Debbie Pulley began attending births in 1970 as a nursing assistant at a Hong Kong Hospital. Later, as a midwife in Georgia, she helped establish the Georgia Midwifery Association, which worked closely with the state’s health department to establish and enforce standards of care for midwives—contributions so significant that she received a certificate of honor from the Georgia Secretary of State.
Debbie’s qualifications don’t stop there. The North American Registry of Midwives certified her as Certified Professional Midwife (CPM) in 1995. The CPM certification is the prerequisite for licensure as a midwife in 35 states. She also serves on the Registry’s board, actively advocates for expanded access to midwifery in legislatures and to the public, and runs the office for Atlanta Birth Care.
Today, however, even though Debbie is a midwife by any normal definition, she is not allowed to publicly—and honestly—call herself a midwife or CPM in the state of Georgia.
In 2015, the Georgia Board of Nursing took over midwifery regulation from the state health department and began requiring midwives to get a nursing degree and become a Certified Nurse Midwife (CNM) in order to practice independently. That is, only licensed nurses can practice midwifery in Georgia.
In June 2019, the Board of Nursing sent Debbie a cease and desist letter forbidding her to identify herself as a “midwife” in any form, and it threatened her with a $500 fine for each violation.
Though she no longer practices midwifery, Debbie feels she shouldn’t have to get a nursing license in order to call herself a midwife. And she wants to be able to truthfully describe her qualifications on her website and in her advocacy work—just as doctors and lawyers do when they are not actively practicing their professions.
Represented by PLF free of charge, Debbie challenged the state’s assault on her free speech rights in a federal lawsuit. Government cannot hijack a word as a licensing condition.