Florida Allows Doctors to Perform C-Sections Outside
of Hospitals
Florida has become the first state to allow doctors to perform cesarean sections outside of hospitals, siding with a private equity-owned physicians group that says the change will lower costs and give pregnant women the homier birthing atmosphere that many desire.
But the hospital industry and the nation’s leading obstetricians’ association say that even though some Florida hospitals have closed their maternity wards in recent years, performing C-sections in doctor-run clinics will increase the risks for women and babies when complications arise.
“A pregnant patient that is considered low-risk in one moment can suddenly need lifesaving care in the next,” Cole Greves, an Orlando perinatologist who chairs the Florida chapter of the American College of Obstetricians and Gynecologists, said in an email to KFF Health News.
The new birth clinics, “even with increased regulation, cannot guarantee the level of safety patients would receive within a hospital.”
Article on page 6
See more local news in Grand Rounds on page 5
Menopause Revolution: Natural, Bioidentical Hormones Improve Health and Longevity
By BECKY GILLETTE
Gynecologist Susan Murrmann, MD, refers to the large government\pharma funded study that came out in 2002 concluding that hormone replacement therapy (HRT) causes breast cancer as “the Hormone Apocalypse.” It sent a message to doctors and patients to stop hormone therapy immediately. Meanwhile, those women smoking never stopped smoking when smoking was linked as the cause of lung cancer.
“Unfortunately, many providers still believe in that study although the data was re-evaluated and stated that risks associated with HRT can vary depending on factors like age, specific types of hormones used, and the duration of therapy,” said Murrmann, who practices at McDonald Murrmann 360 clinics in Germantown. “The average age of the population studied was 63 and the hormones were
not natural (Premarin from pregnant mares’ urine and Provera, a very toxic man-made progestin). The study currently concludes estrogen alone did not increase the risk of breast cancer.”
Murrmann also recommends women get educated by reading several new books including Menopause Brain written by neurologist Lisa Mocsconi, PhD, Weill Cornell Women’s Brain Initiative, that looks at the neuropsychiatric effects such as “brain fog,” depression and anxiety during the menopause transition. The study of brain imaging showed that menopause transition was markedly different with fluctuating hormones.
“The hormone changes impacts on the brain were dramatic,” Murrmann said. “The study showed that the slower brain glucose uptake that is correlated with brain function was decreased over time with decreasing
(CONTINUED ON PAGE 3)
PhysicianSpotlight
By JAMES DOWD
In a time when cesarean section rates have once again been rising across the nation, Alok Kumar, MD, Medical Director of Women’s and Children’s Services at Baptist Memorial Hospital-DeSoto, is working to reverse that trend. With a career grounded in data-driven care, collaboration, and compassion, Kumar is part of a dedicated team of medical professionals who want to change how hospitals — and expectant mothers — approach childbirth.
(CONTINUED ON PAGE 4)
Alok Kumar
Susan Murrmann
Menopause Revolution,
hormones. Dementia is on the rise in the U.S. and has been called ‘type 3 diabetes.’ So, lifestyle and diet are added dimensions. Women are also having more heart disease and bone fractures later in life along with a poorer quality of life without hormones.”
Hormones are not one-size-fits-all. Murrmann first tests hormone levels, and then talks to patients about symptoms and history. It may take adjustments to find out which delivery system--patches that are changed twice a week, topical creams, or hormone pellets placed under the skin-works for each individual.
Estrogen levels, in the form of estradiol along with progesterone and testosterone, are usually checked in the lab work and recommended. Murrmann feels that although the best time to start replacing hormones is as early as possible, she does have a population more than 60 years old that still come in for hormone therapy.
Murrmann advises against oral estrogen because of the first pass effect on the liver at all ages. As people age, liver function declines so topical or non-oral estrogen is best. Testosterone is also recommended in a bioidentical form because of women’s decline in testosterone as they age. Testosterone is present in women, although at much lower levels than men’s. Testosterone can be beneficial for building muscle mass, preventing vaginal dryness, enhancing sexual function and providing more energy.
