HB520 2025-2026 Legislative Session Recap: Historic Progress Toward Midwifery Licensure in Georgia

2025-2026 Was Our Strongest Session Yet!

The 2025-2026 legislative session marked the most significant advancement in Georgia's fight for midwifery licensure since advocacy began in 1991. While HB520—the Licensed Midwife Act—did not receive a committee vote before Crossover Day, the groundwork we laid this session positions us for success like never before.

This was not a defeat. This was a marathon training run that made us faster, sharper, and better prepared to win.


By the Numbers: Unprecedented Advocacy Infrastructure

Professional Lobbying Investment

Terminus Strategies, our professional lobbying firm, executed the most comprehensive advocacy campaign in Georgia midwifery history:

Targeted Legislative Engagement:

  • 10 funded lunches and meetings with key legislators

  • 13 strategic support sessions with midwives and lobbyists (biweekly strategy calls plus ad-hoc communication)

  • Secured presentation opportunity with House Democratic Caucus and Women’s Legislative Caucus

  • Secured and funded an additional presentation with Democratic Caucus with catered lunch

  • Funded NACPM GA sponsorship of Women's Caucus retreat in Jekyll Island

Stakeholder Meetings: Building the Foundation

Our team engaged in extensive technical discussions with major stakeholder organizations to refine regulatory language and address concerns:

Georgia Hospital Association (GHA) -two introductory meetings

  • Addressed hospital liability and safety protocol concerns

  • Clarified emergency care planning requirements

  • Critical insight gained: GHA opposition is now a known obstacle we can strategically address

Georgia Nurses Association (GNA) 

  • Received specific technical feedback on bill language

  • Clarified concerns about APRN references and medication lists

  • Confirmed GNA is in support of our licensure

Georgia OBGYN Society/ACOG - one introductory meeting

  • Identified shared values: high-quality care, patient autonomy, addressing provider shortages, collaboration across teams

  • Discussed national organization policies (ICM Global Standards for midwifery education)

  • Had constructive dialogue about CPM certification appropriateness and board composition

  • Built foundation for ongoing collaboration

American Association of Birth Centers (AABC) - one introductory meeting

  • AABC reviewing HB520 for potential endorsement

Coalition Building: Unprecedented Alliances

In addition to our continued alliance with Black Midwives Over Georgia, NACPM GA was able to establish partnership with multiple other organizations.

Maternal Health Organizations:

Hope for Georgia Moms 

  • Invitation extended for Missi Burgess, NACPM GA President, to join Maternal Health Task Force

  • Receptive to CPM education and collaboration

Healthy Mothers, Healthy Babies  

  • NACPM GA invited to participate in Maternal Health Awareness Day at the Georgia Capitol on January 21, 2026

  • Identified as key policy priority: Perinatal Workforce expansion including midwives as rural access solutions

Georgia Health Initiative

Reproductive Justice & Community Organizations:

Gather & Grow: Georgia Community Doula Coalition Convening (GCDC) 

  • NACPM GA sponsored this event

  • Discussion of how to address licensure concerns while preserving cultural work of doulas

Black Mamas Matter Alliance (BMMA) Georgia Black Maternal Health Taskforce 

  • HB520 identified and supported as "Direct-Entry Midwife" licensure bill

  • Midwifery licensure ranked #2 in top policy priorities (after Medicaid expansion)

  • Discussion of federal funding for midwifery education requiring licensure


Major Public Engagement Events

Lobby for Midwives Day - January 2025

  • Grassroots advocacy day attended by 50+ participants

  • Constituent contacts with legislators

  • Direct advocacy training and execution

Maternal Health Awareness Day at the Georgia State Capitol - January 2026

  • NACPM GA participated as an invited organization, tabling with information and resources

  • Built visibility and credibility with legislators and maternal health advocates

  • Strengthened relationships with allied organizations

  • Read our reflection on this event here.

Reproductive Justice Advocacy Day - February 2026

  • NACPM GA participated as a sponsor and lead in lobbying pod

  • HB520 featured on the legislative agenda

  • Many advocates elevated midwifery licensure throughout the day

  • Fostered critical relationships and expanded coalition network


Grassroots Power

When HB520 faced its critical moment before Crossover Day, over 100 Georgia constituents flooded Chairman Hawkins' office with calls and emails demanding that HB520 be brought to a committee vote.

This unprecedented mobilization demonstrated:

  • Strong grassroots support across the state

  • Motivated base ready to advocate

  • Constituent pressure that legislators cannot ignore

  • Organizational capacity to activate supporters rapidly

This matters. Legislative offices track constituent contacts. A hundred voices on a single issue signals that voters are paying attention—and that creates political leverage.


