A Nebraska midwife filed a civil rights lawsuit this month against her state in federal court over a law forbidding her from participating in home births.
Midwifery has been practiced since the early days of the republic when most American births took place outside of a hospital with the assistance of midwives, according to the legal complaint filed in court. At the time the Fourteenth Amendment, the basis for the new lawsuit, was enacted in 1868, midwifery was universally lawful, and women and their families had many options as to the birth process.
Giving birth at home is legal in all 50 states and can help lessen the burden of childbirth on the health care system. Service charges for home births are generally lower than charges for hospital births and reduce the quantity of unneeded medical interventions.
Certified nurse midwife (CNM) Heather Swanson believes it is her calling to provide childbirth services, especially to underserved communities, so mothers will have the ability to choose where and how to give birth.
Over the past two decades, she has been a practicing CNM, nurse practitioner, and the Nebraska affiliate president for the American College of Nurse-Midwives.
According to Ms. Swanson, her work is important because the Cornhusker State has more counties lacking accessible maternity care than the national average. These so-called maternity deserts mean many women in the state are left without adequate childbirth care.
But Ms. Swanson’s professional activities are limited by Nebraska’s Certified Nurse Midwifery Practice Act, which forces CNMs to be supervised by local physicians and forbids CNMs from attending home births even if under the supervision of a physician.
“I would like to be able to practice to the full extent of my training and education and to do what I could do in other states. And I can’t do that here in Nebraska, which is where I feel called to practice,” she told The Epoch Times.
“Nurse-midwives are prohibited in statute from attending home births—there is a line specifically in our Nursing Midwifery Practice Act that states that we cannot attend home births.”
The law also includes a provision requiring nurse-midwives to enter into a practice agreement with a physician who practices obstetrics, she said.
This physician supervision requirement serves no health or safety interest, and instead serves only to protect physicians’ economic interests, according to the Pacific Legal Foundation (PLF), a national public interest law firm that challenges government overreach.
Available data also demonstrate that physicians rarely make house calls in Nebraska, making it nearly impossible for an expectant mother to have a formally trained medical professional on hand for a home childbirth.
In states that require such practice agreements, there is a reduction in the number of nurse-midwives, particularly in rural areas, Ms. Swanson said.
“And so, in Nebraska, we have a lot of what we call obstetric deserts, where we have a limited number of maternal health providers.”
Defendant Mike Hilgers, Nebraska’s Republican attorney general, is being sued in his official capacity. His official duties include enforcing and defending the laws and health regulations of the state, including the Certified Nurse Midwifery Practice Act.
Co-defendant Charity Menefee, director of the Division of Public Health for the Nebraska Department of Health and Human Services, is also being sued in her official capacity. Ms. Menefee is responsible for regulating health-related professions and facilities in the state, and for adopting rules and regulations to carry out the Certified Nurse Midwifery Practice Act.
There is no good reason for Nebraska not to allow certified nurse midwives like Ms. Swanson to attend home births, PLF attorney Joshua Polk said in a statement.
“Certified nurse midwives, who have extensive childbirth education and training, are uniquely excluded from attending home births, while mothers can deliver their babies with the assistance of unlicensed doulas and lay-midwives without nursing degrees, or even no one at all,” the lawyer said in a statement.
“Nebraska’s CNM ban for home births and the physician supervision requirement violate the right of CNMs to provide critical childbirth care and the right of Nebraska’s mothers to receive that care.”
The Nebraska law “defies logic and basic human rights,” according to PLF.
It is the only state to outright ban certified nurse midwives from home births. Failing to comply can result in felony charges, while lay midwives and doulas, who are not regulated by the state, face no such restrictions.
“I definitely feel like my constitutional rights are being violated,” Ms. Swanson said. “Midwifery has been around since biblical times.”
“My ability to practice my desired profession is being restricted by a state statute that was put into place not because of evidence that supported the restriction, but because of a turf issue,” she said.
The Nebraska attorney general’s office declined to comment on the pending litigation.
