Iowa Homebirth Law
Is Homebirth Legal in Iowa?
Thankfully homebirth has never been and is not currently illegal in Iowa. Families in Iowa are free to choose where and with whom they would like to give birth. However, up until July 1, 2024 there was no law or regulation that governed homebirth midwives. Prior to this law, anyone could call themselves a midwife and charge a fee, making it hard for consumers to verify training and experience.
Who oversees Midwifery in Iowa?
All licensed Midwives in the sate of Iowa are overseen by the Board of Nursing. Certified Professional Midwives also have a Midwifery Advisory Committee that may be called upon by the board to help them understand the community standard for homebirth midwifery and help them assess difficult cases. If consumers would like to file a complaint, they may do so through the Iowa Board of Nursing.
Who can practice homebirth Midwifery in Iowa?
In the state of Iowa ALL MIDWIVES must be licensed to practice. In order to obtain a license you must be a Nurse Midwife or Certified Professional Midwife.
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Iowa Code 148I is the statute pertaining to midwifery in Iowa. Iowa Code 148I.2 states: "Except as provided in section 148I.3, beginning July 1, 2024, every person practicing midwifery in this state shall be licensed pursuant to this chapter. The board shall adopt rules pursuant to chapters 17A, 147, and 272C establishing procedures for the licensure of new and practicing midwives."
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The practice of midwifery is defined in Iowa Code 148I.7 as "the practice of providing primary maternity care to a client during the preconception, antepartum, intrapartum, and postpartum periods and newborn care up to six weeks." Additionally, "Midwife" is defined in Iowa Code 148I.6 as "a person practicing midwifery."
Therefore, if a person is practicing midwifery in the state of Iowa, the person needs to be licensed pursuant to Iowa Code 148I and the rules found in 655--Chapter 16.
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EXCEPTIONS ARE:
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A person who is a member of a Native American, Mennonite, or Amish community who provides traditional midwife services to such a community.
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A person who, in good faith, engages in the practice of the religious tenets of a church or a religious act if no fee is contemplated, charged, or received.
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A person rendering aid in an emergency.
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A student midwife currently enrolled in an accredited midwifery education program and providing services to clients under the direct, on-site, in-person supervision of a certified professional midwife who is licensed and registered as a preceptor with the North American registry of midwives or its successor organization.​
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This chapter does not "Limit or regulate the practice of qualified members of other professions including but not limited to advanced registered nurse practitioner midwives under chapter 152, advanced practice registered nurse midwives under chapter 152E, or certified nurse midwives, from providing services that would constitute midwifery under this chapter." For which no law or regulation has been written to restrict or regulate what a CNM may do at a homebirth.
Are there laws prohibiting what Midwives can do in Iowa?
No, there are no laws prohibiting Midwives from helping clients within their scope of care. In some states there are strict laws surrounding things like vaginal birth after cesarean (VBAC), breech or twins. In the state of Iowa families have maintained their freedom to choose a Midwife to assist them at home in these scenarios and you'll find that the community standard of care includes advanced training and support for these at home. Certified Professional Midwives are required to provide informed consent, create an emergency care plan and have a responsibility to consult for higher risk situations.
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You can find a full list of conditions a CPM must consult for here. Consult is defined as "discussing the aspects of an individual client’s circumstance with other professionals to ensure comprehensive and quality care for the client, consistent with the objectives in the client’s treatment plan or for purposes of making adjustments to the client’s treatment plan. Consultation may include history-taking; examination of the client; rendering an opinion concerning diagnosis or treatment; or offering service, assistance or advice." It is important to note that the Midwife must consult, not the client, and consultation does not prohibit the client from still choosing a homebirth.
What does the law say about birth centers?
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As of July 1, 2025, House file 887 removed birth centers from the meaning of institutional health facility. This was a big moment for birth centers in Iowa, because when it was signed into law there were zero free-standing birthing centers in the state of Iowa. This was largely due to the requirement as an institutional health facility to obtain a certificate of need (CON). This was a very expensive and lengthy process that involved asking permission to open from existing health facilities. This created a manopoly and only one birth center ever obtained that certificate in over a decade, all others were denied. Despite these facilities knowing full well that Iowa has large maternity care deserts and were closing many rural maternity care programs.
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The new definition is as follows:
"Birth center" means a facility or institution, which is not an ambulatory surgical center or a hospital or in a hospital, in which births are planned to occur following a normal, uncomplicated, low- risk pregnancy.