Georgia Midwives Break Law to Meet Rising Demand for Home Births
Certified professional midwives in Georgia risk legal action to meet surging demand for home births, which have increased 72% since 2020 in the state.
GWINNETT COUNTY, GEORGIA — Madie Collins lay on an examination table in a suburban Atlanta home as a certified professional midwife measured her pregnant belly, the sound of children playing outside filtering through windows. The room lacked the sterile atmosphere of a typical medical office, instead featuring children’s toys, scented candles, and warmth from a wood-burning stove.
What makes this prenatal appointment different from thousands of others happening across Georgia is that it’s illegal. The midwife providing care to Collins is not licensed as a nurse, making her practice of delivering babies a violation of state law.
Georgia is one of seven states where non-nurse midwives face legal consequences for delivering babies, ranging from cease-and-desist letters to criminal charges. In North Carolina, the practice constitutes a misdemeanor, while New York classifies it as a felony.
Home Birth Demand Surges Despite Legal Barriers
The legal restrictions come as demand for home birth services continues to climb across the nation. Intended home births rose by 42% nationally from 2020 to 2024, according to the National Center for Health Statistics. Georgia experienced an even steeper increase, with home births jumping 72% during the same period.
These births are typically overseen by certified professional midwives who provide comprehensive care from prenatal appointments through several postpartum visits. This model offers more follow-up care than most new mothers receive in traditional hospital settings.
“That’s her heartbeat,” the unnamed midwife told Collins’ 3-year-old daughter as she pressed a handheld Doppler ultrasound machine to her mother’s belly. “I think Mommy’s baby’s right here.”
Legal Risks vs. Patient Care
The midwife requested anonymity when speaking with KFF Health News due to the legal risks associated with her practice. Despite operating outside the law, she continues providing services in her home office, which features a playground and chicken coop outside.
The examination room where Collins received care differs markedly from clinical settings. No crinkly paper sheets covered the table, and no antiseptic chill filled the air. Instead, the adjacent room where the appointment began offered a family-friendly environment with toys and comfortable furnishings.
Growing Movement Amid Regulatory Challenges
The increase in home births reflects a broader trend of families seeking alternatives to hospital deliveries. Midwives who assist with these births typically maintain longer-term relationships with their clients, providing care that extends well beyond the delivery itself.
Home births currently make up a small but growing percentage of all deliveries in the United States. The rise in Georgia outpaces national trends, suggesting particularly strong demand in the state despite the legal obstacles faced by practitioners.
The situation highlights tensions between consumer demand for alternative birthing options and existing healthcare regulations designed to ensure safety and professional standards. As more families seek home birth services, midwives like the one treating Collins must weigh their desire to provide care against potential legal consequences.
