Advocates Push Birth Centers Amid Clinic Closures
The recent closure of a county prenatal clinic in Lane County, Oregon, has prompted renewed calls for autonomous, nonprofit birth centers. Advocates propose these centers as critical safety nets to fill gaps in care created by system-level contractions in services.
- The closure of the Lane County Prenatal Clinic in early 2021 eliminated a crucial safety net, as it was the only Federally Qualified Health Center offering prenatal services in the Eugene-Springfield area and primarily served Medicaid and uninsured patients. This closure followed the 2019 shutdown of the PeaceHealth Nurse Midwifery Birth Center, further compounding the gap in local maternal care options. - In Virginia, recent landmark legislation effective July 1, 2025, grants Certified Nurse-Midwives (CNMs) independent practice authority after completing 1,000 hours of supervised clinical experience, removing the previous requirement for a collaborative agreement with a physician. This change, along with new laws allowing CNMs to staff 24-hour on-call rosters for newborn nursery care, is designed to address critical staffing shortages, especially in rural hospitals. - A significant financial barrier for midwifery practices in Virginia was addressed with the passage of House Bill 1923, which takes effect July 1, 2025. This law mandates 100% reimbursement parity from private insurers and Medicaid for all licensed midwife types, ensuring they receive payment equal to their CNM counterparts for the same services. - The push for birth centers aligns with a global midwife shortage, with a recent analysis identifying a worldwide deficit of nearly one million midwives. The World Health Organization projects this shortage will persist, with a deficit of over 300,000 midwives anticipated by 2030, underscoring the need for sustainable practice models. - Research from the National Academies of Sciences, Engineering, and Medicine indicates that while births in homes and birth centers are associated with lower rates of medical interventions like cesarean sections, they may also carry a slightly elevated risk of poor neonatal outcomes compared to hospital births for low-risk pregnancies. However, studies also show that midwife-led care is linked to lower C-section rates, higher breastfeeding success, and comparable safety for low-risk pregnancies. - Digital health platforms are an emerging tool to extend the reach of midwifery care and address workforce constraints. Technologies like telehealth consultations for prenatal education and mental health screenings, remote patient monitoring, and mobile health apps are being used to enhance continuity of care, particularly in underserved or geographically isolated areas. - In Virginia, advocacy groups like the Virginia Affiliate of the American College of Nurse-Midwives (ACNM) and Virginia Families for Access to Midwifery were instrumental in passing recent legislation. Their ongoing priorities include addressing barriers that prevent midwives from contracting with Virginia's Managed Care Organizations (MCOs).
