Iowa
Midwives’ lawsuit challenging Iowa certificate-of-need law can continue, judge says
A pair of central Iowa midwives fighting for the right to build a stand-alone birthing center can continue their lawsuit against the state, a federal court ruled Wednesday.
Caitlin Hainley and Emily Zambrano-Andrews, who together make up the Des Moines Midwife Collective, are challenging a state law requiring any new medical facility obtain a “certificate of need” from regulators. That involves, among other expensive and time-consuming steps, giving any potential competitor notice of the proposal and the opportunity to argue why the new facility is not truly needed.
Hainley and Zambrano-Andrews, who currently provide home birth services throughout the Des Moines metro, want to open a birth center with tubs and other equipment so patients can give birth in a home-like setting. Their attorneys say that midwife service, whether at home or a birth center, is fundamentally different than that provided by hospital maternity wards. Their lawsuit, filed in February 2023, argues it is unconstitutional for the state to grant what amounts to a “competitor’s veto” to established businesses.
The state filed to dismiss the lawsuit. Wednesday’s ruling, by Chief District Judge Stephanie Rose, largely denies that motion. But Rose did rule the certificate of need law does not infringe on any “fundamental right” under the U.S. Constitution, meaning it will be easier for the state to prove its law is constitutional.
From 2023: MercyOne Des Moines to shut down its midwives program. What that means for pregnant moms:
The Iowa Attorney General’s Office did not respond to a message seeking comment. Wilson Freeman, an attorney with the libertarian-leaning Pacific Legal Foundation who is representing the midwives, said in an email they believe they will prevail even if the court does not agree the law infringes on their fundamental rights.
Strict scrutiny or rational basis?
Any law that burdens what courts consider to be a fundamental right — such as freedom of speech, the right to marry and have children, and more — must survive what is known as strict scrutiny, meaning it must be found to be “narrowly tailored” to serve a “compelling” government interest.
If a law does not implicate a fundamental right, courts instead apply what is known as rational basis review, meaning the law must only be “rationally related” to a “legitimate” government interest.
In this case, the midwives argued the certificate of need law violated multiple fundamental rights, including the right of mothers to choose their place and manner of giving birth and the right of the plaintiffs to earn their living. But the judge rejected those claims, finding other courts have declined to make birth setting a fundamental right and noting the U.S. Supreme Court’s “unmistakable resistance” to recognizing additional rights as fundamental.
Case can continue, judge rules
Attorneys for the state had asked for the case to be dismissed entirely, but Rose refused, finding the plaintiffs have “plausibly” argued the certificate of need law might fail even under rational basis review.
Among other arguments, Rose noted that the midwives raise the question of why they are allowed to provide home births without a certificate of need, but do need a certificate to provide the same service in a centralized location. Such a distinction does not improve the cost, availability or quality of maternal care, the women argue. Rose wrote the women have asserted a “plausible claim for relief” that the law lacks a rational basis, and agreed the lawsuit should continue.
Previously: Iowa finally passed a law to license midwives. Will it help sway medical field doubters?
Freeman, representing the midwives, told the Register they’re prepared to fight that fight.
“There is no rational reason for the state to require a certificate of need for midwives who want to help women give birth in a dedicated facility, while allowing midwives to attend births literally anywhere else without such a certificate, Freeman said. “While we continue to believe a fundamental right is implicated by the regulation, the law is unconstitutional under either standard.”
And although rational basis review is favorable to the state, similar laws have failed that test before, Freeman said. A Kentucky law requiring a certificate of need for moving companies was struck down under rational basis in 2014.
The case currently is scheduled for a bench trial before Rose in January 2025.
William Morris covers courts for the Des Moines Register. He can be contacted at wrmorris2@registermedia.com or 715-573-8166.
IOWA CITY, Iowa (KCRG) — Volunteers broke ground Saturday for Iowa Valley Habitat for Humanity’s 16th Woman Build, honoring a retired University of Iowa nursing professor.
Liz Swanson, a retired nursing professor, was chosen as this year’s honoree for her decades of impact. The Women Build program focuses on including women in every step of home construction.
