12/12/2025
As community midwives practicing in both a regulated (New Jersey) and unregulated (Pennsylvania) state, we sit at an interesting intersection of reproductive autonomy and access, and end up navigating the state systems in different ways.
But… Does our care look different in the state we’re licensed? No– We’re following the same clinical care standards. We’re having the same good outcomes and transferring well. We’re providing the same respectful and compassionate care.
Ironically, we find it easier to practice in PA where we’re not licensed vs. NJ where we are licensed because of integration and hostility towards midwives. For example, in NJ it is almost impossible for us to get an ultrasound for someone using Medicaid, but in PA we are able to directly write the script for our clients.
In both states, we’re still providing safe homebirth care.
[ID: Photo of Ray listening to fetal heart tones with a Doppler in a birth tub]
