Photo via Centers for Disease Control and Prevention
Florida was the first state to give the green light to so-called “advanced birthing centers.”
Nearly one year later, though, the DeSantis administration hasn’t passed the regulations needed to license such centers, which would be allowed to perform cesarian deliveries in nonhospital settings.
The delay irks Sen. Gayle Harrell, the Republican from Stuart who championed the legislation.
“I will follow up on that, because I’m very interested in advanced birthing centers,” Harrell told the Florida Phoenix in an interview.
The law passed last year with great fanfare by Senate Republicans established the ability for the centers to operate and required them to reach transfer agreements with hospitals in case of medical complications. But the law doesn’t prescribe all the details and authorized the Agency for Health Care Administration (AHCA) to establish licensing rules.
AHCA Deputy Secretary Health Care Policy and Oversight Kimberly Smoak testified last week that the agency has had conversations with the hospital industry but not the traditional birthing centers that have been providing maternity care.
A traditional birthing center handles normal, uncomplicated, low-risk pregnancies under license by AHCA. They are required for the most part to discharge the mother and infant within 24 hours following birth, although there are exceptions for when a mother is in a deep sleep or if the 24-hour period ends in the middle of the night.
Traditional birthing centers cannot perform cesarean sections or administer anesthesia.
There are 27 birthing centers licensed to operate in Florida, according to the Florida Healthfinder website.
‘The next few months’
“We haven’t spoken to birth centers at this point; it doesn’t mean we will not speak to them prior to us moving forward with our rule,” Smoak said.
She said the agency’s goal is to publish a proposed draft rule and hold a workshop on it in “the next few months.”
When asked point blank when the advanced birth centers will be operational, Smoak replied:
“I would not be able to provide you an estimate on that because we have received no interest from anybody that wants to apply for an advanced birth center. But as I said, my team and I are diligently working to get the rule finalized and get that in place to allow for entities to apply for that licensure category.”
Blueprint?
Florida’s version of advanced birth centers could provide a blueprint for the nation to follow, possibly involving private equity financing.
“In addition to Florida being the Wild West in a number of policy directions, it has one of the highest concentrations of private equity-backed health care operators, including OB-GYN and fertility,” Alex Borsa, a researcher at Columbia University, told Stateline, a reporting partner of the Florida Phoenix.
Lawmakers authorized the development of advanced birthing centers as part of a package (SB 7016) pushed by former Senate President Kathleen Passidomo called “Live Healthy.”
The law allows advanced birthing centers to perform cesarean deliveries for screened patients who qualify; planned low-risk cesarean deliveries; and anticipated vaginal deliveries from the beginning of the 37th week of gestation through the end of the 41st week.
They are required to be operated and staffed 24 hours per day, seven days per week, and have two medical directors, one of whom must be a board-certified obstetrician and the other a board-certified anesthesiologist.
The centers must post at least one registered nurse at all times.
OB-GYN changes
Harrell, whose husband was an obstetrician, says advanced birthing centers are akin to ambulatory surgical centers which when first established were limited in their offerings.
“They are doing total hips now,” Harrell said.
“Maternity care has changed dramatically over the last 20 years. It’s a totally different ballgame. You don’t have the relationship with your OB that you used to have 20 or 30 years ago. Now, you have laborists who are employed by the hospitals. You meet them for the first time when you are birthing your baby, and it’s a different ball game. Whereas advanced birthing centers are going to give you a totally different experience. It’s the best of both worlds for me.”
The Live Healthy proposal targeted hundreds of millions of dollars annually to bolster graduate medical education; establish loan programs for doctors, nurses, and dentists; and establish mental health teaching facilities.
The hospital industry, which benefited from the hundreds of millions of dollars the state was infusing into graduate medical education infusion, supported the Live Healthy proposal even though it opposed the creation of advanced birthing centers.
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