Alabama Court Blocks De Facto Ban on Birth Centers in Case Brought by Midwives and Doctors

MONTGOMERY, Ala. — The Fifteenth Judicial Circuit Court issued a ruling today blocking the Alabama Department of Public Health (ADPH) from continuing to prevent the operation of midwife-led birth centers in Alabama. The ruling means Oasis Family Birthing Center in Birmingham, Alabama Birth Center in Huntsville, Birth Sanctuary in Gainesville, and any other birth center complying with standards set by the American Association of Birth Centers can secure licenses from ADPH to operate — and providers will be able to resume serving pregnant Alabamians with much-needed pregnancy care.

A group of midwives and doctors filed the case in August after ADPH created significant uncertainty around the legal status of birth centers that provide midwife-led care by asserting that all such birth centers require a “hospital” license, even though they exclusively provide midwifery care to low-risk patients using a model of care that is safely provided in out-of-hospital settings across the country. At the same time, ADPH has made it impossible for any such birth centers to even attempt to obtain a license, creating a dilemma that is both unlawful and unjustified. ADPH’s actions abruptly shut down operations for one birth center earlier this year, despite a perfect safety record.

Statement from Whitney White, staff attorney with the ACLU Reproductive Freedom Project:

“We are pleased that the court put an end to the Alabama Department of Public Health’s unlawful and dangerous de facto ban on birth centers, allowing the dedicated providers in this case to offer pregnant Alabamians the essential health care they need in birth centers throughout the state.”

The de facto ban ADPH created was especially harmful in a state with the third highest maternal mortality rate in the nation, with Black women making up a disproportionate share of maternal deaths. Alabama also has the sixth highest infant mortality rate in the nation, with Black infants making up a disproportionate number of these deaths. One factor playing into this concerning trend is the growing number of maternal health deserts in the state.

More than two-thirds — or 43 out of 64 — counties in Alabama have little to no access to maternity care. To address this disparity, midwives and providers are working to open birth centers to provide safe and welcoming environments for low-risk patients to access much-needed prenatal care and birthing services, especially for those who have decided that giving birth at home or in a hospital is not the right place for them to deliver, or impossible due to the lack of maternal care available in their area.

The lawsuit, Oasis Family Birthing Center et. al. v. Alabama Department of Public Health, was filed in the Fifteenth Judicial Circuit Court in Montgomery by the American Civil Liberties Union, the ACLU of Alabama, and Bobby Segall of Copeland Franco on behalf of Oasis Family Birthing Center in Birmingham, Heather Skanes, M.D., Alabama Birth Center in Huntsville, Yashica Robinson, M.D., Birth Sanctuary in Gainesville, Stephanie Mitchell DNP, CNM, CPM, and the Alabama affiliate of the American College of Nurse-Midwives.