of maternal mortality and infant mortality, it doesn’t really make any sense that you’re not leveraging all of the providers that you can,” said Taitt. The lawsuit seeks to expand access to midwife-led care, including home births and birth center deliveries, for pregnant women in Georgia.

Representatives for the state of Georgia have not yet responded to requests for comment.