STATE INITIATIVES
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As part of our state initiatives, NATBR conducts targeted legal and policy assessments of each state’s framework governing pregnancy, maternal health, home birth, traditional midwifery, and informed consent, evaluating both hospital and out-of-hospital practice climates, enforcement patterns, and institutional barriers to family choice. We identify and strengthen strategic allies, including those who serve in less visible but influential roles, building coordinated state-to-state networks of legal, clinical, and policy support. We assist in drafting formal letters, policy memoranda, and proposed statutory amendments to advance birth freedom, protect traditional midwifery, and reinforce constitutional safeguards surrounding parental rights and bodily autonomy.
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Pennsylvania has become one of NATBR's highest priorities following the passage of SB507. Throughout the legislative process, we worked extensively to advocate for the preservation of traditional midwifery, religious liberty, and informed family choice.
Our efforts included drafting and submitting proposed amendment language on multiple occasions, retaining legal counsel to analyze the bill's statutory and constitutional implications, and meeting directly with legislators—including the bill's prime sponsor—to discuss the legislation's impact on traditional midwives, plain communities, faith-based birth practices, and Pennsylvania families. We also engaged with policymakers, stakeholders, and advocacy organizations throughout the process while educating the public on the far-reaching consequences of the legislation.
Although SB507 was ultimately enacted, our work did not end with its passage. NATBR has continued documenting its effects, supporting affected families and birth workers, and advancing public education through media outreach and legislative advocacy.
As part of this ongoing effort, NATBR is now involved in constitutional litigation challenging the law and the burdens it places on traditional midwifery, religious exercise, and parental rights in Pennsylvania. The lawsuit represents the next phase of our work to protect birth freedom and preserve the longstanding traditions of community-based midwifery.
You can learn more about the Pennsylvania litigation, its legal claims, and the plaintiffs involved on our dedicated lawsuit page.
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A formal policy letter and proposed amendment language, grounded in Birth Freedom principles and the protection of traditional midwifery, were submitted to senior executive health officials within the State of Florida.. The framework was received with strong interest and reported enthusiasm at the state executive level, reflecting meaningful openness to language centered on constitutional protections, parental rights, and the preservation of traditional midwifery practice.
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The panel brings together midwives, physicians, legal professionals, policy analysts, scholars, and maternal health advocates to ensure that proposed language, strategy, and public positioning are informed by clinical experience, constitutional analysis, and practical realities on the ground. Its purpose is not symbolic endorsement, but substantive review, data evaluation, strategic planning, and broad representation across modalities of maternal care. Participation is voluntary and issue-specific, designed to strengthen the integrity, credibility, and depth of the state initiative while maintaining independent professional judgment among its members. This panel meets weekly.
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State initiatives begin when a state leader submits a formal interest form outlining current laws, enforcement issues, and key concerns affecting birth rights. From there, we provide a structured launch template that walks them through identifying relevant statutes, evaluating the legal climate, and choosing an appropriate organizational structure, whether informal coalition or incorporated entity. We assist in forming a state-specific advisory panel, connect leaders with vetted attorneys, lobbyists, media contacts, and aligned freedom-based organizations, and provide strategic guidance for messaging, amendment drafting, and legislative engagement. Each state remains independently led, but is equipped with national-level strategy, infrastructure, and coordination to build a serious, durable movement.
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If you would like NATBR to come to your state to speak, organize, or assist in launching a formal state initiative, submit a written request outlining your current legislative climate, key concerns, and desired level of engagement. Speaking engagements, strategic planning sessions, and on-the-ground organizing support are available by request and coordinated based on scope and readiness. Send inquiries to info@natbr.org and request speaking or organizing engagement in the subject line.
Interested in helping YOUR state Protect Traditional Midwifery & initiate Birth Freedom ?
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Pennsylvania
Pennsylvania Traditional Midwifery Lawsuit: Timeline and Case Status
Updated September 2026
Pennsylvania’s traditional midwifery lawsuit began with a question about more than a professional title. When Senate Bill 507 became law, it defined who counted as a “midwife” under the Medical Practice Act, authorized licensed categories to practice midwifery, and listed activities certified midwives could perform. At the same time, it said the law neither authorized nor prohibited traditional midwives.
For practitioners who already provide pregnancy, birth, postpartum, and newborn care, that combination raised a consequential question: How would the Commonwealth distinguish traditional midwifery from work it had just addressed within a licensing law?
The case is pending in the Commonwealth Court of Pennsylvania as No. 298 M.D. 2026. This timeline explains the statutory language, the sequence of events, and the relief the plaintiffs have requested.
