HB 520: Georgia Licensed Midwife Act; enact

Georgia currently regulates midwives under Chapter 26 of Title 31 of state law. This bill repeals that chapter entirely and replaces it with a new licensing structure in Title 43, called the Georgia Licensed Midwife Act. It creates a six-member Advisory Board for Licensed Midwives, appointed by the Governor, made up of four licensed midwives, one physician, and one member of the public who has used a midwife's services. The board would issue licenses, set education and certification requirements, handle renewals every two years, and investigate complaints. The bill spells out exactly what licensed midwives can and cannot do, including which medications they can administer, when they must refer a patient to a doctor, and limits on their scope such as no surgical deliveries or epidurals. It also requires insurance plans, including Medicaid, to cover and reimburse midwife-provided maternity care at the same rate as other providers. Practicing midwifery without a license would carry fines of $100 to $500 per violation. The law would take effect as soon as the Governor signs it.

• Repeals Georgia's existing midwifery law (O.C.G.A. Chapter 26 of Title 31) and replaces it with a new licensing chapter in Title 43.
• Creates a six member Advisory Board for Licensed Midwives, appointed by the Governor, to issue licenses, set rules, and discipline violators.
• Requires applicants to pass a background check, hold CPR and neonatal resuscitation certification, complete a pharmacology course, and hold a recognized midwifery certification.
• Allows fines of $100 to $500 per violation for practicing midwifery without a license or breaking licensing rules.
• Requires health insurance plans and Medicaid to cover maternity care from licensed midwives and pay them the same rate as other maternity providers.
• Sets specific limits on midwife practice, barring surgical deliveries, epidurals, forceps, and vacuum extractors, and requiring referral to a doctor when needed.

Practicing and aspiring midwives, pregnant women and families choosing home or birth-center births, physicians who consult or collaborate with midwives, health insurers and Medicaid, and state regulators who currently oversee midwifery under the old law.

Georgians giving birth outside hospitals would gain a formal, state-licensed midwife option with defined training standards, insurance coverage, and complaint procedures, while unlicensed practice would carry fines. Insurers and Medicaid would have to pay midwives the same as other maternity providers, changing how out-of-hospital births are covered and delivered.

• Section 1 adds midwives to the list of professionals covered by Georgia's peer review protections (O.C.G.A. § 31-7-131).
• Section 2 repeals Chapter 26 of Title 31, Georgia's current midwifery law, in its entirety.
• Section 3 creates new Chapter 24B of Title 43, the Georgia Licensed Midwife Act, establishing the Advisory Board for Licensed Midwives, licensing rules, renewal every two years, and discipline including fines of $100 to $500 per violation (O.C.G.A. §§ 43-24B-4 through 43-24B-9).
• New Code Section 43-24B-10 makes practicing midwifery without a license illegal, with exceptions for licensed healthcare practitioners and unlicensed birth attendants who provide required disclosures.
• New Code Section 43-24B-12 limits licensed midwives to non-medicated deliveries between 37 and 43 weeks gestation, except in cases of fetal death or fatal anomaly.
• New Code Section 43-24B-15 bars licensed midwives from surgical deliveries (except emergency episiotomy), epidurals or narcotic anesthesia, and use of forceps or vacuum extractors.
• New Code Section 43-24B-18 requires health insurance and Medicaid plans to cover and reimburse midwife maternity care at the same rate as other providers.
• Section 4 exempts licensed midwives from the Georgia Registered Professional Nurse Practice Act (O.C.G.A. § 43-26-12).

1. 2025-02-27House Withdrawn, Recommitted (House)
2. 2025-02-21House Second Readers (House)
3. 2025-02-20House First Readers (House)
4. 2025-02-19House Hopper (House)

• Karen Mathiak (R, HD-82)Primary sponsor
• Alan Powell (R, HD-33)
• Martin Momtahan (R, HD-17)
• Al Williams (D, HD-168)
• Katie Dempsey (R, HD-13)
• Ginny Ehrhart (R, HD-36)

1. PassedHouse voteFebruary 27, 2025

   95 yea, 62 nay (11 not voting, 12 excused)

   Move from P&CH to Hth: House Vote #112

• midwifery licensing
• maternal health
• home birth
• insurance coverage for maternity care
• health professional regulation