Birth centers at risk of closing as Alabama Supreme Court declines to hear lawsuit, ACLU says

The Alabama Supreme Court has opted not to hear a pivotal case regarding birth center regulations, a decision that advocates are calling a rubber-stamp on state overreach. The move effectively maintains a regulatory environment that many fear could force the closure of freestanding birthing facilities across the state.

The Legal Battle Over Regulation

This development follows a January decision by the Alabama Court of Civil Appeals, which ruled that birth centers must be classified as hospitals. Under this ruling, these facilities are subject to licensing and oversight by the state health department. The 5-0 unanimous decision reversed a previous ruling by Montgomery County Circuit Judge Greg Griffin, which had been celebrated as a major victory for midwives.

Judge Griffin’s original ruling had favored the Oasis Family Birthing Center in Birmingham and the Alabama Birth Center in Huntsville, effectively blocking state regulations that the centers argued would make their operations impossible.

Advocates Denounce the Decision

Whitney White, a senior staff attorney with the ACLU’s Reproductive Freedom Project, condemned the high court’s choice. "By declining to hear this case, the Alabama Supreme Court has rubber-stamped state overreach into pregnant Alabamians’ health care decisions," White said. She added that the current regulatory scheme is disconnected from both state law and clinical evidence, noting that birth centers offer safe, necessary midwifery care.

The centers at the heart of this dispute include the state’s first freestanding birth center, Oasis Family Birthing Center, founded by OBGYN Dr. Heather Skanes in September 2022, as well as the Alabama Birth Center in Huntsville and the Birth Sanctuary in Gainesville. These facilities, alongside the Alabama Affiliate of the American College of Nurse-Midwives and several healthcare providers, filed suit against the Alabama Department of Public Health (ADPH) in August 2023.

Health Care Access in Alabama

The legal challenge argued that the ADPH regulations were overly burdensome, contradictory to national standards, and beyond the department's authority. The stakes are significant: according to March of Dimes data, over one-third of Alabama counties are maternal care deserts, and 28% of women lack access to a birthing hospital within a 30-minute drive. These issues are compounded by the fact that the state’s maternal mortality rate has remained higher than the national average for over 50 years, and a 2025 study highlighted that Alabama has the highest rate of maternal deaths shortly after childbirth in the nation.

While this legal path has closed, the ACLU of Alabama has pledged to continue fighting specific licensing restrictions. "We remain committed to ensuring that every Alabamian has the opportunity to give birth where and how they choose," said JaTaune Bosby Gilchrist, executive director of the ACLU of Alabama.