Georgia Midwives Risk Legal Consequences to Support Growing Home Birth Trend

Midwives Face Legal Risks While Demand for Home Births Surges

In a suburban Atlanta home, Madie Collins lay on an examination table as a certified professional midwife measured her pregnant belly. Unlike a traditional doctor’s office, the room lacked crinkly paper sheets and antiseptic chill. Instead, children’s toys, scented candles, and a wood-burning stove warmed the space. The midwife used a handheld Doppler ultrasound machine to detect the baby’s heartbeat, telling Collins’ 3-year-old daughter, "That’s her heartbeat. I think Mommy’s baby’s right here."

The midwife, who is not licensed as a nurse, is operating in a legal gray area. Georgia is one of seven states where non-nurse midwives face penalties for delivering babies without a license. In North Carolina, it’s a misdemeanor. In New York, it’s a felony. KFF Health News agreed not to identify her by name.

Home Births Rise Nationally, Especially in States Without Licensing

Demand for home births has surged, with a 42% increase nationally from 2020 to 2024, according to the National Center for Health Statistics. Certified professional midwives oversee many of these births. In Georgia, home births rose by 72% during the same period.

Home births account for 1.5% of deliveries nationwide. However, in the eight states where they are most common—Hawai‘i, Idaho, Montana, Pennsylvania, Utah, Vermont, Wisconsin, and Wyoming—they make up 3% to 5% of births.

Advocates Push for Licensing to Improve Safety

Midwifery advocates argue that regulating the profession with licenses could make home births safer. Free birth, without professional assistance, poses risks for both mothers and babies. Missi Burgess, president of the Georgia chapter of the National Association of Certified Professional Midwives, emphasized the need for trained providers: "People are going to keep having their babies at home, and they deserve a trained provider."

Certified Professional Midwives vs. Nurse-Midwives

Certified professional midwives deliver babies in homes or birth centers. Unlike nurse-midwives, they do not attend nursing school, which many cannot afford. Instead, they earn a nationally recognized certificate by attending at least 55 births and demonstrating their knowledge. Nurse-midwives more often work in hospitals or clinics.

Legislative Efforts Stalled Despite Growing Support

For decades, professional midwives have advocated for laws to legalize and regulate their profession. Over the past 15 years, 36 states and Washington, D.C., have allowed certified professional midwives to obtain licenses to deliver babies. In 2024, lawmakers in Georgia, Mississippi, Nebraska, New York, North Carolina, Ohio, and West Virginia introduced bills to join this list, but none have become law.

Opposition from Hospitals and Doctors

Some hospitals and doctors oppose midwife licensing proposals unless certain guardrails are in place. The American College of Obstetricians and Gynecologists has historically raised concerns about home birth safety, though some studies suggest that planned home births with trained midwives can have comparable outcomes to hospital births for low-risk pregnancies.