Three midwives are suing the state of Georgia for alleged harmful midwifery restrictions.
The lawsuit, filed on April 2 through the Center for Reproductive Rights, challenges two restrictions on midwifery in Georgia: one that threatens jail time and financial penalties for any midwife who practices without a nursing license and another that prevents certified nurse-midwives from practicing without physician oversight.
They are suing because pregnant women “should have the autonomy to decide who they give birth with, and taking away options while there is a glaring lack of providers is senseless,” Nancy Northup, president of the Center for Reproductive Rights, said on the organization’s case page.
“We must break down these legal barriers to improve maternal health care in this country,” she added.
Two of the plaintiffs, both Black, are Florida-licensed direct-entry midwives.
One, Jamarah Amani, has provided community-based prenatal, birth and postpartum care to Black and Latino families for more than a decade and is interested in serving families in Georgia.
The other, Tamara Taitt, has two decades of experience in maternal and child health and is the executive director of Atlanta Birth Center, one of three freestanding birth centers in Georgia.
The third plaintiff, Sarah Stokely, who is White, is a certified nurse-midwife licensed in Georgia and Tennessee, but struggles to practice fully in Georgia due to a restriction requiring a physician.
The case page highlights several alarming statistics about maternal health and mortality in Georgia. More than 50% of Georgia’s counties are maternity care deserts, the state’s maternal death rate is about 43% higher than the national average and 87% of maternal deaths in the state are deemed preventable.
Across the board, Black women lead in maternal mortality rates and other negative maternal health outcomes. Experts say midwives and doulas can help improve maternal health outcomes, but state restrictions make it difficult.
People cared for by midwives are also less likely to have pregnancy interventions like C-sections, episiotomies, epidurals and drug-induced labor costly procedures that can lead to health complications, according to the Center for Reproductive Rights’ case page.
Historically, Black women have a rich tradition of serving as midwives for their communities, but today, only 7% of midwives are Black.
“(W)here are the Black maternity care providers, doulas, and midwives in the United States?” two Black maternal mortality researchers, Dr. Heather Olden and Dr. Farida Yada, questioned in a 2025 article published in the Journal of Obstetric, Gynecologic, & Neonatal Nursing.
“Historically, Black midwives, also known as ‘granny’ midwives, attended a significant portion of births, particularly in the southern states; estimates suggest that they attended as many as 75% of births until the 1940s,” they wrote.
“If Black midwives can improve birthing outcomes for Black women, and the racial disparity in maternal health outcomes must be eliminated, why are there not more Black midwives in the birthing space?”
A 2024 TIME magazine article answered that question, explaining today’s shortage of Black midwives. It cited census data showing that half the women providing reproductive care in the 19th century were Black.
Black midwives helped Black women during slavery and also tended to their slave masters’ wives. The TIME article notes that even when slavery was abolished, “Black women preferred delivering at home with the help of a midwife rather than at a hospital due to the prejudice and discrimination they experienced in society.”
But as childbirth became medicalized, the reins of childbirth were taken from the hands of midwives and placed in the hands of White male obstetricians.
“The medical community also targeted Black midwives and midwives of color as posing another threat to their work, and excluded them from practicing within their establishments,” the TIME article says.
“The assault on the practice of midwifery by White physicians drove down the number of midwives. Even worse, this drop-off worsened birth and pregnancy outcomes—especially for Black mothers … who struggled to find Black health care providers who made them feel secure and cared for.”
Today, Drs. Olden and Yada cited commentary attributing the lack of available Black midwives to legal restrictions, limited recognition in the westernized health care system, insufficient funding, lack of mentorship, limited support and lack of midwifery programs at Historically Black Colleges and Universities.
Several other states joined Georgia in midwifery restrictions. While certified nurse-midwives, who have a nursing degree, are legal and licensed to practice in all 50 states, their level of authority varies by state: some can practice independently, while others require physician oversight, as in Georgia.
Meanwhile, certified professional midwives, who do not have nursing degrees, are prohibited in some states and unregulated in others, and certified midwives, who do not have nursing degrees but have health education backgrounds, are only licensed in a few states.
In January, the American College of Nurse-Midwives filed a lawsuit challenging a Mississippi law that includes the physician requirement to practice.
And in March, a group of midwives and birth centers in Alabama asked for a Supreme Court review of a state appellate court decision that would allow the Alabama Department of Public Health to require birth centers to obtain licenses as “hospitals.”
Even with the shortage of Black midwives, Black home births are still rising, according to a 2024 article by National Geographic. Black home birth rates had a 36% jump, from 2019 to 2020 alone and a 21% jump from 2020 to 2021.
According to data by the Centers for Disease Control and Prevention. Because most home births are assisted by midwives, it is more imperative that barriers to midwifery practice are lifted.
The Honorable Minister Louis Farrakhan, National Representative of the Most Honorable Elijah Muhammad, delivered a series of lectures in the 1980s titled “How To Give Birth To A God,” in which he delved deeply into the importance of pregnancy, cultivating new life and why it is critical women are spiritually, mentally, emotionally and physically prepared to give birth.
“The Honorable Elijah Muhammad taught us, and the Holy Qur’an bears him witness, that we are supposed to reverence the womb that bore us into this world.
To reverence the womb means to hold the womb with deep respect and awe, because the womb is majesty. It is the laboratory where God, Himself, operates,” Minister Farrakhan said in part five of the lecture series, delivered August 9, 1987.
Tamara Muhammad is a certified nurse-midwife.
“We have to become a more healthier community to actually really use midwifery treatment,” Ms. Muhammad said to The Final Call, noting that midwives can only practice on healthy women. “Not everybody’s going to have a natural birth, not when we eat the way we eat,” she added.
She pointed to the words of the Honorable Minister Louis Farrakhan, National Representative of the Most Honorable Elijah Muhammad, who published a series of articles in The Final Call on the “war on obesity.”
“Fat is a high-risk pregnancy,” said Ms. Muhammad. For women who desire to have a natural birth with a midwife present, she also recommended childbirth education and seeing birth as divine.
“In the current political climate, investing in Black midwifery is itself an act of resistance and reclamation, a bold affirmation that Black lives, Black births, and Black traditions matter. We cannot afford to lose sight of the vital role Black midwives have always played in their communities,” Drs. Olden and Yada wrote.
“The question ‘Where are all the Black midwives?’ must not be a haunting unanswered question but instead a rallying cry for the return and resurgence of Black midwives who hold the knowledge, power, and legacy to help ensure that all Black women and newborns have the support they need to thrive.”
—Anisah Muhammad, Staff Writer