Nebraskan midwife Heather Swanson believes her calling is to provide childbirth services to underserved communities. She has dedicated her entire career to midwifery, and over the past two decades, her job titles have included certified nurse midwife, nurse practitioner, and Nebraska affiliate president for the American College of Nurse-Midwives.
While hospitals are still the norm for most births, home birth is legal in all 50 states, allowing parents to choose which environment suits their needs. Generally, mothers also have a choice regarding birth attendants: physician attendant, certified nurse midwife (CNM), lay-midwife, doula, trusted friend or family member, or even an unassisted delivery.
This freedom of choice is consistent with our nation’s deeply rooted principles of liberty, privacy, bodily autonomy, and the pursuit of happiness. But Nebraska denies mothers this freedom by outright banning CNMs from attending homebirths. Any CNM who does faces felony charges. In other words, the most qualified providers are uniquely excluded from attending home births, while unlicensed attendants are permitted to help with delivery.
Data shows physicians almost never make house calls in Nebraska, which means this ban prevents mothers who choose to give birth at home from having access to trained medical professionals when they are most needed.
To make matters worse, Nebraska is among three states that mandate CNMs practice only under a physician’s direct supervision, a financial burden borne solely by the nurse. Home births are explicitly off limits, even with a doctor present. Other specialized nurses, on the other hand, have full practice authority without the need for a supervising physician practice agreement.
Heather practiced in Nebraska for more than two decades before moving to Texas, where she served as director of a birth center, then to South Dakota, where she still teaches in a nurse practitioner program.
Heather eventually returned to Nebraska to care for her ailing mother and revive her dream of opening her own practice, Oneida Health, LLC. Once again confronted by restrictions on her ability to earn a living, she resolved to challenge the state’s unconstitutional midwife ban in federal court. Her lawsuit argued that Nebraska’s CNM ban for home births and its physician supervision requirement violate the rights of CNMs to provide critical childbirth care and the rights of Nebraska’s mothers to receive it.
Unfortunately, the district court and Eighth Circuit dismissed her case, and the U.S. Supreme Court declined her appeal.
But the fight is far from over. Pacific Legal Foundation remains committed to the fight for birth freedom and continues to take up other cases across Nebraska—and the country—so that mothers have the freedom to choose and healthcare providers have the freedom to practice.
What’s At Stake?
- A wide range of childbirth choices for one of life’s most sacred moments is consistent with our nation’s deeply rooted principles of liberty, privacy, bodily autonomy, and the pursuit of happiness. A law that denies fully trained and certified midwives the right to assist home births and the right of mothers to receive midwifery services is immoral and unconstitutional.
- When government protects industry insiders, it prevents professionals from pursuing their calling and reduces access, choice, and quality of care for expectant mothers.
