The Iowa Supreme Court expanded on its landmark 2009 decision legalizing same-sex marriage last week by requiring a child’s birth certificate to include both parents’ names.

“These realities demonstrate that the disparate treatment of married lesbian couples is less effective and efficient, and that some other unarticulated reason, such as stereotype or prejudice, may explain the real objective of the state,” Justice David Wiggins wrote in the decision.

The Gartner v. Iowa Department of Public Health decision changes the previous stance of the state Health Department, which refused to issue birth certificates listing both parents in a lesbian marriage. The decision asked a lower district court to remove a temporary stoppage of requests to add names to certificates — formally providing a route to change the policy.

“We’re thrilled with the decision today, and once again, the Iowa Supreme Court guaranteed equal rights for all Iowans,” said Camilla Taylor of Lambda Legal and lead attorney for the Gartners. “The court said we meant what we said in Varnum. Equal is equal.”

Taylor said Heather and Melissa Gartner, a lesbian couple, encountered many difficulties after their daughter Mackenzie’s birth. Mackenzie developed severe health issues, which required the birth mother’s constant presence over fears that the other mother may be shut out of critical decisions.

“The birth mother had to keep watch on her bedside 24 hours a day, because they were concerned the other parent wouldn’t be authorized for medical treatment,” said Taylor, who is also Marriage Project Director in Lambda Legal’s Midwest Regional Office based in Chicago. “The birth mother had her job security threatened, and it was just a really stressful time that they really shouldn’t have had to go through.”

Before the ruling, same-sex couples were forced go through an adoption process to get names of both parents on the birth certificate.

Heal and Maggie McKnight, a local couple, went through a $3,000 process to get listed on their daughter Theo’s “T-bone” birth certificate.

“…Getting a lawyer for [their daughter] and doing a lot of legal paper work is really not the thing you want to do when you just had a kid,” Heal McKnight said. “It was a big intrusion at a time when you’re just learning how to be a family. There are so many things to figure out, like just making sure you are getting the diapers on right.”

The 29-page decision was also a unanimous decision for the Iowa Supreme Court justices, which follows the same lines of Varnum v. Brien. That case three years ago made Iowa the third state in the country to legalize marriage equality.

“This is a great step forward, and I am really proud that even with the new justices on the court this is still a unanimous ruling,” said Kate Varnum, one of the lead plaintiffs of the Varnum case. “The [Iowa] Supreme Court values all families, and they recognized this is really the only way it could go if all marriages are treated equally.”

Varnum added she hopes Iowans “would not put children in the crossfire,” echoing Taylor’s sentiments that the May 3 case would not lead to the same backlash Iowa saw in 2009, which led to three justices failing to be confirmed a year later.

The Iowa Family Leader, which led the efforts to oust the justices both in 2010 and tried unsuccessfully to get rid of Wiggins in 2012, declined to comment on the ruling.

According to its website, the Family Leader believes marriage is a permanent, lifelong commitment between a man and a woman and strongly supports efforts to keep judicial activism in check.

The Iowa decision also comes in the same week the U.S. Department of Education changed the 2014-2015 FAFSA to allow applicants to describe parents’ marital status as “unmarried and both parents’ living together” along with removing gender specific terms like mother and father.

An official with One Iowa — an organization focused on “fighting for full LGBT equality” — said the case “turned a big corner” for Iowa families, but believes there are still unresolved issues in the state.

“… Looking toward the future, we have some of the harshest HIV criminalization laws on the book,” said Matty Smith, the communications director for One Iowa. “We have made some progress this year, but we want to continue to work to move forward that issue.”