Murrmann said it is a fallacy to think once you have gone through menopause, you are done with it.
“You are never done with it,” she said. “Hot flashes never stop but they do lessen. Vaginal dryness gets worse. Fatigue and bone loss can continue. Insomnia may not get better without HRT. Hormones can reduce anxiety and are good for the skin, too. HRT isn’t a panacea; it is not going to turn back the clock. For example, if you are smoking, it will take a toll on the health of your skin.”
Murrmann said frequently women are prescribed antidepressants that have been “repurposed” for menopause symptoms and can cause harm because of weight gain and other side effects related to those drugs.
Murrmann, who has completed a fellowship in functional and anti-aging medicine, said that although hormones are important, they do not substitute for a healthy lifestyle that can enhance your hormones, the quality of life and longevity.
The environment is also critical.
“Most breast cancers are environmental and only 20 percent are genetic,” Murrmann said. “You can take hormones, but they don’t compensate for smoking, lack of exercise, eating highly processed foods, drinking contaminated water and living in a house full of mold. If you are eating french fries every day, that is not healthy. About 80 percent of women come to me to get hormones because they are gaining weight, but they still need to improve their diet and exercise. Every decade, lifestyles seem to get worse.”
She credits the 1960’s book Silent Spring by Rachel Carson for drawing attention to the ways environmental pollutants damage the liver causing abnormal hormone
When talking to women about hormones or general health, I advise them about what is in their environment that is far more dangerous than bio-identical hormones.
–Susan Murrmann
metabolism and possibly contributing to cancer.
“When talking to women about hormones or general health, I advise them about what is in their environment that is far more dangerous than bio-identical hormones,” Murrmann said. “By not giving women hormones, they could die of other issues.”
Other symptoms of low hormone levels can be brain fog or memory issues, a decreased sex drive, itchy ears, joint pain and heart palpitations and many other issues.
Women with a family history of breast cancer may have special concerns about hormone therapy. Murrmann discusses that thoroughly, gives patients handouts and recommends books for more information. Many women with a family history of breast cancer do opt for HRT because it improves the quality of their life.
Thyroid health is a huge issue as women age. Murrmann does extensive thyroid testing on everyone to make sure they are not missing another issue.
“Menopause is not just cut and dried like everyone thinks it is,” she said. “You have to look at the whole person and other issues to treat the woman effectively. I would not be doing my job if I just put every other woman on hormones and didn’t address other lifestyle or health issues. That is why we call our clinic 360. We look at everything. We try to get to the bottom of what is causing symptoms. We have created a lot of options for patients in our clinic.”
She also recommends testing for heavy metals, vitamins and minerals. Mercury can cause brain damage. Cadmium is carcinogenic. “A lot of things can affect your brain so you have to look at everything head-to-toe so you treat the whole patient, not just the numbers in the lab report,” she said.
One therapy she is excited about is infrared sauna. When the body is toxic, people need to sweat. A sauna is great, but so is vigorous exercise. Chelation therapy can also be considered if heavy metal levels are high. She also believes that epigenetics research shows great promise for better treatment of health issues.
Getting Better with Age
As the 401(k) continues to evolve, it remains a great retirement saving strategy
Since their launch in 1981, 401(k) plans have grown to become the most popular company retirement plan in the United States. According to the Investment Company Institute, 401(k) plans hold $7.4 trillion in assets, in more than 710,000 plans, on behalf of nearly 70 million active participants, former employees and retirees.
Saving in a 401(k) has never been easier. Many more employers now offer automatic enrollment with built-in automatic savings increases each year — along with robust investment decision support tools. Here are six more reasons why your 401(k) continues to be a great retirement saving strategy:
Your savings are automatic. With your 401(k), you’re following the core financial planning principle of “pay yourself first.” Money is deposited from your paycheck to your account without you even having to think about it. It doesn’t get much easier than that.
Tax-deferred compounding. You defer paying income tax on money that you save in a 401(k). Income tax won't be due on this money until it is withdrawn in retirement. The money that would otherwise go to pay current taxes remains invested for greater long-term growth potential. As a result, any interest, dividends and capital gains you earn can benefit from the power of tax-deferred compounding.
