Have you heard the term birth center?
Are you birth center curious?
Are you wondering, “Is a birth center right for me?”
Check out MY birth center story in this blog post, where I share the story of my first birth.
In this blog post, I share an interview with Bridget Strub from Wildflower Birth Support. She is working on a community project to open a birth center in the Rochester, NY area. This is a grassroots community movement to build a birth center called the Radiant Birth Center.
Interview With Bridget Strub from Radiant Birth Center
Can you tell me a little bit about why birth centers are beneficial to families?
In the last 10 years, throughout the nation birth centers have grown by 80%. So there are definitely people who are aware of the benefits and consumers who are demanding this type of care. There have been studies that have been done. One was called the strong START study. Another was called the birth center study. And they’ve shown that, overall, birth centers cost less healthcare dollars, they produce better clinical outcomes for mothers and their babies, and they have higher levels of client satisfaction.
And they also reduce racial disparities and outcomes, and are more accessible or equitable for people on all ends of the spectrum as far as their income goes. For the last 20 years, the cesarean rate of low-risk people in the hospital has gone up, it’s now to the point where it’s 25 point something percent.
So, if you are a low-risk person, the lowest risk demographic of person, people that go into the hospital to give birth have a 25% chance that they’ll end up with a cesarean. But that same demographic in the birth center setting has had a 6% chance of a cesarean in the last 20 years. So it’s not that people are less healthy. It’s literally the type of care is just different, and produces different outcomes.
How is a birth center birth different than a hospital birth?
The biggest thing to note is that hospitals were never designed with the physiology of birth in mind. And they don’t operate that way, either. They are about efficiency, and they are about protocols and keeping things systematic. And that’s not how birth works.
I don’t ever want to sound like I don’t like hospitals, we definitely need them. And they are an appropriate place for certain situations. For people who are high risk or for people who want pain medication, like an epidural, we do need hospitals for that purpose. But birth centers fill that need for the low-risk population who want to have a low intervention birth, who want to experience a physiologic birth, where they are able to use water for their labor.
Water Birth in a Birth Center
That’s the other thing is hospitals in our area don’t allow water births. You can labor in the tub, but you can’t give birth in the tub. And that catches a lot of people off guard. They don’t realize that, in hospitals, they don’t really promote privacy, and that need for mammals to feel like secluded and alone and safe. That is not fostered well in the hospital because of the amount of times people come in and out of the room, the noises, the smells, etc.
Sometimes people have very visceral responses to hospitals, and their bodies respond to that, really, before they even realize what’s happening in their brain. That can often slow down the labor process.
So birth centers are meant to be a kind of a place between hospitals and home. It’s a very home like setting, it’s a smaller setting, it’s outside of the hospital. But it still has a lot of the things needed. If there were to have some minor things come up in labor, they have oxygen, there’s Pitocin there it there is excessive bleeding happening after birth. But it’s kind of like the slow food movement. It’s like bringing things a little bit back and into this space where you are the center, truly, and your autonomy and your preferences are prioritized.
Can you tell me a little bit about what the challenges are? Why aren’t there more birth centers in New York State?
New York has the third highest number of births in the United States. Our state has 400,000 births a year. And the other two that are higher than us are California and Texas. So birth centers are a very important option for that number of people giving birth. 83% of people are considered to be low risk. So, if you think of 83% of that 400,000, we need way more birth centers than we have.
New York State only has two licensed and accredited birth centers, which is ridiculous and that is because we have some very restrictive regulations. Firstly, birth centers are required to have to file something called a certificate of need. And basically, that proves to a board of hospital administrators and doctors that there is a need for this service in our community.
“83% of people in our community are considered low-risk and would have access to birth center care.”
That board historically does not understand midwifery. And they don’t understand the need and how this is different. So, they have the authority.
I should back up and say that, up until just this last year, there wasn’t even a process for people to apply for a certificate of need for a midwifery birth center. So, it’s just been a slow grinding process just to get to that point. But that process as a whole is estimated to cost 75 to $100,000, just to apply for that certificate of need. And then then we can start construction, which will cost you know, another hundreds of 1000s of dollars. And there’s a lot of other layers to it too, as far as reimbursements for midwives, through insurance, all of that. All of that plays into why there are so few birth centers.
You are working on a project to bring a birth center to the Rochester area. What is your drive in this project? What got you interested in starting this project?
When I was pregnant, I wanted that option. I don’t feel comfortable in hospitals as an individual. But I knew my husband wasn’t super thrilled about home birth. And I was just like, where’s this other middle ground option?
And then as a doula, just seeing over and over and over again, times where clients who are low risk having a normal labor, just get side-railed through little things that happen in the hospital. For example, it’s little things that people say that really aren’t trauma informed or patient centered or practices that happen that just can really mess with somebody’s frame of mind when they’re in labor.
I think I just got so frustrated to the point where I was like, I either have to walk away from doula work, because I will go crazy or I need to just change the system. I think I got to a point where I was just like, I want to stop talking about it and I have to try to change the system because it needs to be changed.
