I had a wonderful midwife-assisted hospital birth that ended with a need for medical intervention due to my baby having a brain hemorrhage . I highly doubt my son would have survived without the hospital staff. Having a plan for physician backup seems like a no brainer, honestly.
170
cuentaderanaApr 3, 2026
+17
Yep. I delivered my son with a midwife in the hospital. Everything went fine. But if it hadn’t, there was an OB just down the hall. My midwife was amazing, but she couldn’t have helped if I needed an emergency C-section or suffered an amniotic fluid embolism. Having to wait while she found a physician to come help (as in, not someone right down the hall on call 24/7) would have killed me in a life or death scenario.
17
jellifercuzApr 3, 2026
+14
This article is referring to places where the nearest hospitals and physicians are literally hours away. Not all pregnant women can pick up and move to live near to a hospital with a L&D ward.
14
Accidental-GeniusApr 3, 2026
+15
You are a good person and a good mom. Thank you.
15
kstargate-425Apr 3, 2026
+6
Do you mind if I ask how much that cost as it sounds expensive to have a midwife and also to do it in a hospital? Its just a shame that everyone cant have that and its getting worse with the government cutting Medicaid more last year and possibly once again to fund Trumps war, GOP states like GA have a max income level of $40k gross combined, to qualify for Medicaid or they will have to pay for the hospital visit or the hefty monthly insurance.
So its definitely a no brainer but unfortunately in the US, the GOP both forces women to have the child then gives them a hefty bill afterwards or forces them to take cheaper routes avoiding the hospital where they could both die.
If we just rolled back all of Trumps tax cuts to the rich, including the halving of the corporate tax rate from around 30% to the teens over the past decade that would be over 1/3rd the cost of a decades of UHC. Then if they cut loopholes for the rich and taxed them more instead of less, no one would have to worry about being one of the over half million people claiming bankruptcy for medical debt yearly.
6
cuentaderanaApr 3, 2026
+4
My CNM was covered through my insurance. Giving birth with her vs an OB would have cost the same. That may not be true for all insurance plans, but that was the case for mine.
4
AudibleNodApr 3, 2026
+173
>In the suit, a draft version of which was shared exclusively with NBC News, the plaintiffs argue that their midwifery services are essential in Georgia. More than one‑third of the state’s counties are considered maternity care deserts, meaning there are no obstetric providers or birthing facilities, according to the nonprofit group March of Dimes. The plaintiffs also say making it easier for midwives to practice could lower Georgia’s high maternal mortality rate. For every 100,000 births in the state, 30 mothers die from complications during pregnancy or within six weeks afterward, according to March of Dimes.
I'll give you two guesses which communities are historically underserved by OB/GYNs where midwives fill that critical gap. [But you're only going to need one](https://www.marchofdimes.org/peristats/data?reg=99&top=6&stop=92&lev=1&slev=4&obj=1&sreg=13).
173
ruat_caelumApr 3, 2026
+15
Idaho had to close down maturity wards (With doctors) because the GOP laws in the state concerning abortion meant a doctor delivering a still birth could go to jail.
So the doctors left, infant mortality numbers went up/down (which ever was worse and had more babies dying) People had to travel 4+ hours to get to facilities. etc.
15
MLB-LeakyLeakApr 3, 2026
+19
They can still practice within their scope under a physician. Not sure how this changes anything other than patients being better protected.
19
robothawkApr 3, 2026
+81
I mean I imagine these medicla deserts don't have a lot of physicians, and the folk who are trying to hire an independent midwife probably don't have the money or insurance to afford a hospital birth
81
Accidental-GeniusApr 3, 2026
-13
EMTALA protects everyone. They can have a hospital birth for free.
-13
kstargate-425Apr 3, 2026
+19
That doesnt mean they wont get a $20-$70k bill at the end of it, it just means they cant be turned away IF they can get to a hospital which again, in these medical deserts, is hard to find. Also in Georgia to be liable for Medicaid for this to be free, you cant make more than a COMBINED income of $40k a year GROSS.
19
Accidental-GeniusApr 3, 2026
-21
I can send you a bill too, and you can stick it right in the shredder.
-21
techleopardApr 3, 2026
+12
You must be younger.
Hospitals have become wise to this.
You can't get basic non-emergency care if you owe a bill in many places now.
So you break your leg and go to the ER. They splint it but tell you you need to get pins or your leg will heal back wrong and you'll be crippled.
You're not getting those pins if you aren't paying on that initial ER bill.
Now think about it again, and consider what happens when your followup care is literal surgery that will prevent a dangerous situation from becoming a life threatening ER situation, or is meant to control crippling chronic pain.
12
techleopardApr 3, 2026
+8
That's not how it works, at all.