While the home is built in Swanson’s honor, it will go to a fellow nurse and mother of three. The family applied through the affordable housing program.
Swanson said she’s proud to be part of a project that directly connects to her nursing legacy.
“It’s very special to have the unique opportunity to help the nurse who is working nights,” Swanson said.
Swanson said stable housing gives families the security to plan for the future.
“It means security for families. We talked briefly to the children and they said, ‘we’re gonna have our own bedroom,’” Swanson said.
Volunteers are set to begin work on the home in August. Those interested in volunteering can find more information here.
Copyright 2026 KCRG. All rights reserved.
The Iowa Lottery offers several draw games for those aiming to win big with rewards ranging from $1,000 to millions. The most an Iowan has ever won from playing the lottery was $343 million in 2018 off the Powerball.
Don’t miss out on the winnings. Here’s a look at Friday, May 8, 2026, winning numbers for each game:
Winning Mega Millions numbers from May 8 drawing
37-47-49-51-58, Mega Ball: 16
Check Mega Millions payouts and previous drawings here.
Winning Pick-3 numbers from May 8 drawing
Midday: 0-5-8
Evening: 9-9-2
Check Pick-3 payouts and previous drawings here.
Winning Pick-4 numbers from May 8 drawing
Midday: 0-2-7-3
Evening: 0-7-0-6
Check Pick-4 payouts and previous drawings here.
Winning Millionaire for Life numbers from May 8 drawing
14-16-21-43-51, Bonus: 03
Check Millionaire for Life payouts and previous drawings here.
Feeling lucky? Explore the latest lottery news & results
When are the Iowa Lottery drawings held?
- Powerball: 9:59 p.m. CT on Monday, Wednesday, and Saturday.
- Mega Millions: 10:00 p.m. CT on Tuesday and Friday.
- Lotto America: 9:15 p.m. CT on Monday, Wednesday, and Saturday.
- Lucky for Life: 9:38 p.m. CT daily.
- Pick 3 (Day): 12:20 p.m. CT daily.
- Pick 3 (Evening): 10:00 p.m. CT daily.
- Pick 4 (Day): 12:20 p.m. CT daily.
- Pick 4 (Evening): 10:00 p.m. CT daily.
- Millionaire for Life: 10:15 p.m. CT daily.
This results page was generated automatically using information from TinBu and a template written and reviewed by an Iowa editor. You can send feedback using this form.
IOWA — Iowa’s new restrictions on SNAP benefits are drawing concern from advocates who say the changes could make it harder for families to buy food and could put future summer assistance for children at risk.
The state’s SNAP waiver took effect January 1, 2026, limiting what items can be purchased based on Iowa’s taxable food list. While that includes widely discussed restrictions on soda and candy, the policy also affects certain prepared foods, creating confusion for shoppers.
“Something as small as whether or not a utensil is included in a food item actually impacts whether or not you can continue to purchase that item using your SNAP benefits,” Paige Chickering, Iowa State Manager for the Save the Children Action Network, said.
Advocates say the rules can be difficult to navigate, especially for people relying on quick meals. Items like prepackaged salads or sandwiches may or may not qualify depending on how they are packaged.
At the same time, new legislation slated for the next session at the statehouse could make those restrictions more permanent by requiring Iowa to continue seeking federal approval for the waiver.
That’s raising additional concerns about the future of Summer EBT, also known as “Sun Bucks,” which provides food assistance to children when school is out.
“This makes that food assistance dependent on a decision made in Washington, D.C. that is just arbitrary and not really dependent on the needs of Iowans and Iowa children,” Chickering said.
The program is expected to help around 220,000 children in Iowa during the summer months. Advocates worry leaving it up to federal approval of the waiver could jeopardize that support if policies change. They also point out that SNAP plays a major role in addressing hunger compared to other resources.
“We know that for every one meal provided by an emergency feeding organization, SNAP provides nine,” Chickering said.
Advocates say they support improving nutrition but argue there are more effective, evidence based ways to do that without limiting food choices.
For now, organizations across Iowa are working to help families understand the new rules, while also pushing lawmakers to reconsider how the policy could impact food access moving forward.
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