This February, we’d like to honor Black History Month. We pay tribute to the resilience, strength, and contributions of Black individuals throughout history, especially within the realm of childbirth. We’re also reminded of the importance of the availability and quality of birth center care.
Black midwives have played a vital role in the history of childbirth, serving their communities with skill, compassion, and wisdom. Despite facing systemic obstacles and discrimination, these trailblazing midwives provided essential care to expectant mothers and their families, often in the face of adversity. Their legacy continues to inspire us as we strive to uphold their commitment to compassionate and culturally sensitive care.
Despite advances in healthcare, significant disparities persist in maternal health outcomes, disproportionately affecting Black mothers and their babies. We are dedicated to addressing these disparities head-on by providing equitable access to high-quality maternity care and support services. By advocating for change, raising awareness, and fostering partnerships within our community, we strive to create a future where every mother and baby can thrive, regardless of race or background.
Despite our strong commitment to our mission, operating a birth center in California presents unique challenges due to the stringent state and federal regulatory requirements that which are in direct conflict with each other, high operating costs, and complex healthcare landscape. California has some of the most rigorous licensing and accreditation standards for birth centers, requiring extensive documentation, adherence to strict safety protocols, and compliance with ever-evolving regulations. The plus side of this is that as a licensed and accredited birth center, you can know the care you get with us is safe and evidence-based.
Navigating the intricacies of insurance reimbursement, licensing, and legal compliance adds another layer of complexity. This is especially relevant as a birth center that accepts Medi-Cal. A recent University of California San Francisco study addresses these challenges. Operating a successful birth center in California can be so challenging that it proves impossible, forcing midwives and birth centers out of the area or profession. On this sad note, it is with a heavy heart that Best Start Birth Center is sad to announce that for the first time in 35 years, we must suspend labor and birth care effective March 31, 2024.
This midwifery staffing issue is unprecedented and not a reflection of the qualifications or practice of any of the midwives nor the Best Start Birth Center model of care. There are simply not enough midwives available to meet the untenable state and federal midwife credentialing regulations. We must maintain our established “safety first” policy and this, unfortunately, requires us to stop providing labor and birth care.
As of April 1, 2024, Best Start Birth Center will no longer provide prenatal and women’s health care services unless we are able to restructure, reorganize, and recruit additional, qualified midwives that can provide full birth center services and or federal officials directly intervene in this situation. Meanwhile, we will assist our clients in transferring their care to support their birth plan.
The number of qualified midwives available is inadequate to meet patient demand. Midwife education has not kept up with the need, and existing midwives cannot be credentialed in a timely manner. A compounding barrier is the Defense Health Agency’s failure to credential both Licensed Midwives and Certified Nurse Midwives to serve Tricare members. Both license types provide excellent care in birth centers and need to be utilized to their highest scope of practice. San Diego’s military and veteran pregnant people are already underserved. We recognize we are one of many birth centers nationwide closing under circumstances out of our control.
We have been privileged to have shared in the births of 5,637 babies in the birth center and have participated in the beautiful and poignant childbirth journey of many thousands more. Best Start birth center has been honored to assist three generations in our community. Grandchildren of people who gave birth at Best Start have also been born at Best Start. We are grateful to have been present at one of the most important moments of your life. If there is an opportunity to move forward, it will be revealed in a manner that not only supports the dignity of birthing persons and their families, but also the dedicated staff who maintain the highest level of integrity in providing the best care possible.
Unfortunately, we are not the only midwifery birth center closing in California. A recent CalMatters article highlights a California local midwife (in Sacramento) who closed her birth center to head to another country to practice midwifery. The article speaks to the difficulties she faced as a provider who accepted Medi-Cal specifically, often facing long waits for payments, or getting no reimbursements at all for some claims.
The article notes that more than Medi-Cal pays for 40% of births statewide, and more than 80% of these are moms and babies of color. At a time when many hospitals are closing maternity departments and maternal health outcome disparities continue to be a problem, there’s a clear need for midwives.
As midwives, we do what we do because we love it and we believe in the importance and value of our work, but providing care comes with unavoidable costs, no matter how affordable and equitably a birth center operates. It saddens us whenever we see a fellow midwife leave the profession or a birth center close, especially our own, but it’s an understandable outcome knowing all the challenges that persist.
A big thank you for the support and trust of all our clients, the strength of our community relationships, and the commitment of our excellent staff. We hope 2024 brings continued improvement to the system to support all midwives and birth centers. Supporting midwives fully with fair legislation, regulation, and reimbursement could have an immeasurable positive effect on the health of moms and babies.