EMTALA ensures you get life saving stabilization treatment, THAT'S IT.
It is not free. You will still get a bill -- often an even bigger bill than if you had gone to a regular appointment.
Worse, it is important to understand it is stabilization only. If you go to the hospital in labor, yes, they will ensure you get JUST enough care not to die in their lobby. But if you have a birth injury or your child needs advanced care, they aren't doing that. They will try to transfer you to the hospital, who may or may not take you based on insurance. If not, they discharge you and you can come back when you or your baby are imminently about to die again.
8
bronsonriderApr 3, 2026
+1
The words “ hospital, who may or may not take you” made me shudder. In no first world country should such a statement ever be true but unfortunately it is in the US. Still find it shocking medical care depends on the size of your wallet.
1
abstractbullApr 3, 2026
+5
And waiting until birth to have any sort of care is exactly why the maternal mortality rate is obscene. Emtala doesn't cover routine prenatal visits.
5
Tryknj99Apr 3, 2026
+6
You still get a bill.
6
Accidental-GeniusApr 3, 2026
-18
Which you can shred
-18
NightIsHomeApr 3, 2026
+3
What exactly do you think happens if you shred a medical bill? You think the hospital just says ¯\\\_(ツ)\_/¯ and leaves you alone?
3
bbb26782Apr 3, 2026
+2
Doesn’t help when a hospital doesn’t exist. There’s huge stretches of Georgia where a hospital is more than an hour away.
That’s also not how EMTALA works.
2
abstractbullApr 3, 2026
+10
If it's a maternity care desert... there aren't physicians there to practice under. That's why it's a desert.
And the cost to pay the doctors makes it prohibitive. According to people interviewed in the article.
10
ShiftNStabilizeApr 3, 2026
+4
I feel for the underserved and believe we should have universal health care. As is, as a physician, why would I go work in a state that restricts my ability to properly care for patients, underfunds healthcare, makes it easy to be sued, and is profoundly anti-science. The majority of those policies having been put in place by the right wing politicians they vote for. This is how you get health care deserts. You want shitty health care and dead moms and babies, well you voted for it.
Oh, as an aside, I think midwives are great but need to deliver babies in hospital based setting with OB backup in house. If shit goes wrong during a birth you need to act within minutes to prevent tragic outcomes for the kiddo a/o mom. Lowering standards as a stop gate measure to fix a larger problem is a poor practice.
4
TALKTOME0701Apr 3, 2026
+18
They just answer that question in the explanation above. There are no physicians readily available.
The choice isn't use a midwife or go to the hospital. They are serving the areas where there is no local hospital
18
JunahCgApr 3, 2026
+7
And Trump's policy is shuttering even more rural hospitals
7
themoneybadgerApr 3, 2026
+6
The solution to underserved communities should not be lowering the standards. Its like saying, there arent enough electricians in this town so we won't require houses to be wired to code. Im not saying i have the solution but simply lowering the bar for training or supervision doesnt sit right with me.
6
FallouttgrrlApr 3, 2026
+3
In your example, houses would still be built and wiring would still be worked with, regardless of whether or not there were codes or trained electricians
It's not lowering standards for the sake of lowering standards, because sure in a perfect world we wouldn't be doing that
It's trying to make sure that events that *will continue to happen* with or without the right support, still have *some* support
3
Tao_of_LuddApr 3, 2026
+1
The thing is the alternative isn’t “somehow magically summon a doctor” it is “deliver a baby with no medical supervision” and, potentially, alone.
1
MLB-LeakyLeakApr 3, 2026
+99
> The state requires all nurse-midwives to have formal, written agreements with physicians that describe when physicians must intervene in evaluating or treating patients.
They’re banning independent practice, meaning they need to be supervised by a physician. This is because when an issue comes up with a patient there needs to be an expert available to discuss the case or take over. **This is a huge win for patients**
A lot of midlevel organizations and hospitals are trying to blur the lines between being a physician and their training and expand their scopes beyond their training. These agreements with physicians cost money because of the time and crazy high liability insurance. Hospitals can give underrepresented, poor, and undereducated patients a midlevel because they don’t know better.
99
Tao_of_LuddApr 3, 2026
+2
Is it a win for patients if the alternative is giving birth with no medical supervision? I would guess that that is where a bunch of these cases go. Yes, some will get physician supervision, but many who do not have access to a physician and now do not have access to a midwife will have to resort to birthing with only family / friends in attendance (or no one). Mother and infant mortality will rise.
ETA: I have family in the rural Midwest. What I would expect would happen is “informal” midwives. No formal training except experience. “When it’s your time, you give Jo-Ann in (tiny neighboring hamlet) a call and she’ll help you through.”
