The state of Alabama has issued its first licenses to out-of-hospital midwives since 1976.

Al.com reports the newly-formed Alabama State Board of Midwifery approved the licensing of five certified professional midwives on Friday. It is illegal to practice unlicensed midwifery in Alabama. For decades, the lack of licensing effectively outlawed lay midwifery in the state.

Representatives approved the bill Tuesday with an 84-11 vote. It now moves to the Alabama Senate.