Kate Ternus is a mother, homemaker, and book editor. She lives in Nebraska with her husband and their two children, and the couple is eager to continue growing their family.
When Kate had her first child, she lived in South Dakota and gave birth at home with the assistance of certified nurse midwives (CNMs). She had a deeply positive experience, free to decline unnecessary interventions and to labor in a supportive, relationship-based environment.
When Kate and her husband moved to Nebraska, they hoped to have a similar birth experience for their second child. But the couple was shocked to discover that Nebraska offers no freestanding birth centers and prohibits CNMs from attending home births. Those who violate the prohibition face felony charges.
Because Kate couldn’t access any professionally supportive out-of-hospital options in Nebraska, she drove across the border to South Dakota to give birth to her second child in the home of a CNM. The CNM’s home was an hour and a half away, through large stretches of rural farmland—hardly ideal conditions for a woman in labor.
Kate hopes to have another child, but Nebraska’s restrictions leave her with undesirable options: cross state lines to access care, submit to a hospital birth, or forgo medical assistance altogether. Puzzlingly, home birth is still legal in Nebraska; only once a qualified healthcare provider arrives to assist does it become a crime.
For the sake of her own family and for women across Nebraska, Kate is filing a federal lawsuit to restore a woman’s right to birth freedom. She is represented by Pacific Legal Foundation free of charge.
Kate’s complaint explains that the Fourteenth Amendment protects fundamental rights deeply rooted in the nation’s history and tradition—and the right to choose the manner and circumstances of giving birth is exactly that. For most of American history, birth took place at home under midwife care.
Birth freedom fits comfortably within a long line of cases protecting privacy and family autonomy. The Supreme Court has recognized fundamental rights to marry, to procreate, to raise and educate one’s children, and to make intimate decisions free from government intrusion. Birth is among the most intimate moments in a family’s life; Nebraska’s ban falls squarely within that protected space.
Nebraska cannot point to a compelling government interest that justifies such a severe restriction. Research shows that CNM-assisted birth centers produce lower rates of cesarean delivery, preterm birth, and costly interventions, with no increase in adverse outcomes. The need for accessible maternity care is especially acute in rural Nebraska, where hospitals can be hours away, and “maternity deserts” are common.
A state that claims to protect maternal health while banning some of the nation’s most extensively trained and cost-effective midwifery professionals from attending home births is not protecting mothers or babies; it’s protecting hospitals from competition.
A win would restore birth freedom to Nebraska families and open the door to safer, more accessible maternity care for mothers most in need.
What’s At Stake?
- The Constitution protects the right to make intimate decisions about family and childbirth without government interference. A state that restricts that right without a compelling justification violates the Fourteenth Amendment.
