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News & Press: Legislative Alerts

AABC Tells the FTC about Barriers to Birth Center Care

Monday, May 12, 2014   (0 Comments)
Posted by: Kelly Shaw

In response to the Federal Trade commission’s (FTC) February 2014, Federal Register Notice entitled “Examining Health Care Competition,” the American Association of Birth Centers (AABC) published comments detailing concerns birth centers are currently experiencing regarding anti-competitive practices.  These practices cause significant barriers for women and families desiring birth center care, which is associated with equal or superior outcomes to hospital based care.

The AABC comments draw on member experiences in areas such as restrictive state statutes, overly complex certificates of need, the restrictive requirement of a medical director and hospital transfer agreements that are often hostile and anti-competitive.  Evidence from the survey found that midwives and clients are harassed and treated with hostility at many hospitals, whose staffs often refuse to accept the transferred clients’ medical records.  Many birth centers report that local hospital administrators and staff members have repeatedly filed baseless complaints against the midwife and/or birth center with the professional board or licensing agency. Local hospitals have also denied clinical privileges to midwives who work in or own birth centers.  Similarly, birth centers often find it difficult, if not impossible, to find an obstetrician or OB group practice willing serve as a consultant or accept client referrals.  One member reported contacting sixteen different OB practices in her community without finding a single one willing to consult with or accept referrals from her birth center. 

The AABC collected and analyzed statistically significant data from member birth centers on how state regulations impede the development and growth of birth centers today. In this same survey, AABC asked members to indicate whether they have been denied or excluded from beneficial business and professional relationships with physicians, hospitals, managed care organizations, other health plans or other opportunities or benefits.

The letter, including detailed comments from birth centers and sources, is available here. The AABC advocates that the types of restrictions imposed on birth centers and midwives are similar in nature and effect to those imposed on advanced practice nurses and is looking for the FTC’s assistance through the Competition Advocacy program.



About the American Association of Birth Centers
The American Association of Birth Centers (AABC) is a multi‐disciplinary membership organization comprised of birth centers, and individuals and organizations that support the birth center concept including certified nurse midwives (CNMs), certified professional midwives (CPMs), physicians, nurses, women and their families. Founded in 1983, AABC is dedicated to developing quality holistic services for childbearing families that promote self‐reliance and confidence in birth and parenting. AABC publishes materials on birth centers, sets national standards for birth center operation, and promotes state regulations for licensure and national accreditation by the Commission for the Accreditation of Birth Centers. More information about AABC can be found at:

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