GWINNETT COUNTY, Ga. — In a midwife’s suburban Atlanta home with a playground and chicken coop outside, Madie Collins lay on an examination table while the midwife measured her pregnant belly. Unlike at many a doctor’s office, no crinkly paper sheet covered the table and no antiseptic chill lingered in the air. The room next door, where Collins’ appointment began, was filled with children’s toys and scented candles and warmed by a wood-burning stove.
The certified professional midwife pressed the button on a handheld Doppler ultrasound machine she placed on Collins’ belly. “That’s her heartbeat,” she said to Collins’ 3-year-old daughter, who sat beside her mom as a whooshing sound filled the room. “I think Mommy’s baby’s right here.”
The midwife is not licensed as a nurse. In Georgia, that makes what she’s doing illegal. KFF Health News agreed not to identify her by name.
Georgia is one of seven states where delivering babies can earn non-nurse midwives, at minimum, a cease-and-desist letter requiring them to end their careers. In North Carolina, it’s a misdemeanor. In New York, it’s a felony.
Meanwhile, demand for their services is increasing. Intended home births rose by 42% nationally from 2020 to 2024, according to the National Center for Health Statistics, and those births are often overseen by certified professional midwives. In Georgia, they rose by 72%. Midwives who assist with home births typically see clients from prenatal appointments through several visit …