The lawsuit comes after Alabama Department of Public Health (ADPH) has 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 center to even attempt to obtain such a license, creating a dilemma that is both unlawful and unjustified.
The lawsuit brings several statutory and constitutional claims against ADPH, including:
- ADPH lacks the authority to require birth centers to obtain a hospital license because midwife-led birth centers do not constitute “hospitals” under Alabama law.
- Even if ADPH has licensing authority, it does not have the authority to ban birth centers altogether, and by failing to provide any path to licensure, the Department is imposing a de facto birth center ban throughout Alabama.
ADPH’s unlawful actions are exacerbating an already severe crisis for pregnant Alabamians or those seeking to become pregnant. The state has 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.