New law helps clear the way for birthing centers in Iowa
DES MOINES, Iowa — At Des Moines Midwives Collective, they do prenatal and checkup appointments for expecting mothers, but they're not allowed to use this facility for the actual birthing process. They have to either go to the family's home or the hospital. But they say some mothers want an in-between, a home-like environment with a birthing tub and cozy feel, while still having the medical backup and professional facility. Right now, there are none of those in Iowa.
However, a new law that will go into effect July 1 will help clear the way for birthing centers to be opened in Iowa.
Midwife, nurse practitioner and owner of Des Moines Midwives Collective Caitlin Hainley has been fighting for over a decade to make that happen. She sued the state for permission to open a new birthing center, but lost in court.
During that fight, she also was working on the legislative aspect of it, and was victorious there. Last month Governor Reynolds signed a bill that removed birth centers from the definition of health facilities covered by Certificate of Need law. This means standalone birthing centers will now be allowed.
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Certificate of Need was meant to keep costs down but restrict duplicate services. Some other midwives around the state have tried to apply for an exception but got denied and lost that money.
'Birth centers are actually the safest places to have your babies and provide the best outcomes for both babies and moms and also just really help cost savings,' Hainley said. 'So we've known this for a long time, but Iowa has not been friendly to birth centers. We've had something called a certificate-of-need that birth centers have been listed on. To even ask if you can open a birth center, you have to file an application and pay up to $20,000, which you don't get back. It's a way to keep competition away. Instead of actually keeping health care costs down like it was touted to do in the 1970s, so many studies have been done on Certificate of Need law since then. They found that controlling competition in that way actually increases prices and decreases innovation.'
Iowa and Des Moines do not have as many options for mothers as other cities across the country.
'We have an urban maternity desert here in Des Moines. This is the capital city of Iowa, and there are still so many services that pregnant moms can't access. You can't have a water birth in the entire state of Iowa in any single hospital. So if you want a birth, your baby in water, as is done in hospitals across the U.S., you cannot have that here,' Hainley said. 'Women can't get reasonable, high quality midwifery led care in Des Moines for a variety of options and desires.'
Des Moines Midwives Collective hopes to build a birthing center one day to give a place where mothers can get the medical professionalism and homey comfort care while giving birth.
'What birthing centers generally look like, is really the most common model is a house like a single-family home that has been converted to be used as a birthing center. Your birthing room has a bed with like real linens on it, and that's fitted with a specific birthing tub. But really just a homey, comforting environment where the trust is really in the birthing process,' she added.
This new law is just step one of the process of building a birthing center. July 1 it'll be possible to build, but it would have to be a mainly out of pocket clinic. The next step for them is to work on insurance reform, to make this option affordable and possible for all moms and families.
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