Tax-deferred compounding: the sequel.
Employees who are age 50 and older are eligible to make additional “catch-up” contributions beyond the annual Internal Revenue Service limit. This is a significant benefit, especially if you’ve not been able to save as much because of competing financial priorities (such as saving for a college education or supporting aging parents). Catch-up contributions that you make also benefit from tax-deferred compounding.
Free money courtesy of the employer match. You should always aim to save at least enough to get a full employer match (subject to your plan’s vesting rules). A 401(k) match of 50 cents for each dollar you save in the 401(k) plan up to 6% of pay is a 50% return on your investment. A dollar-for-dollar 401(k) match doubles your money.
Roth contribution option. If available to you, contributions to a Roth 401(k) are made with after-tax dollars (no tax deduction), but potential earnings and distributions are tax-free, as long as you have held the account for at least five years and are at least 59 1/2 years old. If you think you’ll be in a higher tax bracket during retirement, a Roth option may be a sound strategy (or consider diversifying your money between both traditional and Roth options).
Chirag Chauhan, MBA, AIF®, CFP® is the managing partner of Bluff City Advisory Group in Memphis, Tennessee For more info, please visit bluffcityadvisory com.
Chirag Chauhan, AIF®, CFP®
Kumar is a full-time partner & physician with Memphis Obstetrics & Gynecological Association (MOGA) and sees OB/ GYN patients in their Southaven office.
According to the National Center for Health Statistics, in 2023 nearly one-third of live births in the United States were cesarean deliveries. This was the highest rate since 2013 and marked a multi-year increase after rates declined from 2009 to 2019.
“We’re working closely with our nursing team to make sure every delivery is given the time and support it needs,” Kumar said. “We’re training staff in alternative labor techniques, investing in tools like birthing balls, and most importantly, educating patients on why it matters.”
When Kumar joined Baptist-DeSoto in 2008, he brought not only his training and skill in obstetrics and minimally invasive surgery, but also a deep commitment to maternal health. Over the years, he has collaborated with colleagues to reduce the rate of primary C-sections in low-risk pregnancies.
In 2021, Baptist-DeSoto launched a pilot program aligned with Mississippi’s NTSV (Nulliparous, Term, Singleton, Vertex) initiative, focused on reducing primary C-sections in healthy, low-risk pregnancies. The program emphasizes clear communication between physicians and nurses, careful data tracking, and best-practice policies to promote spontaneous labor whenever safe and possible.
This means no elective inductions before 39 weeks gestation unless medically necessary, a practice Baptist-DeSoto implemented 15 years ago. The hospital is now revisiting that policy and may push the timeframe to 40 weeks for elective inductions.
“What we know is that babies born before 39 weeks tend to face more challenges, such as feeding issues, temperature regulation problems, and longer hospital stays, Kumar said. “Waiting can make a big difference.”
A major challenge in changing practice patterns, Kumar said, is aligning pro-
vider convenience with what’s best for the patient. With low-risk pregnancies and healthy mothers, early inductions should not be an automatic option. He emphasizes that this shift requires trust between patients and providers, and between team members in the hospital.
“There’s a growing trend of scheduling deliveries based on when a specific physician is on call, but spontaneous labor is almost always safer and smoother when the patient’s body is ready,” Kumar said. “At Baptist-DeSoto we’ve created a culture where physicians trust the nurses and each other. That collaborative environment makes all the difference.”
Still, not every labor goes according to plan, and medical personnel never expect every mother to deliver vaginally. Sometimes, even in low-risk cases, complications arise, and a C-section is the right call, but the key is to avoid rushing to that decision.
As C-section rates continue to climb across the U.S., often due to older maternal age, rising chronic conditions like diabetes, and changing OB/GYN practice models, Kumar remains focused on evidence-based care. His work is not about forcing any one type of birth, but about giving women the safest experience possible.
