American College of Nurse-Midwives Files Lawsuit Challenging Constitutionality of Mississippi’s Anticompetitive Prohibition Against Certified Nurse Midwives Practicing Without a Collaborating Physician

Current Law Presents Irrational Barrier to Prenatal and Maternal Care Amid Statewide Public Health
Emergency

Jackson, Mississippi, January 20, 2025 – In an effort to increase the number of certified nurse midwives (CNMs) to help address Mississippi’s maternal health crisis, the American College of Nurse Midwives (ACNM) filed a lawsuit Tuesday, January 20, 2026, asking a federal court in Jackson to strike down a Mississippi law that prohibits any CNM from practicing unless she finds a physician willing to be a “collaborator” with her.

The lawsuit was filed for ACNM, which has CNM members in Mississippi and throughout the country,
by the Mississippi Center for Justice, Pillsbury Winthrop Shaw Pittman LLP, and Amabebe Law PLLC.
As alleged in the lawsuit, the collaboration requirement severely limits the number of CNMs in the state
and creates a major barrier to closing Mississippi’s gaps in prenatal and maternal care that were identified
by the Mississippi State Department of Health in August 2025 when it declared a public health emergency
in response to rising infant mortality rates across the state.

Proposed bills have been filed in the legislature to eliminate the collaboration requirement for CNMs.
The passage of such a bill would lead to withdrawal of the lawsuit.

According to the lawsuit, “[t]his collaboration can be expensive, and sometimes impossible, for CNMs to
obtain because few Mississippi physicians are willing to collaborate with CNMs who often compete to
serve the same patients.” The lawsuit explains that CNMs possess the training and experience to provide
the full range of prenatal, delivery, and postnatal care for pregnant women and often at a lower cost than
physicians, which provides an incentive for physicians to limit the number of CNMs who practice. The
lawsuit also claims “that the collaboration requirement means that physicians can effectively limit CNMs
from practicing and can require significant fees in order to permit any individual CNM to practice.”
The collaboration requirement, contained in Section 73-15-20 of the Mississippi Code, applies to all
advanced practice registered nurses, but since the ACNM represents only CNMs, the lawsuit seeks only

to prevent the application of the requirement to CNMs, claiming that it is a violation of their right to
practice their profession under the Fourteenth Amendment to the United States Constitution.
In addition to the collaboration statute, the lawsuit also challenges the related regulations adopted by the
Mississippi State Board of Nursing as well as more extensive regulations imposed on physicians willing
to collaborate by the Mississippi State Board of Medical Licensure (MSMBL) which itself is composed of
physicians. Because the MSMBL regulations place additional limitations on CNMs and reduce
competition for physicians, the lawsuit alleges that they also violate federal and state antitrust laws.
“The physician collaboration requirement is an outdated, unnecessary restriction that has nothing to do
with patient safety and everything to do with limiting competition and control over who can provide
care,” commented ACNM Chief Executive Officer Michelle Munroe. “Certified nurse-midwives are
fully trained, nationally certified professionals who deliver high-quality, cost-effective maternity care
every day across this country.”

ACNM is represented by Rob McDuff of the Mississippi Center for Justice (MCJ), Michael Sibarium,
Drew Navikas, and Vinny Sidhu of Pillsbury Winthrop Shaw Pittman LLP, and Eremipagamo Amabebe
of Amabebe Law PLLC.

“With Mississippi suffering from severe shortages of professionals who can deliver babies and provide
prenatal and postnatal care, we need to do everything we can to increase the number of certified nurse
midwives in the state,” said Rob McDuff of MCJ. “Hopefully, the legislature will change the law this
session. If not, we will move forward with our lawsuit to strike it down.”

Speaking on behalf of the Pillsbury team, Michael Sibarium noted: “While these practice restrictions on
highly trained nurses have long been recognized as anticompetitive in other states, they are utterly
irrational given the healthcare crisis facing pregnant women and their newborns in Mississippi. Pillsbury
stands with ACNM in fighting for better healthcare for mothers and their children in Mississippi.”

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The American College of Nurse-Midwives is the professional association representing certified nurse-
midwives and certified midwives in the United States. ACNM sets standards for midwifery education and

practice, advances evidence-based care, and advocates for policies that improve maternal and
reproductive health outcomes.
The Mississippi Center for Justice (MCJ) is a nonprofit law firm that advances racial and
economic justice through litigation, policy advocacy, and community education. Through
partnerships and direct legal services, MCJ works to ensure that all Mississippians have access
to justice and opportunity.
Pillsbury Winthrop Shaw Pittman LLP is one of the world’s foremost law firms, advising clients ranging
from entrepreneurs working out of a garage to the largest public and private companies. Operating
across the Americas, Europe, Asia, Africa, and the Middle East, the firm’s market-leading practices are
consistently recognized for excellence by Chambers & Partners, Financial Times, and other publications.
Amabebe Law PLLC is a top-tier boutique law firm dedicated to helping businesses, creatives, and
mission-driven organizations