What makes birth center care different from home birth?
There’s the obvious fact that people do have to leave their homes to go have a baby at the birth center. I think it’s a more sustainable model for midwifery. The midwives aren’t driving around to every location. I know that doesn’t necessarily impact families. But it does, because when midwives get burned out, their services are not offered in their community anymore. And then families are not offered those home birth services.
One of the reasons we have decided to pursue being a licensed facility or licensed birth center is that homebirth, at least in our area, requires people to pay out of pocket upfront for their care. And then sometimes they have to fight for months with their insurance companies to reimburse them. And, you know, there are lots of people who don’t even have the ability to pay upfront for that care.
Birth Center Sustainability
As a licensed birth center, we would have the ability to bill just like a hospital would for our care, which means we could have the professional fee for the midwifery services. But we also would get reimbursed for the facility that we run, because I know like in Buffalo, one of the centers out there does operate as a birth center, but she’s not able to get reimbursement for the building that she operates out of which is hugely problematic. She has mortgage payments, or rent payments and utilities and all that stuff. She’s not getting reimbursed for that. That’s a sustainability issue.
So, that’s another piece of it. One of the reasons we’re doing licensure is so that we can be accessible to a broader community, a broader demographic of our community, and offer equitable care for everybody who wants it. As an organization, we’re trying to find ways to help, you know, even if somebody doesn’t have insurance to find a way to pay for their care, so that they can also that receive that level of care.
Can you tell me a little bit about where your project is right now, what the future scope of your project looks like? What are your goals in the project? When will it be completed?
The vision for Radiant Wellness and Birth Center really is to be a community hub of support, and really infuse the idea of the village back into birth support. So, we hope to provide midwifery care across the reproductive lifespan. From the first time someone gets any sort of GYN care, all the way through menopause, and especially within the childbearing years as well.
We hope to have ancillary services like chiropractic care and acupuncture and massage therapy, just basically a whole one stop shop for that type of care. So you’re not sending people every which way, especially like lactation support after baby’s born, all that stuff. That’s the vision.
Birth Center Fundraising
And there’s a lot of other things that we’ve dreamed up as well. But the practicality of right now is we are looking at a facility but very tentatively because we’re still in that fundraising stage. With certificate of need, it creates this weird space where you need to have a location identified. But you have no real timeline that you’re going to be operating out of because you have to pay for rent while you’re going through the certificate of need process before you can start construction.
So, we’re still navigating that and the fundraising piece of it is probably the biggest part of it. That’s where we are solidly at. So we’ve raised $30,000, from the community so far. And we’re just continuing to try to find ways to raise those funds.
Can you tell me a little bit about what the journey would look like for someone to have care at the Radiant Birth Center? What might that look like?
In their teenage years, when they start to need gynecological care, they would go to the midwife for that. They would learn a different type of way of interacting with their body, they would discover empowering care from the get go. That would eventually morph into, as they get older, if they need contraceptive care, they would receive that. People can receive regular wellness care as well.
And then when they get pregnant, then they just continue on that type of care with the midwife. They would see a midwife just like they would with an OB or a hospital based midwife for prenatal care. It would all be done at the center, which is nice. They will see the birth center where they will be giving birth.
Birth Center Care Provides a Small, Intimate Care Model
Hopefully, they’ll get to know everybody who works there, too, which, again, will can impact how people feel in their birth when they know the people that are around them, that’s helpful. And then when they go into labor, they just go into one of our three birth suites. We’re hoping to have one of those really nice, big birth pools in each suite.
And they’ll come in or around active labor, do their thing, and then after a baby is born, they’ll stay for a few hours. Usually, it’s under 24 hours that people stay at a birth center, and they get to go home, and then the midwife goes to their house within 24 hours or so to check in on baby, and mom, or birthing person. Then they see the midwife multiple times within the first few weeks too. And then in six weeks, if there are issues with feeding or whatever, we will have a lactation consultant.
If they’ll need an adjustment, or acupuncture care in labor, they’ll have that available too. We’re hoping it’s just a truly comprehensive, well rounded, holistic care. We want people to feel empowered and feel like they are the center of the care. Their priorities are the center of all that happens in their care. They want to be treated as experts in their own care.
Can you tell me a little bit about what our community and anyone reading can do to support bringing the Radiant Birth Center to fruition? And how can they support this project and bring this birth option here?
There are a couple of different ways. I have a team, and we’re small but mighty. Danielle Gilmore is our midwife and she’s our clinical director. And then Sarah Delaney Cox is our Director of Development, she’s been helping us strategize with fundraising. We are finishing up developing our website. So there isn’t yet a website to visit, but we’re on Instagram at Radiant Birth Center. And we’ve got updates there.
We have a donation link through our Instagram page, there’s a link tree on there. Donations are extremely helpful. That’s the first and foremost thing. But there’s also political involvement through an organization called movement for birth liberation. It’s a statewide advocacy effort to help things like birth centers have a way into the world here in our state. I would say follow movement for birth liberation as well and get involved there too. Because that is a great way to politically influence birth options.
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