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Illinois takes baby steps toward first birth center

Published: Thursday, Jan. 24, 2013 5:30 a.m. CST
Caption
(AP photo)
Certified nurse midwife Danielle Kraessig meets with patient Yakini Branch at the PCC South Family Health Center on Wednesday in Berwyn. The clinic may receive a permit to operate the first birth center in Illinois as soon as Feb. 5. Midwives and other supporters of birth alternatives for Illinois women with low-risk pregnancies have been working for years to provide such centers, which are already available in 37 other states.

CHICAGO – Rocking chairs, birthing tubs and changing tables haven’t yet been ordered, but organizers in suburban Chicago are eager to start furnishing their birth center – which may become the first such facility in Illinois.

The birth center at PCC South Family Health Center needs a permit and a license. But these steps seem within reach after years of work by supporters of options for Illinois women with low-risk pregnancies. Birth centers operate in 37 other states. Organizers said they’ve been a long time coming to Illinois.

A state health planning board is set to consider on Feb. 5 whether to grant the first permit to PCC, a nonprofit health center in suburban Chicago that already provides primary care, dental care and behavioral health services. No letters of opposition have been filed about the project.

Illinois once prohibited birth centers, leaving women to choose between giving birth at home or in a hospital. It took two decades of lobbying by Illinois midwives before a 2007 law authorized a pilot program. Their opening was then held back by a lengthy rule-making process that involved negotiations between hospitals, doctors and midwives.

“It nearly brings me to tears sometimes,” said Gayle Riedmann, a certified nurse midwife in suburban Chicago who has led the birth center movement. “It has been a long journey.”

Birth centers can look like homes or clinics from the outside. Inside, women can get prenatal care and deliver their babies in a homelike setting. Trained midwives, rather than doctors, typically monitor the labor and birth, avoiding medical interventions like drugs and cesarean sections when possible and offering alternatives like water births.

The American College of Obstetricians and Gynecologists doesn’t endorse home births, but puts accredited birth centers on par with hospitals for safety. The group’s guidelines say either hospitals or free-standing birth centers that meet accrediting standards are “the safest setting” for childbirth.

What’s more, birth centers provide care more cheaply than hospitals can – on average, $2,300 vs. $8,900.

What took so long? For years, legislative proposals met opposition from the Illinois Hospital Association and the Illinois State Medical Society, Riedmann said. To answer their concerns, the bill was rewritten as a pilot project allowing only 10 birth centers in Illinois.

A turning point came in 2007 when state Sen. John Cullerton, a Chicago Democrat who later became Senate president, threw his support behind the bill.

“He took it on and it just shifted the momentum,” Riedmann said. Cullerton’s staff convinced doctors and hospitals to work out an agreement with the midwives.

Cullerton was persuaded by a key aide, Jay Rowell, whose fiancee was a student midwife. Rowell and Annette Payot are now married, and she is a certified nurse midwife at the PCC clinic.

“We won him over on the facts and my wife’s personal experience and her understanding of the issues,” Rowell said, noting that overcoming resistance from the medical society was “extremely challenging.” The society felt “the best type of care [was] through a doctor, period,” he said.

The medical society and hospital group now take neutral positions on the law.

A task force began working in 1985 to change the Illinois law that prohibited birth centers, said Margie Schaps of the Health and Medicine Policy Research Group in Chicago, a nonprofit organization that’s worked on the issue.

“It’s been a long time coming,” Schaps said. “On one hand, I’m thinking how could we not have done this sooner? On the other hand, I’m excited for the women of Illinois that this choice should be available to them.”

If approved, the birth center in Berwyn would be staffed by certified nurse midwives and backed up by physicians who work at the clinic. A nearby hospital, West Suburban Medical Center in Oak Park, has agreed to take transfers if complications arise during a birth.

The center will have two birthing rooms, said Cecelia Bacom, a certified nurse midwife who has led the planning.

PCC’s birth center will take only women with low-risk pregnancies, Bacom said. In order to ensure the health and safety of mothers and newborns, women who go into labor before 37 weeks of pregnancy must deliver at a hospital. Expectant moms who smoke also must go elsewhere to deliver.

Nearly 80 percent of the current patients at South Family Health Center are uninsured or covered by Medicaid. For women on Medicaid — which pays for more than half of Illinois births — home births haven’t been a real alternative.

“The state pays so little and so slowly” that midwives can’t afford to offer their services for home births, Bacom said. “Out-of-hospital birth was essentially not available for Medicaid women.”

There are 248 centers in the United States, a 27 percent increase compared to 2010, according to the American Association of Birth Centers.

After Berwyn, the state’s next birth center may be in Chicago. Erie Family Health Center is searching for a site near Swedish Covenant Hospital on the city’s northwest side, said Dr. Andrea Lee, an obstetrician-gynecologist at the health center.

Bacom hopes to open the Berwyn center within a year, if all goes well. It’s taken much longer to get to this point than she ever imagined, she said, so predicting an opening date seems unwise.

“I honestly have no idea,” she said.

Online:

The Illinois Health Facilities and Services Review Board meets Feb. 5 to review applications, including from the Berwyn birth center.

http://www.hfsrb.illinois.gov/

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