Tuesday, September 15, 2009

AABC Annual Meeting Recap


I just returned from the American Association of Birth Centers (AABC) Annual Meeting in Savannah, Georgia. It was quite an investment but well worth every penny, as I came home with ideas, connections and inspirations for how to make the birth center a reality. Some highlights:




  • I attended the Commission for the Accreditation of Birth Centers’ (CABC) “Preparation for Accreditation” workshop , learning how to apply for CABC’s provisional accreditation so that the Seasons of Life Women’s Health and Birth Center can be accredited from Day 1 of its operation.


  • During the opening ceremonies, each of the 150 or so attendees introduced themselves. When I stood up and said I was not a midwife, but “just a mom” who will open a birth center in Takoma Park, MD in 2014, the whole room applauded. I was inspired by these supporters of birth centers who were cheering me on. I was also reminded by many that a mother is never “just a mom”, no matter what her passion or profession.


  • I got a great suggestion on how to obtain recent safety data on birth centers, in absence of an updated National Birth Center Study. (The most recent national study was conducted 20 years ago!) Ann Sober of Special Beginnings in Arnold, Maryland said that I could obtain data on infant mortality, maternal mortality and birth location from the Maryland Vital Records Office and crunch the numbers myself. It took a journey of 600 miles to get this great suggestion from Ann, who is only 30 miles away near Annapolis. Go figure.


  • I talked with a representative from the Centering Healthcare Institute and learned that the company is developing a Centering Menopause program. This could be the way to “do for menopause what we did for birth” by offering humanistic care of this natural life transition, supplemented by medical intervention when warranted.


  • I talked with Farah Diaz-Tello from the National Advocates for Pregnant Women (NAPW) about an issue that is near and dear to my heart: birth options as a women’s rights issue. The NAPW has achieved the seemingly impossible: getting conservative pro-life activists to join forces with pro-choice feminists to advocate for birth options.


  • I talked with Susan Hodges, president of Citizens for Midwifery, the only other “just a mom” in this sea of midwives and other birth professionals. Susan gave me a lot of useful advice about how to identify and join forces with other birth consumer advocacy groups, such as regional Birth Networks.


  • I toured the Family Health and Birth Center in Savannah, Georgia’s only birth center. Business is booming there, with people driving from up to two hours away just to give birth at the center. There were even two clients in labor while we were taking our tour.


  • I watched two great DVDs on the train ride home: Laboring under an Illusion and Orgasmic Birth, making interesting viewing for the people in the seats behind me who could see my laptop. This lead to some interesting discussions with people from very different walks of life.


  • The personal highlight of the trip may have been when I ordered a beer at a Savannah restaurant and was asked for my ID! The thought that I could be mistaken for a 20-year-old trying to scam a beer made this 41-year-old “just a mom” very happy.
-Amy Polk

Our Next Steps

Washington Adventist Hospital is in the process of determining what medical uses will remain on the Takoma Park campus, such as emergency care. After these decisions are made, it can be determined how much space, and what kind of space, will be available to non-profit organizations.

In the meantime, our next steps are to:

  • Incorporate as a non-profit in Maryland and file for 501(c)3 status
  • Refine our business plan
  • Continue discussions with hospital administration and medical staff

We are scheduled to complete non-profit incorporation, 501(c)3 filing and our business plan by the end of 2009.

Our History

2007 was a sad year for birth options in the Washington, D.C. area. In April, Takoma Midwives, a hospital-based midwife practice with a devoted following in Takoma Park, Maryland, closed. And only one month later in May, the Maternity Center, a freestanding birth center with a 30-year history in Bethesda, Maryland, closed as well.

At the same time, Washington Adventist Hospital, which has been at its Takoma Park location for over 100 years, announced that it was relocating out of Takoma Park in 2013. The hospital's relocation created the question of what would go in its place on the vacated campus. We put these two crises together and created an opportunity: include a birth center on the Takoma Park campus!

