In Tallahassee, lawmakers are considering a bill that would increase the number of options for pregnant women who are seeking out-of-hospital deliveries.
Sen. Gayle Harrell (R-Stuart) is sponsor of Senate Bill 448, which was passed unanimously by the Senate Health Policy Subcommittee that she chairs.
“A lot of women would really like the opportunity of not delivering in a hospital setting – which can be Petri dishes for all kinds of infections,” said Harrell. “They want a more natural home-like setting to do it.”
The concept isn’t new. Birthing centers date back to the 1970s and 80s, at the start of the “natural childbirth” trend. Many of them, by law, are currently prohibited from using some forms of pain management.
“The original concept of a birthing center was for those who wanted a difference experience,” said Harrell. “It was a natural childbirth; not in a hospital setting. No epidurals or any type of anesthesia would be administered. And most typically, they were delivered by either lay midwives or/and certified nursing midwives.”
Senate Bill 448 would authorize “advanced birth centers” – allowing Caesarean deliveries and epidurals in certain cases. It also calls for keeping women there for up to three days, instead of the standard-practice 24 hours.
“This gives women certainly the next option; a whole new level of experience,” Harrell said. “It requires — consistent with the guidelines of the American College of Obstetrics and Gynecology — that [the centers] be available for low-risk deliveries.”
This week’s unanimous committee approval included bipartisan concern from its members.
“We’re almost creating little ‘mini-hospitals’ with the birthing center,” said Sen. Aaron Bean (R- Fernandina Beach). "And we put requirements on our hospitals to take care of people who can’t payitf off, that don’t even have Medicaid.”
Bean also chairs the Senate Health and Human Services Subcommittee.
“What requirements are there for those that aren’t on Medicaid and can’t pay; is there any charity requirement?” Bean asked Chairwoman Gayle Harrell.
“I don’t know what we require of surgery centers, but this falls under the same kind of category as a surgery center,” Harrell responded. “But this is certainly an option that people would havea choice for.”
Harrell told Bean — and the other committee members — that the centers “couldn’t afford not to take Medicaid.” Sen. Janet Cruz, a Democrat from Tampa, asked whether Medicaid managed-care plans could require pregnant women against their will to be treated at advanced birth centers.
“If a woman is low-risk, she would decide between her and her physician, and I completely agree with that,” Cruz said. “But if she’s low-risk and she’s afraid and she wants to go to the hospital, where is it written that we’re protecting her wants to go to the hospital?”
“There’s nothing specifically that says that has to happen,” said Harrell. “But I can’t imagine that it wouldn’t.”
Next up for SB 448 – a hearing by the Senate Children, Families and Elder Affairs Committee. A House version, HB 383, has been filed by Rep. Colleen Burton, (R-Lakeland).