May 6, 2026: SB 507 became Act 14
Act 14 of 2026 amended Pennsylvania’s Medical Practice Act of 1985. It changed the act’s definition of “midwife” to mean someone licensed by the State Board of Medicine as either a nurse-midwife or a certified midwife. It created a certified-midwife license that expressly authorizes its holder to practice midwifery. It did not establish a licensing pathway for traditional or lay midwives.
Act 14 also addressed the work a licensed certified midwife may perform. Its provisions cover, among other things, prescribing, ordering, and administering medical devices, immunizing agents, laboratory tests, and therapeutic, diagnostic, and preventive measures, subject to the act’s requirements. These are activities that can overlap with questions about the scope of maternity care. The statute places those express authorizations within its licensed certified-midwife framework.
That distinction matters. Act 14 does not say that every act of prenatal care, attendance at birth, or postpartum support is exclusively reserved to a license holder. Nor does its list, by itself, resolve what an unlicensed traditional midwife may lawfully do under other Pennsylvania law. But the act does place a broad set of midwifery-related activities inside an explicit licensing framework while leaving traditional midwives outside it. The plaintiffs sought a legal answer about the consequences of that arrangement.
What Section 4 says—and what it leaves unresolved
Section 4 states that nothing in Act 14 should be construed to “authorize or prohibit” the practice of lay midwives, direct-entry midwives, or other unlicensed birth workers. It further states that those practitioners are not considered licensed or regulated by the Commonwealth under the act.
The two parts must be read together. Section 4 supports the argument that Act 14 did not itself ban traditional midwifery. It also expressly declines to authorize that practice. It does not establish a traditional-midwife license or say which law supplies the legal basis for their work. Meanwhile, Act 14 defines “midwife” for the Medical Practice Act by reference to state licenses and expressly authorizes licensed certified midwives to perform specified activities.
The concern was not that Section 4 expressly declared traditional midwifery illegal. It did not. The concern was how state officials might interpret the entire legal framework when an unlicensed traditional midwife performs work associated with midwifery. The plaintiffs chose to ask a court to resolve that uncertainty rather than wait for it to surface through an enforcement action.
July 2, 2026: The original lawsuit was filed
Individual plaintiffs filed a petition for review in Pennsylvania’s Commonwealth Court. They include traditional midwives and people who rely on traditional midwifery care.
At the time, Pennsylvania’s Midwife Regulation Law of 1929 remained in effect. The plaintiffs alleged that state officials had failed to administer its certificate provisions. Their original filing sought a determination of their claimed rights under that law and clarification of Act 14’s effect on traditional midwifery.
July 12, 2026: The legislature repealed the 1929 law
Ten days after the lawsuit was filed, Pennsylvania enacted Act 21 of 2026, an omnibus Fiscal Code bill. Section 34(4) expressly repealed the Midwife Regulation Law of 1929.
The repeal appeared within broad budget legislation rather than in a stand-alone midwifery bill. The Philadelphia Inquirer reported that some lawmakers said they had not realized the repeal was included when they voted. Because the lawsuit was already pending, the repeal became an additional issue for the court.
July 17, 2026: The plaintiffs amended their petition
The amended petition challenges the repeal and asks what effect it can have on claims filed while the 1929 law was still in force.
It also asks the court to declare that Act 14 does not govern traditional midwives, address the plaintiffs’ claimed entitlement to certificates under the 1929 law, and determine whether oversight by the State Board of Medicine is lawful as applied to traditional midwifery.
Among the remedies requested is a separate legal framework for traditional midwifery: a State Traditional Midwifery Board and rules under the 1929 law concerning examination, licensing, and practice. Those are requests in the amended petition, not orders already issued by the court.
August 5, 2026: Hearing on preliminary relief
The Commonwealth Court held a hearing concerning the plaintiffs’ request for preliminary relief. That stage concerns what temporary protection, if any, should apply while the lawsuit continues.
A preliminary ruling does not decide every claim in the amended petition. The full case concerns the meaning and effect of Act 14, the repeal of the 1929 law, the plaintiffs’ asserted rights, and what lasting relief the court should order.
What remains before the court
The amended petition asks the court to resolve several questions:
How do Act 14’s licensed-midwife definition and express practice authorizations apply alongside Section 4’s language concerning unlicensed birth workers?
What effect does Act 21’s repeal of the 1929 law have on claims filed before the repeal?
Were the plaintiffs entitled to action on certificates under the 1929 law?
May the State Board of Medicine oversee traditional midwifery under the legal framework the plaintiffs challenge?
What final relief, if any, should the court grant?
The plaintiffs’ claims and requested remedies are not court findings. The outcome of the full case remains to be determined.
Read the documents
Attorney Jonathan Goldman has posted the Pennsylvania midwifery case filings, including the amended petition and filings concerning preliminary relief.
The enacted laws are available from the Pennsylvania General Assembly: Act 14 of 2026 and Act 21 of 2026.