The U.S. needs to invest in birth centers

The New York Times published “Why New York Lags So Far Behind on Natural Childbirth” on Nov. 30. It describes how, despite demand, the Mount Sinai Hospital’s Birthing Center will soon close, leaving women few options for low-intervention birthing care. A group of mothers, midwives and doulas have organized to petition the hospital to keep the birth center open.

Although the number of birth centers in the U.S. has increased by 82 percent since 2010, New York only has three. Pennsylvania has five. The Midwife Center in Pittsburgh has served as our region’s only freestanding birth center since 1982 and is now the largest in the U.S. It was opened and has thrived because of consumer-led efforts, similar to the one that is under way in New York.

The desire to avoid unnecessary medical interventions, as well as an increasing body of research demonstrating birth centers’ excellent outcomes, has fueled demand for birth centers. The new Center for Medicare & Medicaid Services Strong Start Evaluation report shows better outcomes for women with Medicaid insurance who received their care at birth centers compared to women with similar risk profiles, including a 26 percent lower pre-term birth rate. Unfortunately, many birth centers struggle financially because of low insurance reimbursements that also don’t pay for the time intensive care that leads to better outcomes.

As U.S. infant and maternal health outcomes remain the worst in the developed world, we need to change our health care and payment systems to ensure evidence-based care that improves outcomes, such as birth centers, is sustainable and accessible.

CHRISTINE HAAS Strip District

The writer is the executive director of the The Midwife Center for Birth & Women’s Health in Pittsburgh.