Shifting Strategy on Pennsylvania Midwifery Legislation – Community Input & Lobbying Now Priority

Update from Abby the Midwife, Founder of the National Alliance for Traditional Birth Rights (NATBR)

Dear Friends, Supporters, and Midwifery Community,

Recent developments in Pennsylvania have required us to reassess our approach to protecting traditional and lay midwifery. After careful consideration, we are pivoting away from pursuing a class action lawsuit. The community remains too fractured, and many individuals struggle with the cohesiveness and realistic expectations needed for such an effort to succeed. While we are still moving forward with the lawsuit - we are not interested in class action any longer- though we still welcome more plaintiffs to the case. Plaintiffs will not have financial obligations.

Instead, our new strategy adds more focus on proactive lobbying, coalition-building, and broad community support and input. We are engaging directly with legislators, gathering stakeholder feedback, and working to shape or amend legislation in ways that preserve access to traditional midwifery, informed consent, parental autonomy, and religious liberty protections.

Key Developments: The New Bill

A new bill has emerged following the passage of SB 507.

SB2520 CAN BE FOUND HERE  - THIS BILL INCLUDES DEFINITION OF LAY MIDWIFERY, REQUIREMENTS AND UNLAWFULL CONDUCT.

The author is an ER physician from Pittsburgh who has been open about his opposition to home birth. During recent conversations (including one with our attorney and my own separate discussion representing NATBR), he acknowledged:

• He waited to introduce and drop this bill until after SB 507 became law.

• His intent is to address lay midwives under the existing 1983 framework.

• The State Board will gain authority to promulgate rules for the "safe practice of midwifery," now explicitly including lay midwives.

He cited reading bad reviews and investigations of individual midwives, which have given him a skewed view of home birth. He has stated outright that he does not believe home birth is safe and thinks it should be banned (though he claims the bill is not aimed at elimination). He also confirmed that ACOG is lobbying behind the efforts of SB507.

Positive notes: The physician indicated openness to working together to amend the bill favorably.

NEGATIVE NOTES: Challenges Within the Community & Lessons Learned

A significant factor in our strategic pivot is the reality of divisions and unrealistic expectations within parts of the midwifery community itself.

Fringe groups of midwives, particularly those who spent considerable time flooding legislators with emails and demands, have unfortunately not demonstrated realistic expectations or practical incentives for lawmakers.

The emails sent directly to the legislature were described to advocates during recent discussions. They were described as frustrating & unrealistic, particularly the demands for full unregulated status and unrestricted rights to practices that may be outside scope.

The Commonwealth has made it abundantly clear it has no interest in full decriminalization of lay midwifery or granting unlicensed practitioners broad authority to administer medications. These maximalist positions are not only unrealistic — they actively created suspicion and a very bad taste in the legislature. Lawmakers are now asking pointed questions about what certain individuals or groups are doing outside their acknowledged scopes of practice.

In fact, these communications appear to have confirmed and reinforced the perceived need for tighter oversight in the eyes of the bill’s author and others. This has damaged credibility, complicated good-faith negotiations, and made it significantly harder for reasonable, strategic voices to be heard.

At NATBR, we believe in principled, effective advocacy grounded in data, heritage protections, religious liberty, and genuine informed consent, not fragmented, all-or-nothing demands that ignore political and legal realities. True progress requires strategic focus, coalition-building, and realistic goals.

NATBR’s Position: NATBR supports SB2520, with necessary amendments. We support stronger informed consent and transparency standards that protect mothers and families.

At the same time, we will push hard to ensure the final language respects traditional midwifery practices, religious freedoms, and the proven safety of community birth for low-risk families.

Provisions in the Bill (Focus on Disclosures & Informed Consent)

The bill centers on enhanced disclosures and informed consent requirements for lay midwifery. While informed consent is foundational to ethical care, the specific mandates raise serious concerns about overreach, especially for traditional and faith-based practitioners. Key excerpts include:

Definition of "Lay midwife": "A traditional midwife, direct-entry midwife..." (full text available in bill documents).

Unlawful Conduct Provisions (amending the Medical Practice Act):

• It is unlawful for an unlicensed individual to:

  • Represent or hold out as a licensed midwife.

  • Administer prescription medication in lay midwifery practice.

  • Fail to obtain a detailed informed consent statement before engaging with a client, which must include:

    • Description of the individual's midwifery education, training, continuing education, and experience.

    • A clear statement that the individual is not licensed by the State as a midwife.

    • A statement that it is unlawful for the individual to administer prescription medication.

    • A written plan addressing medical issues during pregnancy/labor/childbirth and transfer to a licensed provider or facility if necessary.

    • Signatures and dates from both parties.

• Records of these statements must be retained for at least four years.

There is a religious exemption clause: Subsection (f) notes that informed consent requirements shall not compel provision of the form if the client is a member of a recognized religious sect conscientiously opposed to modern medical practice and licensure.

Our Path Forward: Cohesive Lobbying, Amendments, and Strategic Action

This is not the end of the fight, it’s a strategic shift. We are continuing preparations for constitutional litigation against SB 507 and the broader erosion of traditional midwifery rights in Pennsylvania. At the same time, we are prioritizing cohesive, targeted lobbying to protect what matters most.

We will work directly with legislators to offer specific, practical amendments to the new bill. This includes presenting real data on the safety of community birth, highlighting the actual standards and practices followed by responsible traditional midwives, and clearly distinguishing these from fringe ideals, illegal practices, or cases of poor informed consent.

One key lobbying event will be an in-person gathering bringing together midwives, consumers, faith community leaders, and legislators. This will create an opportunity for direct dialogue, sharing of real experiences, and building the relationships needed for meaningful change.

We are also actively seeking broad community input on the bill’s impacts, proposed amendments, and additional evidence we can bring forward. If you are a practicing midwife, a client, a parent, or a supporter, your grounded experiences and feedback are essential.

NATBR remains committed to principled advocacy rooted in facts, heritage protections, religious liberty, and true informed consent, not emotional demands or unrealistic positions.

Traditional midwifery is part of America's healthcare heritage, especially for Amish, Mennonite, Anabaptist, and other faith communities. Over-regulation that ignores data on out-of-hospital outcomes, informed consent realities, and religious freedoms threatens that heritage.

Stay tuned for action alerts, draft amendment language, and ways to get involved. Together, through persistent advocacy and community strength, we will protect birth freedom in Pennsylvania and beyond.

In service to mothers, babies, and liberty, Abby the Midwife (Abigail Iovine) Founder, National Alliance for Traditional Birth Rights (NATBR) Cardinal Birth Midwifery LLC Stroudsburg, PA

Date: June 2026