this post was submitted on 10 Sep 2023
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Dr. Heather Skanes’ team at the Oasis Family Birthing Center in Birmingham, Alabama, started turning away patients this spring as state officials cracked down on alternative childbirth options.

The center had offered patients with low-risk pregnancies a place to deliver their babies outside of a hospital, where cesarean sections weren’t performed, epidurals weren’t administered and midwives took the lead. Some women labored in an inflatable aqua birthing pool, in what Skanes saw as a more supportive environment in which Black women in particular would feel more comfortable and heard.

But in March, officials with the Alabama Department of Public Health told Skanes that they considered the previously unregulated facility to be a hospital that didn’t have proper permission to be open, according to her attorneys.

The American Civil Liberties Union is suing the state Public Health Department on behalf of Skanes over what it has called a “de facto ban” on freestanding birth centers. The court battle is unfolding as the agency is weeks away from implementing licensing regulations for the facilities.

Alabama has an alarming record on keeping expectant and new mothers alive, with a higher share of residents dying in pregnancy and during or shortly after childbirth than almost any other state. More than a third of counties in Alabama lack hospitals with labor and delivery units or practicing obstetric providers, according to a report last year from the March of Dimes.

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[–] medgremlin@lemmy.sdf.org 4 points 1 year ago* (last edited 1 year ago) (1 children)

These birthing centers are just a small step above home births in the grander scheme of things. The regulations being imposed are absolutely necessary for the centers to actually be better options. Even if the pregnancy has had no complications and is very low risk, things like uterine hemorrhage, neonatal hypoxia, or other unpredictable complications can occur. When those things happen, being an hour away from proper emergency care is very likely to be lethal. The 30 minutes away from the hospital by ambulance rule isn't even taking into account the time it takes to recognize the problem and the time for the ambulance to arrive in the first place.

If these centers are going to exist and claim to be a safe option, they need to have adequately trained staff, appropriate facilities, and viable access to emergency care in case of unpredictable complications.

[–] over_clox@lemmy.world 2 points 1 year ago (1 children)

So, if a facility that's 20 minutes away doesn't quite meet all the regulations, let's close it down and make people have to drive over an hour to a facility that does meet all the regulations?

I guess that leaves three options then, deliver at home, just hold it in, or break out the chainsaw...

https://allthatsinteresting.com/why-were-chainsaws-invented

[–] medgremlin@lemmy.sdf.org 1 points 1 year ago (1 children)

Actual medical training and appropriate facilities are not high bars to clear if they want to actually do things right. The education requirements for being a midwife as opposed to a nurse midwife are appallingly lax. It's like saying that a class taught by a high school graduate is equivalent to one taught by someone with an education degree. The person interviewed in the article is an OB/Gyn, but it doesn't sound like her staff has any qualifications. Hell, EMTs get more education on how to actually deliver a baby and care for the mother than some midwives.

[–] over_clox@lemmy.world 1 points 1 year ago

Agreed. Yet still, once upon a time the solution was 'hey, let's invent a hand crank chainsaw'...

Just because a facility might not technically meet every single regulation doesn't mean that a woman can just hold her hoo-hoo shut for an hour or more to get to a proper facility.