Nebraska Lags in Certified Nurse-Midwife Regulation

State remains an outlier with restrictive laws on CNM practice

Published on Feb. 10, 2026

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Nebraska is one of the most restrictive states for Certified Nurse-Midwives (CNMs), prohibiting them from attending planned home births and requiring physician supervision, unlike most other states that allow CNMs to practice more independently. Despite efforts by CNMs and stakeholders to modernize the state's laws, legislative changes have stalled, leading to ongoing legal challenges over the regulatory framework.

Why it matters

The restrictive regulations in Nebraska limit access to midwifery care, which has been shown to improve maternal and infant health outcomes. As the only state with an all-female CNM workforce, the current laws disproportionately impact women's healthcare options in the state.

The details

Nebraska is the only state that explicitly prohibits Certified Nurse-Midwives from attending planned home births, and it is one of only two states that continue to require physician supervision of CNM practice in statute. Efforts by CNMs and stakeholders to modernize the state's laws through legislative channels have stalled, despite bipartisan support for change. In the absence of legislative resolution, legal challenges have emerged as an additional avenue to examine the regulatory framework.

  • In 2025, Nebraska lawmakers considered LB676, a proposal to address Certified Nurse-Midwife regulation, but it did not result in enacted statutory change.
  • Two ongoing legal cases, Swanson v. Hilgers and Lindstrom v. Hilgers, are raising questions about Nebraska statutes that regulate where and how Certified Nurse-Midwives may practice.

The players

Elizabeth Mollard

PhD, CNM, President of the Nebraska Affiliate of the American College of Nurse-Midwives.

Hope Lindstrom

A Nebraska mother who relocated from Oregon and became aware of the state's restrictive Certified Nurse-Midwife regulations.

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What they’re saying

“Many Nebraskans assume our laws reflect standard regulation. In reality, Certified Nurse-Midwives are regulated differently than similarly trained advanced practice clinicians and far more restrictively than national norms.”

— Elizabeth Mollard, PhD, CNM, President of the Nebraska Affiliate of the American College of Nurse-Midwives (businessinsider.com)

“I'm kind of still angry that in my most vulnerable state, I'm still going to have to be fierce in advocating for myself and for my new infant.”

— Hope Lindstrom (businessinsider.com)

What’s next

The two ongoing legal cases, Swanson v. Hilgers and Lindstrom v. Hilgers, are expected to continue examining the regulatory framework for Certified Nurse-Midwives in Nebraska.

The takeaway

Nebraska's restrictive laws on Certified Nurse-Midwife practice, which are out of step with national norms, limit access to midwifery care and disproportionately impact women's healthcare options in the state. Despite efforts to modernize the regulations through legislative and legal channels, the state remains an outlier, underscoring the need for a coherent statutory framework that aligns with evidence-based standards of care.