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'Birth centers could fill a gap': Midwives push for a bill to expand options for expecting mothers

A bill moving through the Iowa Legislature could make it easier to open birth centers in the state, a change that midwives say is critical as access to maternity care declines.

'Birth centers could fill a gap': Midwives push for a bill to expand options for expecting mothers

A bill moving through the Iowa Legislature could make it easier to open birth centers in the state, a change that midwives say is critical as access to maternity care declines.

AS WE TAKE A LIVE LOOK FROM OUR DOWNTOWN SKYCAM AT THE IOWA STATE HOUSE, A BILL MOVING THROUGH COULD HELP EXPAND OPTIONS FOR EXPECTING MOTHERS. SOME MOMS AND MIDWIVES ARE ASKING LAWMAKERS TO MAKE IT EASIER TO OPEN BIRTH CENTERS IN IOWA. vlog CHIEF POLITICAL REPORTER AMANDA ROOKER JOINS US IN STUDIO TONIGHT. AND AMANDA, AS MATERNAL CARE ACCESS DECLINES IN OUR STATE, SOME SAY THIS BILL COULD BE A SOLUTION. THEY DO. JODI AND LARA, RIGHT NOW, IOWA HAS NO BIRTHING CENTERS, AND MIDWIVES SAY IT’S BECAUSE OF A REGULATION THAT CAN REQUIRE THEM TO PAY $20,000 JUST TO APPLY. AND THERE’S NO GUARANTEE OF APPROVAL. THEY WANT IOWA LAWMAKERS TO REMOVE THAT HURDLE. IN THE PAST 25 YEARS, ALMOST 50% OF OUR HOSPITALS HAVE SHUT DOWN THEIR MATERNITY CARE SERVICES. THEIR BIRTH SERVICES. CAITLIN HANLEY IS A CERTIFIED MIDWIFE IN DES MOINES. SHE SAYS HOSPITAL CLOSURES HAVE LEFT MANY EXPECTANT MOTHERS WITHOUT CARE CLOSE BY. WOMEN MIGHT HAVE TO DRIVE UP TO 1 OR 2 HOURS FOR PRENATAL CARE AND BIRTH, AND WE REALLY THINK THAT BIRTH CENTERS COULD FILL A GAP IN THOSE PLACES. BIRTH CENTERS ARE DIFFERENT THAN HOSPITALS. THEY’RE STAFFED BY MIDWIVES AND PROVIDE PRENATAL LABOR AND POSTPARTUM CARE, PRIMARILY FOR WOMEN WITH LOW RISK PREGNANCIES. BUT EFFORTS TO OFFER THOSE SERVICES IN IOWA HAVE HIT DEAD ENDS THE LAST. SEVERAL MIDWIVES THAT HAVE TRIED TO OPEN A BIRTH CENTER HAVE BEEN BLOCKED, BASICALLY JUST BY THE CERTIFICATE OF NEED. HOUSE FILE 887 WOULD REMOVE BIRTH CENTERS FROM THE CERTIFICATE OF NEED PROCESS, ALLOWING MORE TO OPEN WITHOUT A $20,000 BARRIER. MOMS AND MIDWIVES SPOKE AT A SUBCOMMITTEE HEARING TUESDAY, ASKING LAWMAKERS FOR HELP. I, AS A WOMAN, SHOULD HAVE THE CHOICE AS TO WHERE I WANT TO HAVE MY CHILDREN, AND THAT SHOULD BE AN AFFORDABLE OPTION. MANDY SHIVERS HAD HER FIRST BABY AT A BIRTH CENTER WHEN IT CLOSED. SHE HAD HER OTHER TWO IN A HOSPITAL. MY FIRST BIRTH COST ME UNDER $5,000. MY SECOND AND THIRD BIRTHS COST ME OVER $20,000 AFTER INSURANCE. OTHERS SHARED STORIES OF WORKING WITH MIDWIVES LIKE LISA JORDAN, WHO SAYS HALEY HELPED DELIVER HER SON JACKSON. BUT NOT ALL MOMS HAVE THAT SAME ACCESS. HAVING SAFE BIRTH OPTIONS FOR PEOPLE, ESPECIALLY THOSE LOW RISK MOMS AND THOSE IN RURAL AREAS, IT’S JUST NOT AVAILABLE HERE IN IOWA. I’M HERE TO REALLY SPEAK ON BEHALF OF THOSE MOMS THAT THAT DESERVE A VOICE. THE BILL PASSED UNANIMOUSLY THROUGH THE IOWA HOUSE LAST WEEK. HALEY IS HOPEFUL IT WILL GAIN THE SAME SUPPORT IN THE SENATE. IT WILL PROVIDE AN AVENUE FOR MORE MOMS AND MORE FAMILIES TO HAVE CHOICE, FREEDOM OF CHOICE IN THEIR MATERNITY HEALTHCARE OPTIONS. AND THERE WAS A LOT OF PEOPLE AND A LOT OF BABIES, TOO, IN THE SUBCOMMITTEE ROOM TONIGHT, SPEAKING IN SUPPORT OF THIS BILL. NO ONE SPOKE IN OPPOSITION TO IT, AND LAWMAKERS APPROVED IT. IT IS NOW HEADING TO A FULL COMMITTEE FOR CONSIDERATION. THE BILL HAS TO PASS COMMITTEE BY THIS FRIDAY TO STAY ELIGIBLE FOR THE REST OF SESSION. WE’LL KEEP YOU UPDATED ON ITS PROGRESS. JODI.
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'Birth centers could fill a gap': Midwives push for a bill to expand options for expecting mothers

A bill moving through the Iowa Legislature could make it easier to open birth centers in the state, a change that midwives say is critical as access to maternity care declines.

