Relates to midwifery birth centers

Summary of provisions

The bill amends Article 28 of the Public Health Law to authorize midwifery birth centers. The Commissioner of Health will issue regulations relating to their establishment, construction and operation, using state and national professional association standards in consultation with industry and midwives. Services would be by or under the supervision of a physician or midwife, and all in accordance with Education Law practice rules.

Justification

The bill expands the definition of "hospital" to include a new category of health care facility - a midwifery birth center - under the supervision of a physician or a midwife, and authorizes the Commissioner to review Article 28 certificate-of-need requirements to determine those that are appropriate and reasonable for the scope of services provided. All Education Law rules governing midwifery will apply, including the requirement that a collaborative relationship exist for midwives as a condition of practice.

The bill allows for the NYS Commissioner of Health to issue regulations relating to midwifery birth centers, in accordance with standards of state and national professional associations of midwifery birth centers. Midwifery birth centers are accredited by nationally recognized accredi- tation agencies such as the Commission for the Accreditation of Birth Centers and The Joint Commission, which provide quality-control stand- ards and guidelines. It is expected that the Commissioner will convene industry stakeholders, including representatives of midwives, midwifery birth centers and general hospitals providing obstetric services, and that physicians may participate not only through their hospital affil- iations, but also through the rule making process which allows for public comment.

Midwifery birth centers offer high quality, individualized, cost-effec- tive care to promote optimum pregnancy outcomes. Evidence and studies have consistently shown the following:

* Birth centers operated by midwives consistently have low cesarean section rates, fewer labor inductions, and successful parent bonding and breastfeeding without prolonged separation.

* Birth centers dramatically reduce costs since they promote physiologic birth and rely less on expensive technology and unnecessary, routine medical interventions. Women receive subsequent nursing or midwifery follow-up care at home, as needed.

* Birth centers consistently reflect high patient satisfaction, espe- cially for women seeking a welcoming environment with an unrestricted number of friends, support people and family members. Most hospitals restrict the number of people who can be with a woman in labor.

* Birth centers are uniquely positioned to assist New York State in meeting its Medicaid Redesign Team maternal and child health goals. A birth center can provide education in family nutrition, infant feeding, obesity prevention and family planning.

In addition, a 2013 study conducted by the American Association of Birth Centers detailed outcomes of over 15,000 births in freestanding, midwif- ery birth centers across the U.S. during the period spanning 2007 and 2010. The study found 94% of women had vaginal births and only 6% of women admitted to a birth center in labor had cesarean births. The national average for cesarean birth is 32.8% and, according to the authors, the national C-section rate for low-risk women comparable to the study group is 27%. In addition to the low rate of C-sections, there were no maternal deaths and the fetal mortality rate during labor and birth for women who were admitted to the birth centers in labor was 0.47/1000 while the neonatal mortality rate was 0.40/1000 excluding anomalies. Finally, it was estimated that midwifery birth centers saved upwards of $30,000,000 for the 15,574 births included in the study.

Prior legislative history

S 7121 of 2014

Fiscal implications

None

Effective date

Immediately