An Alabama appeals court ruled on Friday that the state can require freestanding birth centers to be licensed and regulated as hospitals, potentially subjecting them to licensing rules that birth center professionals say would make it effectively impossible for them to provide midwifery care in the state.
“We do not believe the legislature intended that a health-care institution providing childbirth care to a multitude of pregnant women should be out of the reach of the regulatory authority of the state agency responsible for protecting public health and safety when the law can be easily construed to prevent that outcome,” the court wrote in its ruling.
The appeals court’s ruling overturns a May 2025 trial court decision in favor of the birth centers, but it will not take effect while the birth centers seek further court review. In the meantime, birth centers in the state will be able to continue providing care.
“We are disappointed in the Court of Civil Appeals’ decision, but this isn’t the end,” said Whitney White, staff attorney with the ACLU Reproductive Freedom Project. “We will continue to fight for pregnant Alabamians to be able to access high-quality midwifery care in birth centers without burdensome and unnecessary interference from the state. The essential care birth centers provide to Alabama families has never been more necessary than it is right now, with Alabama facing a serious maternal and infant health crisis that is disproportionately affecting Black Alabamians, those with low incomes, and rural communities. The care birth centers like Oasis Family Birth Center and Alabama Birth Center provide is a critical part of addressing this crisis and ensuring that all pregnant folks have access to high-quality, patient-centered health care.”
Advocates argue that Alabama’s maternal and infant health crisis makes the ability for freestanding birth centers to operate “more important than ever.”
“The opinion from the Court of Civil Appeals is disappointing, but we remain committed to ensuring that birth centers can continue providing essential healthcare in Alabama,” said JaTaune Bosby-Gilchrist, the ACLU of Alabama’s executive director.“Birth centers are needed here. Midwives and doulas are needed here. And we are committed to continuing this fight on behalf of our clients and all Alabamians.”
The fight for freestanding birth centers is one of ACLU’s legislative priorities for 2026.
