The state of California isn’t making it easy for the many families who wish to bring their babies outside of a hospital. Since 2020, only four licensed birth centers remain open in the state, with half of them having closed.
Birth centers do not require a state license to operate, but one of the main causes of their failure is the costly and time-consuming procedure of acquiring one. Only licensed facilities will be accepted by the majority of insurers including Medi-Cal, the state’s public health insurance program for low-income citizens.
The rapid closure of hospital labor wards, which results in maternity care deserts in communities of all sizes, exacerbates the issue.
For this reason, Oakland Democrat Assemblymember Mia Bonta, who chairs the Health Committee, intends to submit a bill today that would relax the licensing criteria for birth centers.
To guarantee that our surviving birth centers can continue to operate and create the framework for other facilities to open, it is imperative that regulations that are just raising costs for providers and have no bearing on patient safety be removed, according to Bonta.
Bonta intends to present a bill that would eliminate the need that birth centers take part in the comprehensive perinatal services program, a Medi-Cal benefit that offers things like emotional support and dietary counseling. Birth center licensing was practically impossible until recently, when midwives were prohibited from taking part in the program.
Proponents claim that doing away with the criteria completely will expedite the procedure even more and enable them to assist more low-income consumers.
The bill is a component of Bonta’s broader legislative endeavor to safeguard access to reproductive health care in the event of a Trump presidency. Other proposed legislation by Bonta aims to cover the cost of over-the-counter birth control for Medi-Cal patients and to maintain access to abortions at all hospitals, even those connected to religious institutions, in case of an emergency.
Outside of hospitals, trained nurse midwives and licensed midwives can offer low-risk births as well as prenatal and postpartum care. They refer pregnancies at higher risk to hospitals. Birth centers are low-risk birth facilities run by midwives.
After thirty years of operation, the state’s first licensed and recognized birth facility closed its doors in March. nearly the years, the San Diego facility gave birth to nearly 5,600 newborns, but it was unable to keep up with the growing expenses. Numerous others have done the same. According to CalMatters reporting, over 50 maternity hospital awards have closed in the last four years, and at least 19 birth centers have shuttered as well.
Sandra Poole, a lobbyist with the Western Center for Law and Poverty, which is co-sponsoring the bill, said the closures worsen a maternal health care crisis by disproportionately affecting people of color and rural communities.
We have a whole population that is losing access to maternal care, and we’re hearing more and more that people, especially people of color, would prefer to give birth at a birth center for a variety of reasons, such as a mistrust of hospitals or a desire to give birth in a more comfortable environment, Poole said. However, they are simply denied that chance, particularly if they are on Medi-Cal.
According to state data, more over half of California births are covered by Medi-Cal, and 80% of those babies are non-white. Additionally, a statewide survey indicates that more individuals of color than any other demographic group desire alternative birth support services like doulas and midwives. According to the California Health Care Foundation survey, the most often mentioned obstacle to receiving that care is not having insurance.
According to the American Association of Birth Centers, California is renowned for having the most stringent licensing regulations for birth centers nationwide. In the past, midwives have informed CalMatters that operating in California was too challenging, forcing many to leave the state and even the nation.
Although it’s tragic that this legislative initiative is too late to preserve the birth centers that have already closed, Bethany Sasaki, president of the state chapter of the American Association of Birth Centers, said it’s a crucial first step. Earlier this year, Sasaki shut down her birth center in Sacramento when the state denied her a license.
According to Sasaki, this is the first phase of a lengthy effort to increase access to midwives and safe out-of-hospital birth.
The California Health treatment Foundation (CHCF), which strives to guarantee that people have access to the treatment they require at a cost they can afford, is supporting this initiative. To find out more, go to www.chcf.org.
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