Dr. Heather Skanes’ team at the Oasis Family Birthing Center in Birmingham, Alabama, started turning away patients this spring as state officials cracked down on alternative childbirth options.
The center had offered patients with low-risk pregnancies a place to deliver their babies outside of a hospital, where cesarean sections weren’t performed, epidurals weren’t administered and midwives took the lead. Some women labored in an inflatable aqua birthing pool, in what Skanes saw as a more supportive environment in which Black women in particular would feel more comfortable and heard.
But in March, officials with the Alabama Department of Public Health told Skanes that they considered the previously unregulated facility to be a hospital that didn’t have proper permission to be open, according to her attorneys.
The American Civil Liberties Union is suing the state Public Health Department on behalf of Skanes over what it has called a “de facto ban” on freestanding birth centers. The court battle is unfolding as the agency is weeks away from implementing licensing regulations for the facilities.
Alabama has an alarming record on keeping expectant and new mothers alive, with a higher share of residents dying in pregnancy and during or shortly after childbirth than almost any other state. More than a third of counties in Alabama lack hospitals with labor and delivery units or practicing obstetric providers, according to a report last year from the March of Dimes.
There is a lot more to this article that you left out that provides very important context. The state health department is imposing really quite reasonable regulations on the birthing centers for the health and safety of the mothers. Some of the requirements include formal nursing education for midwives (who can otherwise calls themselves midwives after taking barely-regulated online courses), proximity to a hospital that has obstetrics and pediatrics in case of emergency (must be within 30 minutes by ambulance), and building requirements that allow for things like ADA compliance and appropriate medical facilities at the birthing center.
The article does also address the significant systemic problems that mothers, particularly black mothers, face in many hospital settings, as well as the black maternal fatality rates. While these issues are important to discuss and address, inadequately staffed and equipped birthing centers 45 minutes away from the nearest hospital by ambulance are not the answer here. In my professional medical experience working in such a hospital, I’ve seen transfers from birthing centers like the ones discussed in the article that were unable to address maternal uterine hemorrhage and neonatal hypoxia. Luckily, they were close enough to proper hospitals that could care for the mother and newborn, but if they were 45 minutes away by ambulance, the mother and newborn very likely would have died.
The problem is lack of rural hospitals. Without the birthing centers, some people will drive the extra distance, some will opt for home birth.
This policy won’t help Alabama’s maternal mortality rate, especially among it’s poorest.