Senate Health & Welfare hears testimony on S.18 to license freestanding birth centers

The Vermont Senate Health & Welfare Committee on Feb. 13 took testimony on S.18, a bill to establish licensing for freestanding birth centers, hearing from midwives, a consumer who gave birth in a birth center, medical society representatives, hospitals, and state officials.

The bill would create a licensure pathway for freestanding birth centers in Vermont. Supporters said those centers expand access to midwifery-led, lower-intervention care and can improve outcomes for lower-risk pregnancies; hospitals and payers raised questions about financial sustainability, the certificate-of-need (CON) process and Medicaid reimbursement.

Jill Aleman, a certified nurse-midwife who taught for Frontier Nursing University and worked on the federal Strong Start initiative, told the committee that freestanding birth centers are an evidence-based, midwifery-led model of care and emphasized national data showing improved outcomes. She said, “The midwifery led birth center model of maternity care has birth occurring in a freestanding health care facility that is not a hospital, but that is integrated into the health care system.” Aleman cited data used by the American Association of Birth Centers showing roughly 400 freestanding birth centers in the U.S., about 25,000 births annually (about 1 percent of U.S. births), and lower cesarean rates in birth-center populations.

Lindsey LaShawn, a certified nurse-midwife who said she wished to open a freestanding birth center in southern Vermont, argued S.18 would increase options without…