We see Takoma Park, with its reputation as a place willing to try health alternatives, as the perfect location for such a center. We also see Washington Adventist Hospital, with its long history of respecting connections between mind, body, spirit and health, as a natural fit as a partner and backup hospital.

Initial discussions with Washington Adventist Hospital were very positive and they continue to move forward.

In 2008, funded by Birth Options Alliance, a consumer group in the Washington, D.C. area that advocates for the expansion of birth choices, we joined the American Association of Birth Centers (AABC) and took its acclaimed "How to Start a Birth Center" workshop. We toured birth centers around the country, talked with their staff, and reviewed their materials. We became very smart very quickly about what it will take to open a center here in Takoma Park.

Our Vision

The Seasons of Life Women's Health and Birth Center will provide care to women in all seasons of life, from the onset of menstruation, through the childbearing years (including pre- and post-natal care, birth, birth control, and fertility), to menopause and beyond (including gynecological care for post-menopausal women).

The center will be a non-profit organization. All profits from the center will be reinvested in patient care, community education, and other public service activities.

More about Birth Centers

What is a birth center?
A birth center is a home-like setting where women receive care and give birth assisted by midwives.

Who provides care at birth centers?
Midwives provide pre-natal, post-natal and well-woman care at birth centers and attend births. Midwives follow the Midwives Model of Care, which provides the woman with "individualized education, counseling, and prenatal care" and has been proven to reduce "the incidence of birth injury, trauma, and cesarean section" (Source: Citizens for Midwifery).

Where do birth center midwives attend births?
Birth center midwives attend births at home, in their centers and in hospitals.

How is giving birth in a birth center different from giving birth in a hospital?
  • Labor is typically allowed to unfold at its own pace.
  • Pain relief typically emphasizes immersion in water, changing positions, and the mother's own internal psychological resources, instead of drugs (although some pain relief drugs are available).
  • Mothers are typically encouraged to eat and drink during labor to keep up their strength. Most birth centers have kitchens on-site where the mother's family can prepare this food.
  • Mothers are encouraged to walk around and try different positions (standing, sitting, leaning, squatting, etc.) to ease pain and facilitate birth.
  • Midwives and birth assistants attend births in long shifts, striving to provide the mother with continuous support from the same people throughout her entire labor.
  • Birth centers typically put the mother in greater control of her environment, allowing the mother to choose her own clothes, light level, music, aromatherapy, etc.
  • The mother is typically allowed to have whomever she wants to support her in labor, without a restriction on the number of people or relationship to the mother. Husbands, partners, friends, relatives, children, doulas... all are welcome if invited by the mother.
  • Mothers, their partners and their newborns typically all stay together, without the baby being separated from parents in a nursery. Mothers are encouraged to breastfeed immediately after birth and are given help getting started.
  • Stays in birth centers are typically short, with most families going home the next day.
Who uses birth centers for childbirth?
Birth centers are able to serve the vast majority of pregnant women who are classified as low risk; 83% of women are low risk at the end of pregnancy, according to data from the Centers for Disease Control and Prevention's National Center for Health Statistics (Source: Childbirth Connection).

How do I know if I'm low risk?
Birth centers have clinical practice guidelines that specify under what conditions the center can accept a woman as a patient and under what conditions the woman should be transfered to the care of an obstetrician. Midwives use their guidelines, combined with years of experience and judgment, to identify, to the greatest extent possible, the need to transfer before it becomes an emergency. The backup hospital for the Seasons of Life Women's Health and Birth Center will be Washington Adventist Hospital's new location in Silver Spring, Maryland, which is 8 miles away from the birth center's location in Takoma Park. This meets the common standard for emergency cesarean sections: "30 minutes from decision to incision".

