A coalition of midwives has initiated a constitutional challenge against the State of Georgia, contesting a regulatory framework they argue unlawfully restricts the practice of midwifery and exacerbates gaps in maternal healthcare access.
Filed in state court, the lawsuit targets statutory and administrative requirements that mandate midwives obtain nursing degrees and licensure, while also entering into formal supervisory or collaborative agreements with licensed physicians.
The plaintiffs contend these provisions impose undue economic and professional barriers that are not rationally related to patient safety.
Claims Center on Constitutional and Access Grounds
The complaint alleges that Georgia’s regulatory scheme violates provisions of the state constitution by limiting the right to practice a lawful profession and restricting patient access to qualified healthcare providers.
Plaintiffs include certified nurse-midwives and birth center operators who argue that the physician agreement requirement—often involving monthly fees and liability coverage—creates a de facto barrier to entry. In some cases, midwives report difficulty securing willing physician collaborators, effectively foreclosing their ability to practice.
Lead counsel Hillary Schneller of the Center for Reproductive Rights stated that the laws “fail to advance patient safety while criminalizing qualified providers ready to meet critical healthcare needs.”
The Georgia Attorney General’s office has declined comment, citing pending litigation.
Regulatory Context and Statutory Constraints
Georgia is among a minority of states that do not license certified midwives who are not also registered nurses. Additionally, while nurse-midwives are recognized, they must comply with strict written agreement requirements governing physician oversight and intervention protocols.
The plaintiffs argue that these constraints are inconsistent with national standards and create a fragmented regulatory environment that undermines workforce capacity.
Factual Record Highlights Maternal Health Indicators
The litigation is grounded in broader public health data cited within the complaint. Georgia faces significant maternal health challenges, including:
- More than one-third of counties designated as maternity care deserts
- Only 36% of rural hospitals offering labor and delivery services
- Approximately 30 maternal deaths per 100,000 births
The plaintiffs further emphasize racial disparities, noting that Black women experience disproportionately higher maternal mortality rates nationwide.
Comparative Litigation and Emerging Jurisprudence
The case aligns with a growing body of litigation challenging midwifery restrictions across multiple jurisdictions. Recent actions in Mississippi and Alabama have similarly contested physician collaboration requirements and facility licensing rules.
In parallel, courts in some states—including North Carolina and Hawaii—have issued rulings or settlements expanding pathways for midwives to practice, signaling a potential shift in how such regulations are evaluated under constitutional and administrative law frameworks.
Potential Legal Implications
If successful, the Georgia lawsuit could recalibrate the balance between state regulatory authority and professional licensing rights, particularly in the context of healthcare workforce shortages. It may also influence judicial scrutiny of whether physician oversight mandates constitute legitimate safety measures or impermissible economic protectionism.
Legal observers note that the case could set a significant precedent for evaluating occupational licensing regimes under state constitutional doctrines, especially where public health access considerations are implicated.
