In Tvrdy v. Hilgers, (D NE, Sept. 26, 2026), a Nebraska federal district court upheld a state law prohibiting certified nurse midwives (CNM) from attending home births without a physician also being present. Midwives may attend births alone only in a license health care facility. In the case, two pregnant mothers sued claiming that the ban violates their religious beliefs. The court explained:
The plaintiffs assert they are devout, practicing Christians…. They explain there are “two religious commitments” at play here. The first is that childbirth “should occur in a manner consistent with their convictions regarding family life, maternal responsibility, and the proper exercise of parental judgment”… Those convictions include their beliefs that “children are gifts from God and that parents are entrusted with the responsibility to make conscientious decisions regarding childbirth” and “the welfare of their children”…
The second is that they have a “religious obligation to act as faithful stewards of the lives and health of both mother and child by taking reasonable measures to promote safety during labor and delivery”…. In their view, neither a hospital birth nor an unassisted home birth allows them to honor both commitments. They believe a CNM attended home birth does.
Plaintiff sought a preliminary injunction under Nebraska’s First Freedom Act and the First Amendment. The court said in part:
The Court concludes, at least at this preliminary stage, that the defendants have demonstrated the government has a compelling interest in protecting the health and safety of the plaintiffs and their children….
,,, At least two children have died in Nebraska in the last four years in home births attended by midwives….
The Court also concludes that the defendants have demonstrated the Act’s restriction on solo CNM-attended home births is the least restrictive means of furthering that compelling interest, as to both Nebraska mothers and children and as to the plaintiffs in this particular instance…..
The Act does not prevent physicians or PAs from attending home births, and it does not prevent CNMs from attending births in birthing centers—low-intervention environments which aim to simulate the home-birth experience. In summary, the plaintiffs have not persuaded the Court that they are likely to prevail on their Freedom Act claim.
The court rejected plaintiffs’ 1st Amendment claim because the restriction is a neutral law of general applicability.
Pacific Legal Foundation provides additional background on the case.