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SAVANNAH, Ga. — A legal challenge to Georgia’s regulations on midwifery is shedding light on the state’s maternal health care shortages and the limitations imposed on certified nurse-midwives.
The lawsuit contends that existing state laws hinder access to necessary care by mandating that certified nurse-midwives work under physician collaboration agreements, restricting their ability to practice independently.
This issue is particularly pressing as vast areas of Georgia experience a scarcity of accessible maternity services.
Reports from the March of Dimes highlight that over one-third of the state’s counties are classified as maternity care deserts, indicating an absence of obstetric providers or nearby birthing facilities.
Furthermore, the organization ranks Georgia 49th nationwide in terms of maternal and infant health outcomes, underscoring the urgent need for reform.
Michelle Monroe is the CEO of the American College of Nurse-Midwives, and she says expanding access to midwives could help address those gaps.
“Midwives can offer the solution to our maternity care deserts,” Monroe said.
Certified nurse-midwives are registered nurses with advanced training in midwifery and women’s health care. In addition to assisting with childbirth, they also provide prenatal, postpartum and gynecological care.
However, under current Georgia law, nurse-midwives cannot practice without a collaborating physician.
“More than 51% of counties in Georgia do not have an OB-GYN provider at all,” Monroe said. “Midwives are available to fill that gap, but our regulations in Georgia do not allow us to actually do that.”
Advocates also say misconceptions about midwifery limit patient access and awareness.
Monroe said most certified nurse-midwives work in hospitals rather than home birth settings.
“About 90% of midwives do births in hospitals,” Monroe said. “Only about 10% are in the birth center or home birth space.”
Supporters of the lawsuit say allowing greater independence for certified nurse-midwives could expand maternity care options, particularly in rural areas where hospitals and obstetric providers are scarce.
Monroe said advocates are seeking full practice authority for midwives in Georgia, allowing them to operate independent practices under national standards.