Midwives were decriminalized in Missouri by a Supreme Court decision five years ago. Since then, the Department of Health reports out-of-hospital births have jumped 68 percent.

Friends of Missouri Midwives spokeswoman Sarah Greek says women are making more choices about how they birth children these days. She says that directly correlates to a decision five years ago in the courts to let midwives legally practice. Greek says Missouri was the only state for a long time that placed such restrictions on pregnant women and on midwives. Greek says until the court ruling decriminalized certified professional midwives, Missouri was the only state where midwives faced felony charges for practicing. She calls that “shocking.”

And she says birth centers are becoming more widespread, although challenges remain. She says the ruling has resulted in more birth centers as well … the Birth and Wellness Center just became the first licensed birth center ever in the St Louis area, and the only licensed birth center currently in the state of Missouri.

Greek sees the increase in out-of-hospital births as a positive sea change for the choices available to women. Births attended by certified professional midwives has doubled in Missouri just over the past two years. Insurance companies are working with midwives to cover the costs of childbirth more and more, Greek says, but says Medicaid still will not pay for out-of-hospital births. She hopes that possibility is on the horizon.

AUDIO: Jessica Machetta reports (1:16)