“We have to bring the art of obstetrics back into alignment with what we know scientifically. That’s not easy, but it’s necessary,” he said. “And it starts with respecting labor, being patient, and putting mothers and babies first.”
Kumar’s path to medicine was one of persistence and passion. After graduating from Duke University with a bachelor’s degree in biology, he earned his MD from the University of Tennessee College of Medicine and completed a residency at the University of Tennessee Health Science Center. Following a stint in private practice in Annapolis, Maryland, he returned to the Mid-South.
The decision to return was as personal as it was professional. Today, Kumar’s extended family shares dinners
What we know is that babies born before 39 weeks tend to face more challenges, such as feeding issues, temperature regulation problems, and longer hospital stays. Waiting can make a big difference.
–Alok Kumar
and holidays, and his home is filled with laughter, creativity, and conversation.
“My daughter was just six months old, and we had no family support in Maryland,” Kumar said. “Coming back to Memphis brought us closer to my parents, and my wife’s family joined us here soon after. Now we have family gatherings with more than a dozen people at our dinner table. It’s the life I dreamed of.”
In addition to delivering babies and mentoring hospital staff, Kumar finds joy in the arts and the outdoors. He is an avid gardener, creates concrete planters, tends to tropical houseplants, and loves landscape and family photography.
“There’s something about making things with your hands that’s deeply fulfilling,” Kumar said. “It’s similar to medicine in that way; it’s about process, patience, and care.”
Kumar tries to model the love and respect he has for his career with family, friends, and patients. That includes maintaining a positive outlook when he is occasionally mistaken for indicted gynecologist, Dr. Sanjeev Kumar, but with whom he has no connection.
At the end of the day, he wants his daughter and two younger sons to know that their father enjoys his career and will support them in theirs, whether they follow him in medicine or pursue something entirely different.
“Being a physician is a demanding profession, but I always try to talk about it in a positive light around my family,” Kumar said. “Yes, there are long hours and missed dinners sometimes, but I’m at the table six nights a week. My kids see what I do, and they see that I love it. Maybe they might love it one day, too.”
GrandRounds
West Cancer Center Welcomes Three New Physicians
West Cancer Center is pleased to announce that these fine physicians have joined their practice recently as West expands its women’s health footprint in the Mid-South.
SC, before completing OB/GYN residency at the Medical University of South Carolina in Charleston. With a dedication to oncology care, she was chosen by the University of Kentucky in Lexington, for a fellowship in Gynecologic Oncology.
Linda Han, MD, is a board-certified breast surgeon with over 20 years’ experience as a leader in surgical education, quality improvement, and specialized patient care. She comes from Parkview Cancer Institute in Fort Wayne, Indiana, where she was director of Breast Oncology, chief surgery quality and optimization officer for the health system, and adjunct clinical professor of surgery in the School of Medicine at Indiana University.
Mackenzie Harbin, MD, has a distinguished resume including recognition for outstanding teaching and surgical excellence. She earned her medical degree from the University of South Carolina School of Medicine in Greenville,
Brandon Edwards, MD, to Join MidSouth Internal Medicine
With over 10 years professional experience, he received a B.S. in Biomedical Science from Auburn University then continued his education as
Leah Tonkin, MD, MBA, DipABLM, is a board certified OB/ GYN and Lifestyle Medicine with over 16 years in private practice in Memphis. Before joining West, she was a hospitalist for Integrated Physician Services providing emergent care in labor & delivery and gynecologic surgery. Dr. Tonkin went to medical school and earned her internship and residency in OB/ GYN at the University of Tennessee Health Science Center.
a Doctor of Medicine at the University of Tennessee Health Science Center. Edwards completed his residency and a fellowship at the John Peter Smith Health Network in Fort Worth, Texas where he was Chief Resident. He has received many honors and serves as an active community volunteer. Edwards accepts most insurance and is taking new patients.
Master Clinician and Inspirational Academic Leader Named Executive Dean of College of Medicine at UTHSC
and as the senior vice president for the UT Health RGV clinical practice, where he has had a transformative impact.
