This does NOT seem like a good idea.
(out of gift links, sorry!)
7 Likes
Here is a gift link to the article:
1 Like
How many surgeons will do it if their insurance won’t cover them or their rates go up if the surgeons want to perform them?
I’m a big fan of hospital births with all the bells and whistles.
5 Likes
If we were younger and of child-bearing age, it would be a big no. Outpatient centers are for things like colonoscopies or minor knee surgeries.
3 Likes
“Advanced birth centers were promoted as a way to expand access to maternity care in the state, where many hospitals have closed their labor and delivery departments in recent years. So-called maternity care deserts have grown in rural areas outside Florida’s major cities.” (from the article)
When big hospitals refuse to do c-sections in rural areas most likely because of liability
or are not even available either by absense or distance then the birthing centers that are available have to be able to deliver care in a timely manner.
The alternative is a woman needs emergency surgery and does not receive it.
As for everything needs a hospital…there are home births, birthing centers, doulas, etc. Will emergencies be covered in any of these circumstances? Nice to have a back up plan. This law gives a back up plan to those in need of one.
2 Likes
It would be perhaps a “no” if you had hospitals close to you.
This law is made for those living in rural areas where hospitals are not available hence the " advanced birthing centers" which are meant to expand health care to those who otherwise would have no health care. They need the permission to have c-sections to cover emergencies.
3 Likes
This sounds like a great idea in order to get health care to women who wouldn’t necessarily have access to it.
I had pretty extensive reconstructive surgery at an outpatient clinic last year, under general anesthesia, no problem at all. The surgeon told me that outpatient clinics have a lower rate of infections than hospitals.
That’s all well and good, but a pregnant woman can bleed out in minutes if things go wrong with a cesarian section.
4 Likes
You’re making the assumption that only hospitals would be equipped for surgery. There is no reason a birthing center which can perform c-sections would be less prepared.
Lots can go wrong in any surgery–people just close their eyes to a lot of those possibilities.
2 Likes
Agreed. Lots can go wrong during a home birth or an hour long ride to the hospital too. I think this provides an alternative where those might be the only other options.
There isn’t just the surgery on the mother to worry about but also the care of the baby(ies) after the birth. Is there a level 2 or 3 nursery in the area? Can anyone put in an umbilical
line? Would the mother and child have been better cared for by airlifting them to a hospital?
Probably no perfect answers.
5 Likes
It’s definitely not ideal and I would agree that the providers running the clinics would have to have a level of expertise beyond what would be typical.
It’s not perfect, a hospital birth would (to me) always be preferable, but maybe better than the current alternatives. I think about where I live in the PNW and I have friends that are a solid 90 minutes from an ER and even farther from a real hospital. That gap in time is a real issue in many parts of the country.
3 Likes
Shouldn’t we be addressing the real problem of hospital deserts instead of for-profit workarounds? Are there many priorities for a secure nation more important than access to basic health care?
Public policy and public choices have brought us to this point, and they can be changed.
11 Likes
Well sure, but no one is going to build a hospital in a remote rural area with a sparse population. Maybe a clinic but there just aren’t enough people to staff or maintain a full hospital or enough patients to justify it.
Now I have no idea how rural Florida is or what their medical situation is, but before I moved out west I had no real grasp that there are places in the country that are really remote. I have a friend here who grew up 60 miles from a stoplight 
. There’s a mountain community near us that has one county police officer assigned to the area, it takes him days to respond to calls.
It would be lovely to have a fully staffed medical center for these communities but, in my opinion, a fully staffed clinic is better than an hours long ride to the hospital.
I’m a Pedi. I have seen enough bad deliveries, for both mother and child, that I insisted on giving birth in hospitals that had ICUs and neonatal ICUs. Sure, most deliveries go smoothly, but when they don’t, mothers and babies who don’t have access to good ICUs and NICUs die.
It is truly ironic that so many anti-abortion states insisted that surgical abortions, which are very safe and can be done easily in an outpatient clinic by a trained nurse or PA, had to have all sorts of hospital-level regulations and staff who had hospital privileges, of course as a means to prevent the clinics from operating. Now, these very same states, dealing with maternity facility deserts, are saying that it’s perfectly safe to do C-sections outside the hospital!
21 Likes
While I agree that the anti-abortion laws aren’t helping, it’s not the only reason. In the past 2 years, the hospitals in the two counties adjacent to mine in VA closed their labor and deliveries, forcing the remainder to come to our little hospital. The reason stated in the articles was a decline in the number of deliveries - i.e. it’s not profitable anymore. I do know that it is already affecting deliveries at ours. My co-worker’s D had a planned induction (first child and past her due date) rescheduled twice at the last minute due to the number of patients and not enough staff to take care of them. She was not amused!
My area is rural, but we aren’t in the middle of nowhere. We are about 1:15 from a major hospital. Most people choose to go there, or another somewhat nearby (1:30-2:30) hospital for important issues. Some choose those options even for childbirth, but it definitely isn’t ideal for that!
1 Like
I’ve had a post with these exact same sentiments in draft form since this morning. I wasn’t sure if posting it would be “off topic” so I’m glad to see your post. I agree with you 
%
7 Likes
I am confused as to how these clinics will solve the problem of “obstetric deserts.” The reason such shortages exist is because of a shortage of trained medical personale (OBs/surgeons, anesthesiologists, scrub nurses, neonatal nurses etc.) living in these remote areas so they can be available for C-sections. When people claim that small hospitals close their OB units because they don’t do enough births to be profitable, most just assume the hospitals are being greedy. But think of what it really means: You have to pay a team of a minimum of 3 highly trained professionals (OB, anesthesia, scrub nurse) around the clock to be in the hospital (or within a few minutes away), so they can be available at a moment’s notice for an emergency c-section. Then you need to pay for back-ups for everyone on this team in case of sickness, or vacation, or heck just so they can have a glass of wine occasionally. How are you going to find people willing to lead this lifestyle? How are you going to pay them?
2 Likes
And remember, the OB always has a malpractice lawsuit target on her back. Anything goes wrong with the delivery, sue the OB. Junior has any problem down the road? Blame it on the delivery, and sue the OB.
I suspect that the next step is to decide that NPs and PAs can be allowed to do C-sections independently in these outpatient birthing centers.
1 Like
So what’s better–planning to have your C-section two hours away, or having it in a for-profit clinic without the necessary back up?
What are people in those places doing for medical care now? If there are OBs available for these clinics, there are OBs available for actual hospitals.
And “justify” to whom? (And I don’t think what you’re describing is Florida in any shape or form.)