The first birth center in Arkansas has been established as a model that can be duplicated nationally, with the first birth possible before month’s end, according to officials with the University of Arkansas.
There are 250 birth centers in the United States, and nearly all of them operate independently and uniquely, said Cara Osborne, co-founder of the Birth Center of Northwest Arkansas. If the idea grows nationally, officials say the medical cost savings could be more than $2.5 billion annually.
The center was conceived differently, according to Osborne, who is also an assistant professor in the Eleanor Mann School of Nursing and a certified nurse-midwife.
“Our idea from day one was developing a birth center that was replicable, so we have kept records of the process and we have chosen to use web-based systems that can be deployed in multiple sites,” Osborne said. “We could potentially form licensing agreements or franchising agreements. The idea of making it replicable is about making it easier to open a birth center.”
Osborne came to University of Arkansas in August 2010 after teaching and serving as course coordinator at the private Frontier Nurse University in Hyden, Ky. She previously practiced as a nurse midwife at Massachusetts General Hospital in Boston. She holds a master’s degree in nursing from Vanderbilt University and a doctorate in maternal and child health from Harvard University.
Football, never far from the minds of many in Northwest Arkansas, is also the source for an explainer on the “Approach” used by the new center.
“You’re the quarterback here. You call the shots,” notes the center’s website. “You tell us what you want and we’ll help you deliver the game winning throw. Our clinician is your coach, and the rest of our team is your defensive line — protecting you from harm and making sure you stay focused on your goals. Together, we make a winning team.”
The center is located about two miles from Mercy Hospital in Rogers, and Osborne worked closely with the hospital to develop the birth center. The center is designed for low-risk, healthy women who want to take an active role in the birth process.
“The national emergency transfer rate in birth centers is less than 2 percent,” Osborne said. It is very uncommon, but it only makes sense to put the birth center close to a hospital. We have a physician on-call from the Family Practice group at Mercy if one is needed.”
The birth center awaits an onsite visit from the Arkansas Department of Health before it receives a license to operate, she said. The center has more than 20 women who have entered their information into the center’s interactive online health record system.
“Theoretically the first birth will happen before the end of March,” she said.
The center’s services will include prenatal care, labor and delivery care, midwifery care, water births, postpartum care and breastfeeding support. Initially it will be staffed by two certified nurse-midwives. Additional nurses will be hired as the number of births increases, Osborne said.
“At every birth there will be at least one nurse midwife and at least a nurse and very often two nurse midwives,” she said. “It is very personal care. We’re hoping to do 15 to 20 births a month, which is a pretty low volume.”
CHAIN OF SUPPORT?
The birth center could be the first of a chain that would grow nationally, like a popular restaurant. The team behind the birth center is currently looking at expanding to sites on the east and west coasts, Osborne said.
For the past 30 years, birth centers have consistently shown dramatic savings when compared with hospital birth and also demonstrated that quality midwifery care is both safe and cost-effective, according to the American Association of Birth Centers. If 10% of the 4 million women who give birth in the U.S. each year delivered their babies in birth centers, the savings would be at least $2.6 billion, according to the association.
A recent national study performed by Truven Health Analytics found that among women and newborns with employer-provided commercial health insurance, average total charges for care with vaginal and cesarean births are $32,093 and $51,125, respectively. The majority of the costs of hospital births in the U.S. are related to the facility fees for the hospitals, Osborne said.
“The hospital runs a model of care that is expensive,” she said. “If you are paying to keep a labor and delivery unit, a postpartum unit and a nursery and a neonatal intensive care unit, that’s expensive. Women stay in the hospital two to three days if it is a vaginal birth and four days if it is a cesarean section. That’s where the majority of the costs come from.
“Pregnancy, labor and birth are normal physiologic events, not diseases,” she said. “But most physicians and hospitals approach maternity care just as they would care for any other disease and focus on the things that could go wrong rather than maintaining ‘normal" function.’ A birth center setting is focused on maintaining a normal physiology. The length of stay is only 12 hours after the birth, followed by a home visit.”
The Birth Center of Northwest Arkansas features a main room that comes with a sofa, television and galley kitchen. There are three birth rooms that resemble hotel suites, with double beds, soaking tubs and walk-in showers.
“It is a home-like setting, so people don’t feel like they are walking into a place for sick people,” Osborne said. “They feel like they are walking into a friend’s house.”
The center website includes the following list of other unique amenities.
• We don’t have any hospital gowns. Instead we have soft robes, fluffy towels, and high thread count sheets for you to use.
• Our beds don’t have any stirrups on them. Instead our clinicians will bend their knees, crouch, and kneel to accommodate what is most comfortable for you.
• We would really like for you to eat and drink during labor. In fact, we’ve built a whole kitchen for you to make your own comfort foods.
• We really want for you to walk around and stay active during labor. That’s why we picked this spot — there is a great walking trail and fishing dock out back! This means that you won’t have things, like a routine IV line, that would make moving around difficult.