Key Developments: Pennsylvania Litigation

On July 2, 2026, a group of Pennsylvania traditional midwives and Amish families filed a constitutional challenge in the Commonwealth Court of Pennsylvania to protect the future of traditional midwifery, religious liberty, parental rights, and birth freedom within the Commonwealth.

At its core, this case asks a simple question: Who should decide the future of traditional midwifery—the families and communities it serves, or the very institutions that compete against it?

The lawsuit asks the Court to uphold Pennsylvania's Midwife Regulation Law of 1929 and affirm that it remains valid law. It seeks to ensure that traditional midwives continue to have a lawful pathway to practice independent of the hospital-based licensure system created under the Medical Practice Act and, more recently, Act 14 of SB507.

The petition also recognizes that Act 14 authorizes the State Board of Medicine to promulgate regulations governing MIDWIFERY. Should those regulations be interpreted or applied in a manner that reaches beyond Certified Midwives and infringes upon the rights of traditional midwives protected under the 1929 law, the plaintiffs ask the Court to intervene to prevent that overreach and preserve the independent legal status of traditional midwifery.

A central issue in the case is government oversight. The current statutory framework places authority over traditional midwifery in the hands of the State Board of Medicine—a board composed primarily of physicians, hospital representatives, and licensed professionals who participate in the same maternity care marketplace. The plaintiffs contend that allowing direct competitors to regulate, restrict, or determine the future of traditional midwifery presents an inherent conflict of interest and threatens fundamental constitutional protections.

Accordingly, the lawsuit asks the Court to establish a constitutional framework that protects the rights of traditional midwives and the families they serve. It seeks a system of oversight that is impartial, consistent with legislative intent, and free from the control of competing medical interests. The plaintiffs contend that any future regulatory structure affecting traditional midwifery should respect due process, equal protection, religious liberty, parental autonomy, and the longstanding legal recognition of traditional midwives under Pennsylvania law.

This case extends beyond professional regulation. It is about preserving the freedom of Pennsylvania families to choose traditional midwifery, protecting faith communities whose birth practices are rooted in sincerely held religious beliefs, safeguarding the livelihoods of apprentice-trained midwives, and ensuring that government agencies cannot erase existing law through administrative inaction or by delegating authority to those with competing interests.

The plaintiffs seek a durable legal framework that protects both public accountability and constitutional liberty, ensuring that traditional midwifery remains a recognized and protected part of Pennsylvania's healthcare and cultural landscape for generations to come.

READ IT HERE:

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