Alabama Supreme Court Declines to Hear Challenge to Unnecessary “Hospital” Licenses for Birth Centers

MONTGOMERY, Ala. — The Alabama Supreme Court today declined to review a January 2026 state appellate court decision that allows the Alabama Department of Public Health (ADPH) to require birth centers to obtain burdensome and unnecessary licenses as “hospitals.” Litigation is ongoing to challenge specific restrictions in the licensing rules. However, by declining to hear this case, the Alabama Supreme Court has opened the door for regulations that could threaten the ability of birth centers to continue operating long-term in the state, despite evidence that these independent facilities safely provide much-needed midwifery care to low-risk pregnant patients in a homelike setting.

“Birth centers have been a lifeline for pregnant Alabamians and their families,” said Dr. Yashica Robinson, founder of the Alabama Birth Center. “Birth centers fill a critical gap in access to prenatal, pregnancy, and postpartum care across our state, especially for Black women, people living in rural communities, and people with low incomes. Our birth center was founded to expand access to high-quality midwifery care and help combat our state’s maternal and infant health crisis. We will do everything we can to continue providing this essential care to our communities.”

Amid the state’s maternal and infant health crisis — which disproportionately impacts Black women and families, Alabamians with low incomes, rural communities, and others impacted by widespread maternity care deserts — birth centers play a critical role in expanding access to pregnancy-related care. Evidence shows that the midwifery care provided at birth centers is safe and improves patient outcomes, including by reducing preterm births, unnecessary cesarean sections, and health disparities.

“By declining to hear this case, the Alabama Supreme Court has rubber-stamped state overreach into pregnant Alabamians’ health care decisions,” said Whitney White, senior staff attorney for the Reproductive Freedom Project of the American Civil Liberties Union. “The Alabama Department of Health’s regulatory scheme for birth centers is misaligned not only with state law, but with clinical evidence. Birth centers provide safe, essential midwifery care to low-risk pregnant Alabamians — and communities need access to them. Despite this setback, we remain committed to fighting for Alabamians and their families to have access to the essential care that they need, and we will continue fighting for birth centers as the case continues.”

"While we are disappointed that the Alabama Supreme Court declined to review this case, 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. “We look forward to making our case that regulations cannot be so restrictive as to essentially ban birth centers in our state."

Plaintiff Oasis Family Birthing Center in Birmingham, Alabama’s first freestanding birth center, first opened and began safely providing essential care for pregnant Alabamians in 2022. Additional birth centers, including Plaintiff Alabama Birth Center in Huntsville, have also opened since an Alabama state trial court first blocked the Alabama Department of Public Health’s attempt to restrict access to birth center-provided care at an earlier stage in this case.

The lawsuit, Oasis Family Birthing Center et. al. v. Alabama Department of Public Health, was originally filed in the Fifteenth Judicial Circuit Court in Montgomery in August 2023. The plaintiffs – Oasis Family Birthing Center in Birmingham, Heather Skanes, M.D., Alabama Birth Center in Huntsville, Yashica Robinson, M.D., the Alabama affiliate of the American College of Nurse-Midwives, Jo Crawford, CPM, and Tracie Stone, CPM – are represented by the American Civil Liberties Union, the ACLU of Alabama, Covington & Burling LLP, and Bobby Segall of Copeland Franco.