ABSTRACT

Recent years have seen increased activism on behalf of homebirth midwives, with grassroots movements in many states focused on gaining professional status for midwives, and legislation regulating and decriminalizing their practice. However, changing the legal status of homebirth midwifery in the United States may not be the most important issue in creating access for maternal services of this type; in fact, legal status is relatively unimportant to this issue. Participant-observation and interviews indicate that, regardless of legal status, homebirth midwives may be subject to prosecutorial discretion, onerous reporting and insurance requirements, and increased state reach via administrative agencies. These findings reaffirm other studies that have pointed to the limits of law; the gap between doctrine and legislation, and implementation; and the contingent and constitutive relationships between law and transformational change.