Midwives and their advocates are celebrating an Alabama court ruling that permanently blocks the Alabama Department of Public Health (ADPH) from regulating freestanding birth centers like hospitals.

“This ruling is a powerful affirmation of what birth workers, families, and communities across Alabama have long known: midwife-led care is essential,” JaTaune Bosby Gilchrist, executive director of the American Civil Liberties Union of Alabama, wrote in a recent release.

“As hospitals and obstetric services close across the state—particularly in rural areas—birth centers and midwives are stepping in to fill a dangerous gap in access.“

“In a state facing a maternal health crisis, we need more options, not fewer,” she continued.

The Fifteenth Judicial Circuit Court in Montgomery Thursday blocked the ADPH from continuing its current policy regarding more stringent rules for midwife centers, according to court documents.

“This decision brings us one step closer to ensuring that safe, accessible, and community-based birthing care is available to everyone who needs it,” Gilchrist wrote.

The ruling prevents the ADPH from “imposing onerous licensing rules that would have made it effectively impossible for these centers to provide evidence-based midwifery care in the state,” the ACLU release says.

The birth centers’ lawsuit was filed in August 2023 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.”

“ADPH’s actions abruptly shut down operations for the one birth center then-operating in Alabama, despite a perfect safety record,” it reads.

The release continues that “the de facto ban on this essential care was especially harmful in Alabama, which has some of the highest maternal and infant health rates in the country, with Black women and infants making up a disproportionate share of deaths.”

“One factor playing into this concerning trend is inadequate access to pregnancy-related care, including the growing number of maternal health deserts in the state and closures of hospital labor and delivery units,” it reads.

The decision from the Fifteenth Judicial Circuit Court holds that the Alabama Legislature never authorized ADPH to regulate midwifery care in birth centers, leaving that responsibility to the Board of Midwifery and other professional licensing boards in the state.

“The ruling ensures that plaintiffs Oasis Family Birthing Center in Birmingham and Alabama Birth Center in Huntsville, which have been safely operating for the past year, may continue providing midwifery care to pregnant Alabamians,” the release reads.

It adds that the centers will operate “in accordance with evidence-based standards set by the American Association of Birth Centers.”

“We are elated that the dedicated midwives at Alabama’s birth centers can continue to provide crucial care to pregnant Alabamians across the state without undue interference,” said Whitney White, staff attorney with the ACLU Reproductive Freedom Project.

“Midwifery care in birth centers is safe, can improve patient outcomes, and can play a critical role in expanding access to equitable pregnancy care in Alabama.”

According to the most recent statistics from the March of Dimes, more than a quarter of all Alabamians — and nearly 90 percent in rural areas — have no birthing hospital within 30 minutes’ drive.

“Today’s decision will allow even more Alabamians to access this essential care and pave the way for more birth centers to open in the state,” the ACLU release reads.

The lawsuit was filed 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.