Lesson #3 - Legality of Home Birth: Difficult Choices for Midwives

For more information, please read the document titled, The History and Legalities of Midwifery in Alabama.
    1. Risk of Prosecution - If an independent midwife attends a family at their birth in Alabama, she is at risk of being charged with practicing nurse-midwifery without a license due to the judicial precedent that was established in Toni Kimpel’s case and reaffirmed against Karen Brock. Conviction carries with it a Class C misdemeanor, including a fine and possible jail time. According to judicial precedent, it does not matter if the midwife is compensated for her services; if she is performing actions that are within the legal scope of nurse-midwifery according to the Code of Alabama, it is possible that she could be prosecuted.

    2.  Risk versus Continuity-of-Care - The reality in Alabama is that a midwife is usually only prosecuted if she provides continuity-of-care when a transfer to a hospital is required, or if there is a difficult outcome involving the well-being of mother or infant. Due to medico-legal concerns, it is difficult for most physicians to form collaborative relationships with out-of-hospital care providers. Infrequently, a midwife has been able to secure a positive relationship with a physician within her community. It is because midwives value continuity-of-care that ALMA is actively seeking legalization for midwifery in Alabama.

    3. Midwife Choices - Each midwife in Alabama must decide the scope of her midwifery practice in light of the current legal situation. Some midwives choose to obtain out-of-state licensure and their clients plan to birth across state lines. Other midwives choose to continue attending births in their communities within Alabama. ALMA respects each midwife’s choice while encouraging all midwives to be open and accountable to both the families they serve and to one another.

Next ---> Lesson #4 - A Bad Law: Why Change is Necessary
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