The Power of Choice: The Law of Birth Centers

Baby chicks at zoo Having Choices


Being a child means not having to worry about paying bills, buying groceries, having clean clothes to wear, and all the other things we parents have to think about on a daily basis. But it also means not having control over what you eat for meals, what style and color clothing you have to wear, etc. And for some head-strong, opinionated, independent and/or spirited children that can be difficult. This description happens to fit my Darling Boys. A typical conversation about lunch between me and Darling 1 usually sounds something like this:


Me: Do you want turkey or PB&J for lunch?

Darling 1: Tuna.

Me: An apple or an orange?

Darling 1: Raspberries, please.

Me: Pretzels or goldfish?

Darling 1: Baked Lays.

Me: Alrighty then.

(I have the same conversation with Darling 2, but you wouldn't understand his side of the conversation very well yet.)


Of course, the choices and answers change from day to day and sometimes several times in one day. There are a few absolutes. Darling 1 never wants cheese on his sandwich, unless it's a grilled cheese; his drink of choice is always apple juice; and he will always eat anything with chocolate in it. Darling 2 loves cream cheese on anything; will always eat raspberries; and doesn't care for apples. I am always happy to accommodate their tastes if I have those items on hand. It's really all about having a choice. We all like to have choices in life about important and even not-so-important things. Imagine if a friend or spouse told you what you were having for your meal every time you went to a restaurant. That would be annoying and constrictive, wouldn't it? The power to choose and make decisions about how our life will play out is empowering.


Birth Centers


Having a choice has not always been an option in many areas of life. In fact, until fairly recently, a woman did not have a choice as to who would deliver her child, in what manner, with what kinds of drugs and where. Now women can choose whether to see a doctor or midwife, what kinds of drugs and to an extent when, if any at all, and even the location of the birth. One of the choices of where to give birth is a birth center. It isn't at home, and it isn't a hospital; it's a happy middle-ground.


A birth center is an affordable option for pregnancies that are considered low risk and for women who are seeking to have a birth with little interventions. Birth centers are caring, warm and homelike setting where the women are supported and respected as well as safe and secure. They are typically staffed by midwives rather than doctors. The woman giving birth is able to decide how she would like the birth to go, much like a home birth without the constraints of fetal monitoring, IVs, and other procedures considered invasive by some. Birth centers do have systems set up to deal with problems that may arise and/or emergencies. They do have relationships with nearby hospitals and doctors in such cases.


The Law


The new Health Care Reform Bill guarantees facility fee payments to birth centers all over the US. Specifically, there is a mandate of Medicaid payment for the birth center facility fee in the states and jurisdictions where birth centers are licensed. The American Association of Birth Centers (AABC) is now setting meetings with the Federal Medicaid director and the Medicaid directors of the individual states to discuss implementation of the law. Full implementation depends on how birth centers are licensed in each state. For instance, Minnesota recently passed a law that licenses free standing birth centers that are staffed with midwives. The new law sets out medical standards for the centers and requires Medicaid to pay for deliveries at these facilities, which will end up saving the government quite a bit.


There are now 38 states, or 76%, with legislation licensing birth centers. The details vary with each state. Yet only 24 birth centers in 22 states are accredited with the Commission for the Accreditation of Birth Centers. It's important to find and read any law or regulation controlling birth centers in your state before you make the decision to use such a facility.




Another consideration is whether your insurance covers a delivery at a birth center. It is much cheaper than delivery at a hospital, and some insurance companies are opting to include birth centers in its plans. However, many companies are not yet covering a delivery at a birth center because it is considered riskier since there usually are typically no doctors on staff and are not equipped to handle a medical emergency. Most of the legislation on this topic is very new, and insurance constraints are likely to change in the coming years. Especially when the cost of delivering a baby in a birth center is much more economical, even for an insurance company.


The Scoop


While a birth center was not something I was interested in when I gave birth to my Darling Boys, it is fast becoming a popular option among many who might otherwise choose a home birth or a midwife. Have any of you had any experiences with birth centers? Would you want to deliver a baby at a birth center? Please leave a comment here, on Facebook or Twitter. On Wednesday, I will post tips for choosing a birth center and helpful websites with pertinent information. Over and out….




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