MONTGOMERY, Ala. (WIAT) — Because there weren’t any active birth centers in Alabama, the state repealed its rules regulating those centers in 2010 as part of the Red Tape Reduction Act.

But now, the Alabama State Department of Public Health wants to reinstate those regulations.

At a hearing Thursday, midwives said the rules are antiquated.

“Reviving a 35-year-old document is lazy and a bad idea. There is so much to change, it is obvious why it was repealed in 2010,” licensed midwife Nancy Megginson said.

Megginson, who has been a midwife for the last three years in Alabama, was previously a nurse who had spent eight years in the field, five of which were spent in labor and delivery. She said many of the document’s definitions are outdated with current medical practice.

“Toxemia, being defined as pre-eclampsia for many years now. The National Association of Childbearing Centers has been American Association of Birth Centers since 2005. And the immediate post-partum recovery time is no longer one hour, but two hours,” she said.

Dr. Stephanie Mitchell, who runs Birth Sanctuary Gainesville, said the regulations could threaten the operation of centers in rural areas.

“You can see the map here, but basically you’re seeing in Sumter County we don’t have access. It’s a health care desert. I am here, I am available. We are in an emergency situation and it’s clear from everyone’s words today that these proposed rules and regulations are inappropriate,” Mitchell said.

Sharon Holley, vice president of the American College of Nurse Midwives for Alabama who also teaches nurse-midwifery at UAB, said her graduates wouldn’t be eligible to work in a birth center under the regulations, which require a year of labor and delivery or newborn ICU experience.

“We don’t need them leaving the state, which is what they’re all doing. We need them here where the crisis is terrible,” Holley said.

Many raised concerns that the proposal didn’t include input from midwives themselves. Health Department officials said that although they did not consult the Alabama Board of Midwifery, they also sought input from the regulatory boards governing the licensing of certified nurse midwives.

The deadline for submitting more comment to the department is Sept. 2.

Alabama had the fifth highest infant morality rate in the nation, as well as the third highest maternal mortality rate in 2020, according to the Centers for Disease Control and Prevention.