Georgia Midwives Face Criminalization Amid Maternal Health Crisis Lawsuit
A groundbreaking lawsuit has been filed against the state of Georgia, aiming to decriminalize the work of midwives who are currently banned from providing essential care. This legal action comes as Georgia grapples with a worsening maternal health crisis, where Black women are more than twice as likely to die from childbirth compared to white women. The lawsuit, brought by the Center for Reproductive Rights, represents a critical effort to expand access to safer birthing options in a state with some of the strictest midwifery laws in the country.
Midwives Blocked from Practicing Despite Critical Need
Tamara Taitt, a nationally accredited midwife and executive director of the Atlanta Birth Center, finds herself in an extraordinary and frustrating position. Under Georgia law, she cannot provide routine clinical care to the center's clients, despite her extensive training and certification as a certified professional midwife (CPM). This credential allows her to practice in 39 states, but in Georgia, only certified nurse-midwives—those who are also licensed nurses—are permitted to work legally. Taitt could face fines of up to $1,000 or even imprisonment for performing basic tasks like prenatal visits or delivering babies.
Georgia suffers from a catastrophic shortage of maternal health providers, with half of its counties lacking an obstetrics provider and a third classified as "maternal health deserts." More than 40 labor and delivery units have closed since 1994, exacerbating the crisis. Yet, the state continues to block trained midwives like Taitt from practicing, leaving families with limited options for holistic, less medicalized care. Birth centers, which offer alternatives to hospital births with fewer invasive interventions, are in high demand, especially given that C-section rates in Georgia are three times higher than the World Health Organization's recommendations.
Plaintiffs Highlight Personal and Systemic Impacts
The lawsuit includes plaintiffs like Jamarah Amani, a midwife who was forced to leave Georgia due to its restrictive laws. Now based in Florida, Amani works with Black families, including young and low-income mothers, through a mobile clinic. She expressed her frustration at having to turn away Georgians seeking her care because she cannot obtain a license in her home state. Another plaintiff, Sarah Stokely, is a certified nurse-midwife licensed in Georgia but finds the state's requirements financially untenable. She commutes two hours north to Tennessee to care for mothers, as Georgia mandates physician oversight that can cost midwives $1,000 per month.
Angela Aina, executive director of the Black Mamas Matter Alliance, emphasized the public health implications of these restrictions. "In the face of that reality, the state of Georgia is not expanding access to care," she said. "It is actively blocking trained, qualified midwives from practicing." Historically, Black midwives were the primary maternity care providers in the U.S., but systematic exclusion through regulations has drastically reduced their numbers. Research shows that thousands of traditional midwives served Georgia families a century ago, but by the mid-20th century, that number had dwindled to just 2,000 due to stringent licensing laws.
Global and Local Perspectives on Midwifery Care
Evidence suggests that midwifery care leads to fewer unnecessary medical interventions and better outcomes for mothers and babies. Globally, organizations like the World Health Organization advocate for expanded midwifery access, noting it could prevent over 60% of maternal and newborn deaths. However, in the U.S., midwifery pathways vary widely, with Georgia representing an outlier in its severity. While states like New Mexico allow licensed midwives to administer medications independently, Georgia's laws align with groups like the American Medical Association, which opposes expanding nonphysicians' scope of practice.
Despite the criminalization, families in Georgia continue to seek out unlicensed midwives for home births, driven by fears of unnecessary medical interventions in hospitals. Sekesa Berry, a community midwife serving Black women, reports that clients often contact her saying, "I don't want to die," reflecting awareness of the state's maternal health crisis. Although unlicensed midwives rarely face criminal charges, their precarious status hinders coordination with hospitals during emergencies.
The state has 30 days to respond to the lawsuit. For now, Georgia remains an exception among its neighbors, most of which offer licensure pathways for direct-entry midwives. As Taitt poignantly stated, "Instead, Georgia is choosing to leave a skilled, committed workforce on the sidelines even as communities struggle to access care." This legal battle underscores the urgent need for policy reform to address Georgia's maternal health disparities and support midwives in providing safe, accessible care.
