Alabama Birth Centers Secure Permanent Legal Protection
In a significant victory for maternal healthcare access in Alabama, a state trial court has permanently blocked the Alabama Department of Public Health (ADPH) from imposing hospital-like regulations on freestanding birth centers.
The ruling, issued by the Fifteenth Judicial Circuit Court in Montgomery, ensures that birth centers can continue providing evidence-based midwifery care without unnecessary regulatory burdens.
The court’s decision, finalized on May 2, 2025, determined that the Alabama Legislature never authorized ADPH to regulate midwifery care in birth centers.
Instead, this responsibility falls to the Board of Midwifery and other professional licensing boards in the state.
A Critical Win for Maternal Healthcare Access
The ruling directly benefits the plaintiffs in the case—Oasis Family Birthing Center in Birmingham and Alabama Birth Center in Huntsville—allowing them to continue their operations without interruption.
Both facilities have been safely providing care since 2023 under the terms of a preliminary injunction.
“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.”
Addressing Alabama’s Maternal Health Crisis
This legal victory comes at a crucial time for Alabama, which continues to face significant challenges in maternal and infant health.
The state has some of the highest maternal and infant mortality rates in the country, with disproportionate impacts on Black women and families and low-income communities.
“This ruling is a powerful affirmation of what birth workers, families, and communities across Alabama have long known: midwife-led care is essential,” stated JaTaune Bosby Gilchrist, executive director of the ACLU of Alabama.
“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.”
The Legal Battle Over Birth Center Regulation
The lawsuit, officially titled Oasis Family Birthing Center et. al. v. Alabama Department of Public Health, was filed in August 2023 after ADPH created significant uncertainty around the legal status of birth centers by asserting that all such facilities required a “hospital” license—despite the fact that they exclusively provide midwifery care to low-risk patients.
This regulatory approach effectively shut down operations for the only birth center operating in Alabama at that time, despite its perfect safety record.
The court’s permanent injunction now ensures that birth centers will be regulated appropriately for the services they provide, not as hospital facilities.
A Family Law Perspective on Birth Options
From a family law standpoint, this ruling represents an important victory for parental autonomy and reproductive rights in Alabama.
Families now maintain their legal right to choose where and how they give birth, with options beyond traditional hospital settings.
The availability of birth centers is particularly significant in areas classified as “maternal health deserts”—regions with limited or no access to obstetric care.
As rural hospitals continue to close labor and delivery units across Alabama, birth centers provide a critical alternative for families seeking safe, personalized care.
The Role of Birth Centers in Alabama’s Healthcare Landscape
Birth centers in Alabama provide midwife-led care for low-risk pregnancies in a homelike setting, offering an option between hospital birth and home birth.
These facilities follow evidence-based standards set by the American Association of Birth Centers, providing comprehensive prenatal care, labor and delivery support, and postpartum services.
The permanent injunction ensures that both existing birth centers can continue operating according to these evidence-based standards, and it also clears the path for additional birth centers to open throughout the state.
This expansion could significantly improve access to maternal healthcare in underserved communities.
Understanding Your Rights as an Expectant Family in Alabama
For expectant families in Alabama, this ruling provides clarity about available birthing options.
Under Alabama law:
- Families can choose to receive care from licensed midwives in birth center settings;
- Birth centers are regulated by appropriate professional licensing boards, not as hospital facilities; and
- Insurance coverage for birth center services varies by provider, but the legal status of these facilities is now firmly established.
As the maternal healthcare landscape continues to evolve in Alabama, families should stay informed about their options and legal rights throughout pregnancy and childbirth.
The Future of Maternal Healthcare Access in Alabama
The court’s decision sets an important precedent for maternal healthcare regulation in Alabama, potentially influencing how other alternative healthcare models are regulated in the future.
Advocates hope this ruling will contribute to expanded access and improved outcomes for mothers and babies throughout the state.
As Gilchrist noted, “In a state facing a maternal health crisis, we need more options, not fewer. This decision brings us one step closer to ensuring that safe, accessible, and community-based birthing care is available to everyone who needs it.”
For families navigating pregnancy and birth planning in Alabama, the ruling provides both immediate practical benefits and long-term hope for a healthcare system that offers more choices and better outcomes.
Get Legal Support for Family-Building in Alabama
Are you planning a family or expecting a child in Alabama?
The experienced family law attorneys at Baxley Maniscalco can help you understand your legal rights and options throughout the family-building process. Contact our office today to schedule a consultation about your specific situation.
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