Birth Centers at Risk

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2007-cesareandataSince 1970, there has been a dramatic increase in the number of medical interventions during labor and delivery.  Now nearly 1 in 3 pregnant women who deliver in a hospital will undergo a cesarean section.  However, this increase in medical interventions – including episiotomies, fetal monitoring, caesarean sections, epidurals – has not corresponded to better maternal and child health outcomes.  In 2007, the maternal mortality rate in the US was higher than it had been in decades.  Experts agree that the high percentage of cesarean sections is a major contributing factor,  in addition to the disparity in access to quality healthcare for women of low socio-economic status

 However, birthsattended by Certified Nurse Midwives (CNM) have demonstrated 5% lower caesarian section rates and 12% fewer medical interventions. CNM – run birth centers offer an excellent alternative to hospital delivery for low risk pregnancies.   Patient safety remains a priority and in the case of complications, patients will be transferred to a collaborating local hospital for advanced care. Care at birth centers is also more cost-effective – an important factor in bridging the gap of high-quality healthcare especially for low-income women.

 Unfortunately, the future of birth centers nation-wide may be at risk.  Centers for Medicare & Medicaid Services (CMS)has increasingly been denying claims for reimbursement for birth centers in several states.  Many affected birth centers attend a high percentage of low-income women in rural and urban areas.  Lack of support from CMS has a profound impact on birth centers and could force many to close completely.  The Medicaid Birth Center Reimbursement bill, if passed, will guarantee that birth centers in all states will be reimbursed fairly.  Contact you representative today to voice your support of the Medicaid Birth Center Reimbursement. The time to address the maternal health crisis is now.

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5 Responses to “Birth Centers at Risk”

  1. carriesummerterm Says:

    This is very interesting. My post was also related to advocating for expanded CMS reimbursements. I will contact my senator voicing my support of this bill.

  2. adellinentatin Says:

    Nice advocacy post for birth centers although I was a little bit disturbed with the comparism figures advanced with regards to hospital births. It should be noted that the neonatal mortality rate in a given country is a function of obstetric care and neonatology care, not midwifery care. This is because birthing centers care for low risk cases in which very few complications will occur and often refer high risk cases with higher probabilities for interventions to obstetricians.
    Obviously, there are several benefits to birth centers and women should be educated on these and offered the choice of where to have their babies. More so, although birth centers are independent facilities, a growing number of them are now affiliated with and often housed inside hospitals which lessen some of the risks associated to them.

  3. asamarth Says:

    I would like to comment on the increasing number of Cesarean sections, these are driven in a big way by maternal choice. More women want to deliver by CS and hence they are at increased risk of complications. This behavior can be changed by proper education and information during antenatal visits!

  4. apandit Says:

    This is a great view about current birthing practices in USA.But I would like to comment that the maternal mortality has risen and one of the leading reasons is that women who could not be pregnant in the past can get pregnant.i.e. Females with medical diseases which prevented them from getting pregnant or caused recurrent misscariages and females advance matrenal age are able to get pregnant and that has a great impact on the maternal mortality rate.
    As I am trained in a tertiary hospital I would like to all pregnant patients should globally receive such high standrads of care as a tertary hospital can but you are right in rural places where health resources are inaccesable or spare birthing centres could play a vital role.
    At the same time I strongly believe that each birthing centre should always have a inhouse OBGYN as the most uncomplicatd appearing pregancy can suddenly lead to medical emergency and hence I dont share the view of a completely mid-wife run birth centres as they have limited training in managing Obstretics emergency.

  5. hbbos Says:

    I would like to preface my comment with the fact that I am a Maternal-Fetal medicine specialist, trained to manage complicated pregnancies, who runs a clinic once a week through a midwivery office.
    I think that funding for midwifery care is important, however I am concerned when the number game with infant and maternal morbidity and mortality it their augment. Midwives are trained to care for low risk mother. Obstetricians are trained to care for complications of pregnancy. Our training is different, but that does not make one better than the other. There are some complications that only a physician can treat, but there are some women with complete social needs that will be so much better treated under the care of a midwives more holostic approach.
    The funding war should never become about who is better. Both are great. The issue is making sure that the appropriate care provider is available for each and every pregnant women – and cost should not be the determining factor.

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