Health Care Reform May Limit Access to Birthing Centers, Midwives

The new federal health law must include coverage for maternity care, in most situations, yet extending coverage to midwives and birthing centers may not be guaranteed, despite stipulations that forbid insurers from discriminating against licensed medical providers.

Although the majority of women still choose to have their babies delivered by obstetricians in hospitals, a growing number of women are now choosing to forgo the traditional hospital delivery in lieu of a midwife delivery at a birthing center.

Birthing Centers among a Growing Trend of Non-Traditional Birthing Options

Birthing centers, which are most often staffed with midwives, are generally chosen by women as an alternative to traditional labor and delivery, which is commonly associated with medical intervention, such as drugs and electronic fetal monitoring.

In 2012, about 1.36 percent of all births in the United States took place outside the hospital, according to the Centers for Disease Control and Prevention. Among those births, 29 percent occurred at freestanding birth centers.

Although birthing center deliveries still make up a very small percentage of the nation’s total, they did increase 70 percent between 2004 and 2012, according to the CDC.

Although Medicaid programs are required to cover freestanding birth centers, private insurance plans have yet to adopt this across-the-board coverage. Coverage of midwifery services has been mandated by federal law.

Birthing Centers: A Practical Alternative for Many

This comes as a shock to many, such as Cynthia Pelligrini, senior vice president for public policy and governmental affairs with the March of Dimes, who said that both certified mid wives and birthing centers “have a good record of safety and patient satisfaction and birth outcomes.”

Further, the Agency for Healthcare Research and Quality and the American Association of Birth Centers released data that showed the difference in cost between traditional hospitals and birth centers. In 2010, the average cost of a vaginal birth at a hospital was $10,166, while the average cost at a birth center for the same delivery was $2,277.

Although some advocates predict that private insurance plan coverage of birthing centers will soon be routine, for now coverage for birth centers and midwives remains less predictable.