Freestanding Birth Centers Offer Options During COVID-19 Pandemic

The COVID-19 pandemic has turned our everyday worlds upside down. This is especially true for pregnant people who now are re-examining the risks and benefits of giving birth in the hospital setting and may be seeking alternatives. Freestanding birth centers have been associated with excellent outcomes in multiple studies and offer childbearing families another option for their pregnancy and birth care. With hospitals at risk of reaching capacity due to COVID-19 admissions, freestanding birth centers can help to provide care for lower risk pregnancy and birth.

Freestanding birth centers are founded on the midwifery and wellness model, guided by principles of prevention, sensitivity, safety, appropriate medical intervention, and cost-effectiveness. Birth centers are not hospitals, but are an integrated part of the health care system. Birth centers are appropriate for women anticipating a normal pregnancy and birth. Care begins in the prenatal period and extends to the six-week postpartum visit. Birth centers offer many tools for managing the pain of labor and birth – including birth tubs, slings, freedom of movement and, in some birth centers, nitrous oxide.

American Association of Birth Centers' member birth centers across the country are seeing an increase in inquires due to the COVID-19 pandemic. Many are accepting late transfers, including in the third trimester, as long as the client has a low-risk pregnancy, regular prenatal care, and complete records.

Birth centers have taken precautions to reduce exposure to the virus including extra cleaning, telehealth prenatal visits, and limiting support people at the birth to two, to name a few.

AABC President Amy Johnson-Grass, ND, LN, LM, CPM said, “Freestanding birth centers across the country are experiencing an increase in people wanting to transfer to birth centers to avoid the hospital during COVID-19. We are seeing hospitals and freestanding birth centers working collaboratively to put plans in place in the event hospitals are overwhelmed. Along with so many other changes happening in our lives today, I see this as a positive paradigm shift for freestanding birth centers and maternity care in this country. Research supports the freestanding birth center model and its appropriateness for low-risk women.”

For families considering a birth center for their maternity care, here are four questions to ask:

1.  Are the birth center and its providers licensed?
2.  Is the birth center accredited by the Commission for the Accreditation of Birth Centers (CABC)?
3. What are the arrangements if you need to be transferred to the hospital? How often does this happen?
4. What do the charges for care cover, and will your insurance plan pay for these services? 

Families can learn more about the freestanding birth center model of care and find an AABC member birth center near them at birthcenters.org.
 
AABC strongly encourages steps be taken by state and federal legislators to improve access to birth centers in the U.S. by mandating reimbursement for birth center care in all states by commercial and public payers, and to pass the BABIES Act, HR 5189, which would set up demonstration model birth centers in underserved communities to provide care to those whose local hospitals have closed to maternity care. Additionally, midwives with national certification should be reimbursed by Medicaid in all states.