Alabama licensed five certified professional midwives on Friday, marking the first time in more than 40 years the state has issued licenses to out-of-hospital midwives.

“The future of midwifery in Alabama is looking really good,” said Kaycee Cavender, a member of the newly-formed Alabama State Board of Midwifery. “We’ve been waiting on this day for a long time."

Alabama last issued a midwifery license in 1976. Since then, it’s been illegal to practice midwifery without a license – effectively outlawing lay midwifery in the state. Alabama women could choose home births, but the births could not be legally attended by a midwife or other professional.

Then in 2017, Alabama lawmakers voted to legalize midwifery after more than a decade of lobbying by grassroots organizations – and over the opposition of some of the state’s largest professional medical associations. After some legal back-and-forth over rules and regulations, the board began accepting license applications at the end of 2018.

“We have a responsibility as a board to ensure applications are complete and accurate," said Cavender. "We want to make sure we license the midwives that deserve to be licensed.”

On Friday, the board approved the license of five certified professional midwives: Stacey Bufkin, Tori Dennis, Karen Brock, Rebekah Myrick and Layla Brown.

Myrick, who lives in Jefferson County, said that it felt “surreal” to watch the board vote to approve midwife licenses.

“I was born and raised here in Alabama and it was always my dream to be able to serve here, but because of the law I felt forced to leave the state for my training and had to practice in Tennessee,” said Myrick, who lives in Jefferson County. She’s been working as a Certified Professional Midwife for three years, traveling to Alabama’s neighboring states to deliver babies.

“To be able to come home and serve these women and do what I feel like is my passion and my God-calling is amazing," said Myrick.

Cavender said she expects the application for a sixth midwife, Lauren Collins, will come before the board for a vote at its next meeting.

Cavender said she has been pleasantly surprised at the number of applicants. Before the process began, she didn’t expect to ever see more than about 10 certified professional midwives working in the state.

Most of the newly-licensed midwives live in Birmingham and North Alabama. Only one lives south of Birmingham, she said.

Certified professional midwives legally practice in about 33 other states, delivering babies in out-of-hospital settings. They receive certification through a testing and apprenticeship process accredited through the North American Registry of Midwives. The certified professional midwife credential is a requirement for being licensed in Alabama.

They’re different from certified nurse midwives, which are registered nurses with education credentials on par with nurse practitioners. Nurse midwives work in hospitals and alongside obstetricians in medical clinics. They have always been allowed to practice in Alabama, though few of them do, relative to most other states. Alabama law requires them to be closely supervised by a doctor.

Alabama’s certified professional midwives can only attend low-risk births and are required by law to transfer care of a mother over to an obstetrician if complications arise. Alabama does not have any birth centers, but they would be able to practice in a birth center should one open.

Unlike in some other states, Alabama’s midwives won’t be allowed to treat women who have had previous c-sections. It’s a restriction that disappoints Myrick, but she said she is glad more Alabama women will now have the choice of using a midwife.

“So many families will have the option of having a licensed provider at their home birth now,” said Myrick. “they won’t have to go unassisted or go under the radar with an unlicensed midwife.”

More information about midwifery licensing is available at the midwifery board’s website, ALSBM.org.