Bill Refinement: Technical Improvements

Throughout the session, HB520 was strengthened through stakeholder feedback:

Clarifications Made:

  • Bill scope: educational requirements needed for stakeholder collaboration and support

  • Medication jurisdiction and pharmacy rules addressed

  • Professional licensure board composition

  • Decriminalization for Traditional Midwives

Strategic Decisions:

  • Some technical issues better addressed in Rules and Regulations vs. legislation

  • Preparation of substitute bill incorporating stakeholder feedback

  • Strengthening decriminalization language


What We Learned: Strategic Intelligence

The Obstacle Is Now Visible

The Georgia Hospital Association's opposition is identified, understood, and can now be strategically addressed.

This clarity is power. We now know:

  • Which stakeholders need targeted education

  • What concerns must be addressed in next year's bill language

  • Where coalition-building efforts should focus

  • How to counter misinformation and fear-based objections

Legislative Process Mastery

We deepened our understanding of:

  • Committee scheduling and agenda-setting dynamics

  • Crossover Day deadlines and strategic timing

  • The critical role of Rules Committee positioning

  • Importance of Democratic and Republican caucus engagement

  • Value of presenting to Women's Caucus and other affinity groups

Relationships Are Everything

The dozens of meetings, lunches, presentations, and coalition events weren't just about HB520—they were about building trust, credibility, and long-term relationships with:

  • Legislators who will champion future bills

  • Maternal health organizations who share our goals

  • Community leaders who can mobilize support

  • Healthcare stakeholders who can become allies instead of obstacles

Why This Session Was Historic

For the first time in Georgia midwifery advocacy history:

✅ We had professional lobbyists working consistently on our behalf with strategic legislative access

✅ We engaged in multiple substantive meetings with major healthcare stakeholder organizations

✅ We were invited to participate in Maternal Health Awareness Day at the Capitol

✅ We sponsored and participated in Reproductive Justice Advocacy Day with HB520 on the agenda

✅ We secured presentations to Democratic Caucus and Women's Caucus

✅ We built alliances with organizations that have statewide reach

✅ We identified legislative champions willing to actively advocate on our behalf

✅ We received technical feedback from stakeholder organizations that will strengthen future bills

✅ We positioned midwifery as a maternal health workforce solution alongside other provider types


The Path Forward: Why We're Positioned to Win

Georgia's need for midwifery care has never been more urgent:

🚨 One of the worst maternal mortality rates in the nation

🚨 Over 40% of counties are maternity care deserts

🚨 Families desperately want access to respectful, comprehensive midwifery care

🚨 Struggling birth center infrastructure and closures

And now we have:

💪 Professional lobbying infrastructure

💪 Strategic stakeholder relationships

💪 Legislative champions ready to lead

💪 Coalition partners with resources and reach

💪 Grassroots supporters willing to mobilize

💪 Technical refinements that address concerns

💪 Clear understanding of opposition and how to counter it

What Happens Next

Immediate Actions (2026):

  1. Continued lobbyist engagement: Terminus Strategies continues building relationships and strategizing even without an active bill

  2. Constituent education campaign: Supporters educating their own representatives using resources at www.georgiacpm.org

  3. Counter-campaign development: Planning targeted strategy to address Georgia Hospital Association opposition

  4. Coalition strengthening: Deepening partnerships with maternal health organizations, faith-based allies, and community leaders

  5. Bill refinement: Incorporating stakeholder feedback into improved legislative language. 2027 starts a new biennial session in Georgia, which means we will have a new bill number for 2027-2028.

2027 Legislative Session Preparation:

  • Substitute bill ready with technical improvements

  • Stakeholder endorsements secured

  • Legislative champions briefed and ready

  • Grassroots network prepared to activate

  • Counter-campaign to GHA opposition planned for execution


How You Can Support This Work

The infrastructure we've built requires sustained investment.

Our lobbyists continue working even without an active bill—building relationships, strategizing for next session, positioning us for success.

This professional advocacy is not free. It requires funding.

Every dollar you contribute funds:

  • Professional lobbying that opens doors midwives can't access alone

  • Strategic stakeholder meetings and coalition-building events

  • Legislative briefings and educational materials

  • Grassroots mobilization campaigns

  • Technical bill drafting and legal review

The Bottom Line

Licensed midwives practice in 38 states. Georgia will be joining them.

Not because it's easy. Not because opposition doesn't exist.

But because the need is real, the evidence is clear, and we are relentless.

Your children and grandchildren will have access to licensed midwifery care in Georgia because we refused to quit after this setback.

We adapted. We learned. We built. And we're coming back stronger.

The 2025-2026 session wasn't the finish line—it was the most important training ground we've ever had.

And we're ready for what comes next.

Melissa Burgess