Alabama Birth Center Regulations

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Alabama Department of Public Health Draft Birth Center Regulations

In August, the Alabama Department of Public Health (ADPH) approved regulations that will severely restrict the ability of birth centers to open and operate in the state. 

These regulations were written without the input of nationally recognized experts like AABC, and without the input of the most important experts-- local stakeholders such as Alabama birth center owners, the local consumer advocacy group, or the Alabama State Board of Midwifery.

37% of Alabama's counties are Maternity Care Deserts and Alabama has the third highest rate of pregnancy related/associated deaths nationally. These regulations are restrictive in many ways but we are especially concerned about the following areas:

  • Certified Professional Midwives are not allowed to practice to their full scope despite the fact that Alabama licenses CPMs and the AL Attorney General explicitly confirmed that CPMs may practice in birth centers. 
  • The RN staffing model is unnecessary and financially unsustainable.
  • A staff or consultant physician is required to be on call and able to arrive at the birth center within 30 minutes at all times (this is not the standard of care, if advanced intervention is needed, the client should be transferred to the hospital). 
  • Written transfer agreements are required, however there is no requirement for hospitals to enter into such agreements. 
  • Eligibility criteria exclude clients over 40, people who've had cesareans, and remarkably, people with a history of miscarriage or abortion. 

Get Involved

Now that the regulations have been approved by ADPH they move to the Alabama Legislative Council for final approval. This body can choose to hold a hearing on the regulations. If they do nothing, the regulations go into effect October 15th, 2023. 

If you live in Alabama, please follow the steps below to contact your legislators. Tell them to hold a public hearing and to implement AABC's model regulations. 

  1. Use this tool to find your legislators. Look for your State Senator and your State House Representative
  2. See if one or both of your elected officials are on this list.
  3. If they are, contact them to demand a public hearing. Recommend that the council implement AABC's model birth center regulations. Call script and email template below.
Letter Template

Dear Senator/Representative ____________,

I'm writing to express my concern about the proposed birth center regulations. I'm a ________________(midwife, physician, nurse, parent, doula, advocate, etc) and I support birth centers in Alabama. [Tell a little bit of your story]. Birth centers are a proven solution to the perinatal mortality crisis. Childbearing families need safe, accessible care in Alabama. ADPH's Maternal Mortality Review, found that AL has the third highest Maternal Mortality Rate in the nation. Birth centers offer high quality, evidence-based care which improves outcomes for parents and babies.

I'm asking you to hold a public hearing on these regulations. We have a clear, evidence-based alternative to these rules. The American Association of Birth Centers publishes model regulations that are in line with the nationally recognized Standards for Birth Centers. They offer states a straightforward, functional pathway to licensure.

Birth center access is an important part of the solution to the crisis facing our families. We need immediate regulatory overhaul so Alabama physicians and midwives can expand access to care by opening birth centers in our state. 

Sincerely,

Call Script

Phone tip: They'll listen to you longer if you stay focused, clear, and polite. Take a deep breath--you've got this.

  • Hello, I'm calling about the proposed birth center regulations. Can I speak with Senator/Representative ____________?
  • Hi, my name is_________. I'm a __________ (parent, midwife, physician, advocate, RN, etc.) 
  • Tell your story briefly.
  • The proposed birth center regulations will make it nearly impossible for birth centers to open and operate in Alabama. AL has the third highest rate of maternal mortality in the nation. Research demonstrates that birth centers have excellent outcomes. In a state where 37% of counties are maternity care deserts--we need more skilled providers serving our communities. 
  • I'm asking you to hold a public hearing on the proposed rules. These regulations are opposed by local and national birth center experts. We have a clear, evidence-based alternative. The American Association of Birth Centers publishes model regulations that are in line with the nationally recognized Standards for Birth Centers.
  • Will you commit to calling for a hearing? 
  • Thank you for your time, have a nice day. 
Sign the Petition

Sign the petition, organized by Birth Sanctuary Gainesville, one of the three Black led birth centers that ADPH is preventing from providing birth center care in their community. 

Sign now>>