2
AudibleNodApr 3, 2026
-6
[States that have deeply integrated midwives into their health care systems are associated with better outcomes for mothers and infants, according to a new study published in PLOS One.](https://www.advisory.com/daily-briefing/2018/03/13/maternal-midwife#:~:text=Maternal%20fetal%20medicine%20by%20the,and%20the%20mothers'%20experience.%22)
-6
hasa_digaApr 3, 2026
+73
“According to ProPublica, the researchers did not include rates of maternal deaths and severe complications because those data were unreliable.”
Real robust study there, even ignoring the fact this write up doesn’t make any attempt to posit a causative relationship.
73
kradaanApr 3, 2026
+19
I wonder how many children were lost before even Georgia had to step in? Legislation like this isn't just spur of the moment, its a knee jerk reaction to problems too egregious to ignore.
19
mangorain4Apr 3, 2026
+5
this is good news for patients. I’m a PA, so a midlevel just like a midwife. physician supervision is key.
5
GrandStairApr 3, 2026
+18
Physicians (MD/DO): ~15,000–20,000+ hours
Nurse Practitioners (NP): ~500–1,500 hours
👉 Doctors receive far more clinical training hours than nurse practitioners.
18
nebraska_jones_Apr 3, 2026
+8
Certified nurse midwives are NOT nurse practitioners
8
seiryuu-abiApr 3, 2026
+15
The article mentions that these are registered nurses (RNs) not nurse practitioners (NPs).
15
Rice_KrispieApr 3, 2026
+8
Certified nurse midwives are NPs, though are all also technically RNs.
The midwife in the article has an MSN in midwifery, which can be found on her clinic page.
8
seiryuu-abiApr 3, 2026
+3
That’s odd. Where I’m from it’s its own certification, CNM (Certified Nurse Midwife) and you gain an MSN (Master’s) before licensure not entering into an NP program.
3
Fearless_Roof_4534Apr 3, 2026
+1
Dropping a link to MidlevelWTF here: https://www.midlevel.wtf
Seriously, the jokes about NPs and PAs write themselves. Personally I only allow myself to be seen by a physician since I know how bad the training deficiencies of NPs and PAs are.
1
Accidental-GeniusApr 3, 2026
+10
Good for GA. Proud of my home state for doing something right.
10
SketchyVillagerApr 3, 2026
+1
Our midwife ran out of the delivery room and I ended up delivering my son by myself. They still probably charged the state the full bill, too.
1
rames92Apr 3, 2026
+1
What did women do for everyone to hate us so much?
1
Fearless_Roof_4534Apr 3, 2026
+1
Dropping a link to MidlevelWTF here: https://www.midlevel.wtf
Seriously, the jokes about NPs and PAs write themselves. Personally I only allow myself to be seen by a physician.
1
aftertaste_kingApr 3, 2026
-11
Georgia: “We have some of the worst maternal outcomes in the country.” Also Georgia: “Let’s make it harder to access care.” At minimum, people should be calling their reps and local hospital boards about this.
-11
Knees0ckApr 3, 2026
+5
The very same state that forced a brain-dead woman to term.
5
Accidental-GeniusApr 3, 2026
+20
We have some of the worst outcomes BECAUSE OF THE MIDWIVES
20
ScientificSkepticismApr 3, 2026
+2
I'd think it's because black women are mistreated by the medical system, given their 3x higher chance of black women dying in childbirth.
But hey... sure Georgia bucks that trend ([it does not](https://www.cdc.gov/pcd/issues/2025/25_0125.htm))
2
abstractbullApr 3, 2026
+2
Wow. Where did you get that claim??
2
themoneybadgerApr 3, 2026
+11
What, requiring a midwife to have an actual nursing degree or a dr supervision? Not sure how making sure everybody in a delivery room is qualified is a bad thing.
11
kstargate-425Apr 3, 2026
+5
Its more so that people cant afford the hospitals and now that they cut Medicaid further and you cant make more than a combined income of $40k, gross, yearly to qualify, it fucks over the poor once again. It seems logical until you dig into why midwives are even needed in the first place and realize the government, especially Republican states, dont care about minorities nor the poor and are absolutely fine with both forcing them to have the baby then allowing both the mother and child to die.
ETA: I need to go to bed, my spelling is atrocious 🤦♂️
5
themoneybadgerApr 3, 2026
+4
Im not defending the mess of a healthcare system we live in, im just saying lowering the standard of care is a bad solution. The biggest way to "f*** over the poor" is to send them to birthing centers with no drs on site and no way to address complications for the mother or baby. Allowing unsupervised or untrained midwives will only incentivize birthing centers to staff with less qualified people.
4
ShakesDontBreakApr 3, 2026
-5
Wait. Abortion is illegal and now you cant even choose to have a midwife.
Guess billionaires are just making money off of babies in Georgia.
54 Comments