Vt. Legislature should support licensing of freestanding birth centers | Columnists

I’ve been a certified midwife for seven years and have lived in Vermont the entire time. As a midwife, I have looked after hundreds of families. I have captured babies in both small community hospitals and large tertiary care centers. But when it came time to have my own three babies, I chose to give birth outside of a hospital. From my professional experience, I knew that hospitals – important and safe places of birth for many – are not necessary for people with medically uncomplicated and low-risk pregnancies.

A birth outside of a hospital does not always mean a birth at home. Many people choose a third option: a freestanding birthing center. Free-standing birthing centers are facilities similar to residences, which are usually looked after by midwives. They are different from the birth centers in hospitals. They take care of medically uncomplicated or “low-risk” women. And Vermont is one of only eight states in the country that doesn’t have a single freestanding birthing center in the entire state.

It has been my experience time and time again that pregnancy and childbirth go best when people are given information, options and empowered to choose what is best for them. In Vermont, we don’t give families every possible option. Currently, any Vermonter wishing to use a freestanding birthing facility must travel to New Hampshire or Massachusetts. We are doing Vermonters a disservice by forcing those who can afford to travel abroad to give birth, and by not giving those who cannot afford the money or time to travel to give birth to their babies offer options. It is a fundamental reproductive right that all people, regardless of their circumstances, should be able to choose where and how to give birth.

There is solid evidence from years of research that freestanding birthing centers are safe, cost effective and increase patient satisfaction. The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the Society for Maternal-Fetal Medicine endorse this treatment model as a safe and evidence-based option for low-risk mothers. Freestanding maternity centers work with nearby hospitals and generate revenue for community hospitals through referrals for lab work, ultrasound scans, specialty consultations, and when the pregnancy becomes high-risk, referrals for hospital care.

It’s true that the birth rate in the US is falling, including in Vermont. People choose to have fewer children or no children at all. Our healthcare system is being weighed down by rising costs, an ongoing pandemic, and stagnant health insurance reimbursement rates. Some people worry that adding freestanding birthing centers to the Vermont landscape could take away important revenue for small community hospitals. I would actually say the opposite. Freestanding maternity centers will not only serve a local need, but will also attract patients from a large geographic area and bring more patients actively seeking this type of care to the service areas of small community hospitals.

Regardless of cost analysis or financial arguments, saving a failing healthcare system should not be the responsibility of the mother and her family. Birth is a vulnerable, intimate, deep moment. People deserve to give birth to their babies where they feel the safest and most supported. And it’s our job as healthcare providers, legislators, and community leaders to give Vermont residents every opportunity to choose where and how to start their own families. A bill to support the licensing of free-standing birth centers is currently pending in the Vermont legislature. I hope you join me in asking your legislators to support them (H80).

Jesse Ridgway, MSN, CNM, is a board certified midwife and lives in Putney. She is a member of the Vermont Birth Center Coalition. Columnists’ opinions do not necessarily reflect the views of Vermont News & Media.

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