Members of the Alabama Court of Civil Appeals on Friday reversed a lower court's ruling that barred the Alabama Department of Public Health (ADPH) from licensing birth centers that operate in the midwifery model of care.
Montgomery County Circuit Judge Greg Griffin in May 2025 blocked ADPH from licensing freestanding birth centers like hospitals after years of litigation and protests from midwives and other birthing advocates.
However, the Alabama Court of Civil Appeals said in a ruling released on Friday that ADPH didn't exceed its authority in adopting the 2023 regulations on birth centers.
"Based on our de novo review, we conclude that there is no genuine issue of material fact and that (ADPH State Health Officer) Dr. Harris is entitled to a judgment as a matter of law on Count One. Freestanding birthing centers operating in the midwifery model of care, like those operated by Oasis and ABC, are 'hospitals' within the definition of § 22-21-20(1) because they are health-care institutions' primarily engaged in offering to the public generally, facilities and services for ... obstetrical care.' As such, the ADPH and Dr. Harris had the authority to regulate those institutions pursuant to § 22-21-28(a), and the 2023 regulations adopted by the ADPH are valid. We, therefore, reverse the judgment declaring the 2023 regulations invalid and render a judgment declaring that the ADPH did not exceed its statutory authority under § 22-21-28(a) in adopting the 2023 regulations," members of the Alabama Court of Civil Appeals wrote in the opinion on Friday.
The Alabama Court of Civil Appeals continued, "We also reverse the judgment insofar as it granted a permanent injunction in favor of the plaintiffs. To obtain a permanent injunction, a movant must, among other things, demonstrate success on the merits. Sycamore Mgmt. Grp., LLC v. Coosa Cable Co., 42 So. 3d 90, 93 (Ala. 2010). The injunction was based on the circuit court's determination that the ADPH and Dr. Harris lacked licensing authority over freestanding birthing centers operating in the midwifery model of care. As we have concluded, the birthing centers operated by Oasis and ABC are "hospitals" as defined in § 22-21-20(1)."
"Therefore, they are required to obtain a hospital license from the ADPH to operate. See Ala. Code 1975, § 22-21-22 and § 22-21-25(a). The plaintiffs have not succeeded on the merits of their claim in Count One, so the circuit court committed reversible error in granting the permanent injunction. Therefore, we reverse the judgment insofar as it granted injunctive relief, and we render a judgment for Dr. Harris denying that relief," they wrote in the ruling.
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