State bans top U.S. midwifery group official from calling herself a midwife.
A top official for the North American Registry of Midwives is suing the Georgia Board of Nursing over its ban on her use of the title “midwife” because she is not licensed in the state.
Debbie Pulley, who serves on the credentialing body for the largest group of non-nurse midwives in the country, said the board’s actions violate her First Amendment rights. She filed the claim on Dec. 11 in the U.S. District Court in Atlanta, specifically naming board President Janice Izlar as the defendant.
Neither the board nor Izlar has filed a response through the court, records show.
The Georgia Board of Nursing investigated Pulley after GateHouse Media — now part of the USA TODAY Network — found her practicing unlawfully as part of its “Failure to Deliver” investigation into the rise and risks of out-of-hospital births.
Georgia restricts midwifery to only people with a current certification from the Georgia Board of Nursing to practice as a certified nurse-midwife.
Pulley is not a certified nurse midwife. She is a certified professional midwife, a credential provided by the North American Registry of Midwives — or NARM — to those who complete a midwifery program or apprenticeship and pass a capability test. Certified professional midwives are not required to have nursing degrees, and some have no more than a high school diploma.
As a result of its investigation, the board issued Pulley a cease-and-desist order in June, demanding she stop calling herself a midwife and threatening to fine her $500 for each violation, according to the lawsuit and a copy of the final order.
Pulley responded by removing all references to her certified professional midwife credential — and the term midwife in general — from the NARM website, her social media account and the website of the Atlanta Birth Care, where she now works as an office manager, her federal complaint states.
Pulley had been assisting with births in Atlanta for 38 years, according to her website. But she claimed in the lawsuit that she no longer practices and instead advocates for midwifery through her role with NARM.
The board finalized the order Dec. 2. Pulley filed her lawsuit the following week.
“The state of Georgia can’t ban words,” said Pulley’s attorney Jim Manley. “I am an attorney. I’m licensed in Arizona and Colorado, but if I go to Georgia, I am still an attorney. It’s accurate for me to describe myself as an attorney if I’m giving legislative testimony or talking to someone about this case, even though I can’t hang a shingle and write wills for people.”
The same should apply to Pulley and her title as a midwife, Manley argued.
“Debbie is a certified professional midwife, and the First Amendment protects her right to say that,” Manley said. “It’s important for her to be able to talk about her qualifications and experience when she is advocating for midwifery.”
The Georgia Secretary of State’s communications director, Ari Schaffer, who also represents the Board of Nursing, would not speak about the order or Pulley’s lawsuit. Shaffer referred the USA TODAY Network to the attorney general’s office, which also declined to comment.
More than 30 states currently license non-nurse midwives like Pulley. Around a dozen states lack laws or regulations governing the practice. Georgia, along with North Carolina, the District of Columbia and Illinois, ban non-nurse midwives from practicing at all.
Dozens of the North American Registry of Midwives’ members are located in those states that ban non-nurse midwives, according to the organization’s most recent annual report.
The organization shields those midwives by denying the public access to its roster. In an interview last year with USA TODAY, Pulley said releasing that information could jeopardize those who violate state laws or regulations.
“We don’t know necessarily where they’re practicing,” Pulley said at the time. “We don’t care to find out.”
Non-nurse midwives have unsuccessfully lobbied state lawmakers for years to license and regulate them.
Until Georgia “creates a legal path of licensure for the Certified Professional Midwife,” Pulley’s website states, “I will not be practicing clinically.”