A bill moving through the Iowa Legislature could make it easier to open birth centers in the state, a change that midwives say is critical as access to maternity care declines.Iowa currently has zero birth centers, and midwives blame the state’s certificate of need (CON) process. The process requires applicants to pay up $21,000 to request approval. That money is nonrefundable—even if the request is denied.House File 887, which passed a Senate subcommittee Tuesday, would remove birth centers from the CON process, allowing them to open without that financial hurdle.Filling the Maternal Care GapDes Moines midwife Caitlin Hainley says the bill could help address growing gaps in maternal healthcare.“In the past 25 years, almost 50% of our hospitals have shut down their maternity care services, their birth services. So, we now have large swaths of maternal health deserts across the state of Iowa,” Hainley said. “Women may have to drive up to one or two hours for prenatal care and birth, and we really think that birth centers could fill a gap in those places," she added.Birth centers are different than hospitals. They're staffed by midwives and provide prenatal, labor and postpartum care, primarily for women with low-risk pregnancies.Another midwife testified Tuesday that many Iowans in rural areas are opting for home births—not necessarily by choice, but because they have no other nearby options. "There are midwives in this state that are ready to open birth centers. There are families that want to utilize them," Bethany Gates, a certified professional midwife, said.Gates also said she often gets calls from mothers who have recently moved to Iowa from states that have many birth centers including California, Texas, Wisconsin and Minnesota."'Where are the birth centers?' is the question that I get, and I have to tell them that we literally have zero birth centers. So, I am very much in favor of this bill."Families Want More OptionsDuring Tuesday’s subcommittee hearing, several mothers also spoke in support of the bill.Iowa mom Mandy Shivers said she had her first child at a birth center. When the center closed, she gave birth to her second and third children in a hospital. She said the hospital deliveries were significantly more expensive."My first birth cost me under $5,000. My second and third births cost me over $20,000 after insurance," Shivers said. "I, as a woman, should have the choice of where to have my children, and that should be an affordable option."What comes next?The Iowa House unanimously passed House File 887 last week. During Tuesday's Senate subcommittee hearing, no one spoke in opposition to the bill, and lawmakers signed off on it.It now heads to the full committee for a vote. Friday is the second funnel deadline, which means most bills have to pass through a floor vote in one chamber and committee in the other chamber to stay eligible for the rest of session.» Subscribe to vlog's YouTube page» Download the free vlog app to get updates on the go: Apple | Google Play

A bill moving through the Iowa Legislature could make it easier to open birth centers in the state, a change that midwives say is critical as access to maternity care declines.

Iowa currently has zero birth centers, and midwives blame the state’s certificate of need (CON) process. The process requires applicants to pay up $21,000 to request approval. That money is nonrefundable—even if the request is denied.

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House File 887, which passed a Senate subcommittee Tuesday, would remove birth centers from the CON process, allowing them to open without that financial hurdle.

Filling the Maternal Care Gap

Des Moines midwife Caitlin Hainley says the bill could help address growing gaps in maternal healthcare.

“In the past 25 years, almost 50% of our hospitals have shut down their maternity care services, their birth services. So, we now have large swaths of maternal health deserts across the state of Iowa,” Hainley said.

“Women may have to drive up to one or two hours for prenatal care and birth, and we really think that birth centers could fill a gap in those places," she added.

Birth centers are different than hospitals. They're staffed by midwives and provide prenatal, labor and postpartum care, primarily for women with low-risk pregnancies.

Another midwife testified Tuesday that many Iowans in rural areas are opting for home births—not necessarily by choice, but because they have no other nearby options.

"There are midwives in this state that are ready to open birth centers. There are families that want to utilize them," Bethany Gates, a certified professional midwife, said.

Gates also said she often gets calls from mothers who have recently moved to Iowa from states that have many birth centers including California, Texas, Wisconsin and Minnesota.

"'Where are the birth centers?' is the question that I get, and I have to tell them that we literally have zero birth centers. So, I am very much in favor of this bill."

Families Want More Options

During Tuesday’s subcommittee hearing, several mothers also spoke in support of the bill.

Iowa mom Mandy Shivers said she had her first child at a birth center. When the center closed, she gave birth to her second and third children in a hospital. She said the hospital deliveries were significantly more expensive.

"My first birth cost me under $5,000. My second and third births cost me over $20,000 after insurance," Shivers said. "I, as a woman, should have the choice of where to have my children, and that should be an affordable option."

What comes next?

The Iowa House unanimously passed House File 887 last week. During Tuesday's Senate subcommittee hearing, no one spoke in opposition to the bill, and lawmakers signed off on it.

It now heads to the full committee for a vote. Friday is the second funnel deadline, which means most bills have to pass through a floor vote in one chamber and committee in the other chamber to stay eligible for the rest of session.

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