Black and Indigenous birthworkers have been monitored since the early 1900s, especially in the rural South, but this law creates new licensing requirements for midwives.

In the following decade, 22 states and municipalities will employ this strategy. This includes creating new qualifications similar to the state of Florida, where birth workers are now required to witness 15 births by a state registered physician. Other states will require traditional birth workers (also called "granny midwives") to join midwife clubs, where they are monitored by the state.

Many Black birth workers stop practicing because they are not able to read the forms required for licensure. This will disrupt Black & Indigenous birthwork practice outside of hospitals and decimate community-led infrastructure that maintains knowledge and memory of Black & Indigenous Southern traditions of birthing.