Are birth centers safe?
Yes. The seminal study on outcomes in birth centers appears in a 1989 New England Journal of Medicine article. The article concludes: "Birth centers offer a safe and acceptable alternative to hospital confinement for selected pregnant women, particularly those who have previously had children, and that such care leads to relatively few cesarean sections." A new study with more recent data is expected later in 2009.

Are birth centers just for pregnant women?
No. Women of all ages can receive individualized care from skilled midwives at birth centers. Seasons of Life Women's Health and Birth Center will provide care to women throughout the life span, from the onset of menstruation, through the childbearing years (including pre- and post-natal care, birth, birth control, and fertility), to menopause and beyond.

Do birth centers take insurance?
Yes. Most birth centers take insurance. In a national survey of birth centers conducted by the American Association of Birth Centers, major insurance companies that cover birth centers included Aetna/US Healthcare, Blue Cross/Blue Shield, CHAMPUS and Humana. Seasons of Life Women's Health and Birth Center will strive to negotiate contracts with numerous insurers, including Medicare and Medicaid, so that as many women as possible can use the center.

How common are birth centers?
There are about 200 birth centers in the U.S. There are two birth centers in Maryland, both in the Annapolis area: Special Beginnings and Bay Area Midwifery. There are two other birth centers in the Washington, D.C. area: BirthCare in Alexandria, Virginia and the Family Health and Birth Center in Washington, D.C.

Do birth centers have to be licensed?
Licensing requirements vary from state to state. Birth centers in Maryland are required to be licensed. Maryland's requirements are set by the Department of Health and Mental Hygiene's Office of Health Care Quality. Seasons of Life Women's Health and Birth Center will be licensed.

Do birth centers have to be accredited?
About 25% of birth centers earn accreditation through the Commission for the Accreditation of Birth Centers (CABC). The Commission offers a one-year provisional accreditation for new birth centers, so that they can be accredited from Day 1 of operations. Seasons of Life Women's Health and Birth Center will seek this accreditation for new centers. Some of us recently took the Commission's "Preparation for Accreditation" workshop to begin this process.

Do birth centers offer water births?
Yes. Many birth centers offer water births, in which the mother gives birth in a tub specially made for this purpose. Her partner can also be in the tub, supporting her in labor. Some birth centers charge a modest fee (about $150) for water births, due to the non-reusable equipment involved. Seasons of Life Women's Health and Birth Center will seek to offer this highly popular birth option.

Do birth centers offer VBACs - vaginal births after cesarean section?
Yes, to an extent. Birth center midwives use their clinical practice guidelines to determine if a woman is a good candidate for a VBAC. If this is the case, then the woman can proceed with a VBAC either in the hospital assisted by midwives or in the birth center, under certain circumstances. Seasons of Life will seek to offer VBACs, both at the center and at the hospital, in compliance with CABC standards. VBAC is a subject of much debate at this time, and CABC standards regarding VBAC are currently under review.

Are birth centers usually public non-profits or privately owned businesses?
Most birth centers are privately owned businesses, but about 25% are non-profit organizations run by either community boards or public agencies. Seasons of Life Women's Health and Birth Center will be a non-profit organization. All profits from the center will be reinvested in patient care, community education, and other public service activities.

Who else is opening birth centers?
According to the American Association of Birth Centers, there are over 20 centers that plan to open their doors in the next few years, including one in Baltimore.

I'm pregnant now and can't wait until 2013. Or I have other health needs and want to be seen by a midwife right away? What are my options?
The local consumer advocacy group Birth Options Alliance maintains an online directory of Washington, D.C. area options to see a midwife. If you are currently pregnant, keep Seasons of Life Women's Health and Birth Center in mind for your post-baby health needs, such as birth control and menopause. Join our Yahoo group to stay informed of developments.

Welcome

Welcome to the Seasons of Life Women's Health and Birth Center blog. Through this blog, as well as our website (http://www.seasonsoflifebirthcenter.org/) and Facebook group (coming soon), supporters of the birth center can keep up to date on developments.