After an extensive nationwide search, Michael Hocker, MD, MHS, a highly accomplished academic physician, innovative educator and mentor, and inspirational servant leader, has been named the new executive dean of the College of Medicine at the University of Tennessee Health Science Center. He will begin his tenure in July 2025.
Hocker currently serves as the dean and chief academic officer for the University of Texas, Rio Grande Valley (UTRGV) School of Medicine,
BEAUTIFUL MEDICINE BEAUTIFUL YOU
Hocker led the new college through full accreditation from the Liaison Committee on Medical Education (LCME) of its medical education programs, positioning the college to expand its student body to better serve the region through planned combined programs, including an MD/PhD program to train physician-scientists, as well as an MD/ MBA program to equip physicians with the business skills necessary in today’s health care climate.
Dr. Donald J. Bearden named Chief of Pediatric Psychology and Behavioral Health at Le Bonheur
Le Bonheur Children’s Hospital has named Donald J. Bearden, PhD, ABPP-CN, its first chief of Pediatric Psychology and Behavioral Health. Bearden will be an associate professor at the University of Tennessee Health Science Center. The newly created position at Le Bonheur will help support families by incorporating psychology and behavioral health into the care of the patient and family. Bearden comes to Memphis from
Children’s Healthcare of Atlanta where he was a senior neuropsychologist and section director of Psychology. Bearden was an assistant professor of Pediatrics, Division of Neurology at Emory University School of Medicine.
Bearden will oversee the expansion of this new division with new faculty and expanded care. At Le Bonheur, he will play a critical role in addressing the health inequities that affect children and families in the MidSouth region.
A New Hope for Autism Treatment Arises at UT Health Science Center
Il Hwan Kim, PhD, a researcher at the University of Tennessee Health Science Center, has witnessed firsthand the challenges and heartaches faced by parents raising children with autism spectrum disorder (ASD) in the United States.
Little is understood about the mechanisms underlying ASD, especially given its prevalence, affecting approximately one in every 36 children. While the exact causes of autism remain largely unknown, scientists have long suspected that both genetic and environmental factors play significant roles.
Kim is leading a team of researchers whose discoveries have unveiled a crucial mechanism of the blood-brain barrier (BBB) in ASD development. “The blood-brain barrier is often considered the brain’s gatekeeper,” Kim explained. “This barrier is like a highly selective security checkpoint, deciding what substances get access to our brain.”
At the heart of their research is a gene called SHANK3, known for its involvement in brain development and function. Mutations in SHANK3 have been linked to ASD, but until now, its role in the BBB was uncharted territory.
The ground-breaking study revealed that SHANK3 is expressed in the endothelial cells of the BBB, the very cells responsible for forming the barrier itself. “When SHANK3 was selectively knocked out in these cells in neonatal mice, our team observed a curious phenomenon: the male mice showed increased permeability of the BBB, meaning the barrier was more ‘leaky’ than usual,” Kim said. “This led to reduced neuronal excitability and impaired communication behaviors, which are hallmark features of ASD.”
Although the BBB’s permeability normalized as the mice matured, the neuronal and social impairments persisted into adulthood. “This suggests that early disruptions in the BBB could have lasting effects on brain function, underscoring a critical window during brain development that could be targeted for therapeutic interventions,” Kim said.
The team also identified a potential mechanism involving the protein β-Catenin, which is crucial for maintaining the tight junctions in the BBB.
By modulating β-Catenin signaling in the affected mice, the researchers were able to restore the BBB’s function and significantly improve the mice’s neuronal activity and social behaviors.
The project findings, which have been published in Nature Communications, opens a promising new avenue for treatment.
While this research is still in its early stages and primarily conducted in mice, the implications are profound. It highlights the importance of the BBB in brain health and its potential as a therapeutic target for neurological disorders.
Regional One Health Advances Surgical Care with State-of-the-Art Technology
Regional One Health announces an advancement in surgical care with the incorporation of a state-of the art hybrid operating room and three da Vinci 5 robotic surgical systems.
