Midwife Regulations Stir Debate on Home Births in Nebraska
Recent developments in Nebraska have rekindled debates about the availability and regulation of midwifery care in the state, highlighting the intricate legal landscape surrounding home births. Concerns have been raised over the restrictive laws that limit the practice of nurse midwives, despite their capability to provide essential obstetric care.
In a notable case from late April, nurse midwife Heather Swanson legally assisted in a home birth in Hastings. This event unfolded after expectant mother Hope Lindstrom challenged the state’s ban, arguing it infringed upon her 14th Amendment rights and religious freedom. The state ultimately settled, permitting the home birth.
Swanson, who has practiced as a nurse midwife since 2002, carried out a thorough risk assessment to ensure Lindstrom’s suitability for home birthing. She coordinated with local emergency services to prepare for any potential complications. This successful home birth has fueled optimism among nurse midwives for legislative changes.
Swanson expressed confidence in the safety of planned home births with licensed providers, emphasizing the importance of adequate risk assessment. “I feel like there’s enough evidence to say planned home birth attended by a licensed provider is where we see the safest outcomes, if risks are appropriately assessed and attended to,” she stated.
Conversely, some experts, like Mollard, criticize the current home birth system in Nebraska for being perilous. “Right now, we have a really ugly system where you have a choice of a hospital or giving birth alone or giving birth with somebody who is practicing illegally,” Mollard commented, highlighting the lack of regulated options.
Nebraska’s 1984 nurse midwifery law recognizes only nurse midwives, inadvertently allowing less-educated midwives to operate without oversight. This loophole was addressed by the Nebraska Supreme Court in 2024, prohibiting unlicensed individuals from presenting themselves as qualified to treat physical conditions.
The court cases that prompted this decision involved Judy Jones, a 78-year-old professional midwife, who faced charges after attending home births where complications arose, including a tragic incident in Douglas County.
Currently, many mothers in Nebraska seeking alternatives to hospital births are left with the option of unassisted births. Madison Jones, a mother of four and an advocate for midwifery care, chose this path when she had no midwife available in rural Nebraska. Her background as a labor nurse and doula helped her navigate the complexities of an unassisted birth.
Legislative efforts are underway to address these challenges. Nurse midwives seek full practice authority to facilitate home births legally, while professional midwives aim for state licensure to practice lawfully. Despite the introduction of two bills in the 2025 legislative session by State Sen. Ben Hansen, neither advanced. Both groups plan to continue their advocacy in the 2027 session.
