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Why are there no Birth Centers in Louisville?  

post #1 of 8
2/1/08 at 6:25pm
Thread Starter 
cross-posting in tribal area

Why are there no freestanding birth centers in Louisville? Are they illegal in KY? Or is it because Direct entery midwives aren't liscensed in KY? I know there are CNMs so some midwives do exist here. There are about 5 hospitals with maternity services, some more mother and baby friendly than others. But no real homelike option at all besides home with a midwife who is risking everything to be there with you, or UC which is great but not a comfortable option for some, especially most first time moms. How are Freestanding Birth Centers started and run? Do we need to push state govt to liscence CPMs first? There's a team working on that but from what I can see, progress is s l o w. On the CPM issue, anyone have success stories in other states about how this was pushed through?
post #2 of 8
2/1/08 at 11:33pm
Wisconsin is an inspirational state- they passed their legislation the first year they tried (Indiana is on year 14 now I think).

I'm not sure the details of FSBC in KY, I do know there's only a couple in Indiana.
post #3 of 8
2/2/08 at 12:39am
Is midwifery legal at all in KY? Birth centers can be CNM or CPM run. In my mind the main benefit to a CNM run birth center (which is where DD1 was born) is that it is typically covered by insurance, it's not the hospital but it's not your house, since some people aren't set up for a home birth, either living in cramped apartments, with IL's etc. The drawback is that they're typically not all that less conservative than OBs on some things (fairly easy to get risked out), and they have to be backed by an OB which can be tricky to come by. The laws on what CNMs can do vary by state and even by city so it's hard to say why there's not one in Louisville. They are also notoriously difficult to turn a profit on (insurance), so lots of them are shutting down all over the place.

A CPM run birth center I don't think is legislated any differently than homebirth, so if a homebirth is legal then a birth center should be too. The issue there is that it's essentially the same as a homebirth costwise to parents, and there's no safety benefit unless you live prohibitively far from a hospital. We have 2 where I live but almost everyone just opts for the homebirth because it's so much more comfortable and the midwives encourage it. But, we have a lot of rural areas served so some feel more comfortable coming into town, and it's easier on the midwife than having to make the drive.

"But no real homelike option at all besides home with a midwife who is risking everything to be there with you"

does this mean that it's illegal there? I'm sorry, I'm just ignorant of all the state laws.
post #4 of 8
2/2/08 at 3:02pm
Thread Starter 
Sorry if I wasn't clear. Homebirth direct entery or cpm, midwives aren't legal here. There are some who operate under the radar at their own risk God bless them. CNMs are legal in the hospitals under an OB.
post #5 of 8
2/2/08 at 3:05pm
Thread Starter 
Quote:
Originally Posted by busybusymomma View Post
Wisconsin is an inspirational state- they passed their legislation the first year they tried
How did they do it?
post #6 of 8
2/2/08 at 3:54pm
Given what I know about KYs midwife laws, I'd say that's why there are no birth centers there. However, in other states, there are OBs who run OOH birth centers and supervise CNMs in them. Here's an example of one like that: http://www.thebirthinginn.com/.

There also used to be one in OK, but I just found out they've closed . I think it must be really hard for an OB to do something like that because of the concerns with malpractice insurance, but obviously it *is* possible, as SOME do it.
post #7 of 8
2/2/08 at 5:08pm
CNMs can work in birth centers every bit as CPMs, so those factors aren't necessarily related. In fact, Tennessee law says that CPMs can not work in birth centers even though we're licensed. Birth centers are few and far between in the South in general.
post #8 of 8
2/2/08 at 7:57pm
Quote:
Originally Posted by JamieCatheryn View Post
How did they do it?
Well, here's a quick blurb but my understanding is that it was a big grassroots thing... and Katie Prown (lobbyist turned SAHM I believe) really put a TON of work going to see legislators etc.

http://www.wisconsinguildofmidwives.org/Legalstatus.htm
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