The new OR enhances the hospital system’s role as the region’s level one trauma center for adults. This OR seamlessly integrates imaging technology and surgical suites for a comprehensive approach to complex cases.
The new OR allows Regional One to treat patients with vascular diseases and abnormalities of the vascular system. The hospital’s vascular surgeons can now treat thoracic and abdominal aortic dissections or aneurysms, high-risk carotid disease and end-stage peripheral arterial disease contributing to limb loss. These cases include endovascular abdominal and thoracic aortic aneurysm repairs, transcarotid arterial stenting, and arterial and venous reconstructive procedures that rely on real-time fluoroscopic imaging.
The hospital system can now apply both endovascular techniques (diagnostic or therapeutic) and open surgical procedures to improve blood flow to the brain, extremities or abdominal/pelvic organs. Surgeons can perform life-saving surgical procedures after traumatic injuries to the chest, abdomen, neck and extremities that require real-time fluoroscopic imaging.
Regional One Health also added three da Vinci robotic surgical systems, one in an inpatient OR and two in the outpatient center. The new robotic surgery platform provides surgeons the ability to actually feel the instruments and offers enhanced dexterity, control, and visualization.
Florida Allows Doctors to Perform C-Sections Outside of Hospitals
By PHIL GALEWITZ
Florida has become the first state to allow doctors to perform cesarean sections outside of hospitals, siding with a private equity-owned physicians group that says the change will lower costs and give pregnant women the homier birthing atmosphere that many desire.
But the hospital industry and the nation’s leading obstetricians’ association say that even though some Florida hospitals have closed their maternity wards in recent years, performing C-sections in doctor-run clinics will increase the risks for women and babies when complications arise.
“A pregnant patient that is considered low-risk in one moment can suddenly need lifesaving care in the next,” Cole Greves, an Orlando perinatologist who chairs the Florida chapter of the American College of Obstetricians and Gynecologists, said in an email to KFF Health News. The new birth clinics, “even with increased regulation, cannot guarantee the level of safety patients would receive within a hospital.”
In spring 2024, a law was enacted allowing “advanced birth centers,” where physicians can deliver babies vaginally or by C-section to women deemed at low risk of complications. Women would be able to stay overnight at the clinics.
Women’s Care Enterprises, a private equity-owned physicians group with locations mostly in Florida along with California and Kentucky, lobbied the state legislature to make the change. BC Partners, a London-based investment firm, bought Women’s Care in 2020.
“We have patients who don’t want to deliver in a hospital, and that breaks our heart,” said Stephen Snow, who recently retired as an OB-GYN with Women’s Care and testified before the Florida Legislature advocating for the change in 2018.
Brittany Miller, vice president of strategic initiatives with Women’s Care, said the group would not comment on the issue.
Health experts are leery.
“What this looks like is a poor substitute for quality obstetrical care effectively being billed as something that gives people more choices,” said Alice Abernathy, an assistant professor of obstetrics and gynecology at the University of Pennsylvania Perelman School of Medicine. “This feels like a bad band-aid on a chronic issue that will make outcomes worse rather than better,” Abernathy said.
Nearly one-third of U.S. births occur via C-section, the surgical delivery of a baby through an incision in the mother’s abdomen and uterus. Generally, doctors use the procedure when they believe it is
safer than vaginal delivery for the parent, the baby, or both. Such medical decisions can take place months before birth, or in an emergency.
Florida state Sen. Gayle Harrell, the Republican who sponsored the birth center bill, said having a C-section outside of a hospital may seem like a radical change, but so was the opening of outpatient surgery centers in the late 1980s.
continued on page 8 >
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Florida Allows Doctors,
Harrell, who managed her husband’s OB-GYN practice, said birth centers will have to meet the same high standards for staffing, infection control, and other aspects as those at outpatient surgery centers.
“Given where we are with the need, and maternity deserts across the state, this is something that will help us and help moms get the best care,” she said.
Seventeen hospitals in the state have closed their maternity units since 2019, with many citing low insurance reimbursement and high malpractice costs, according to the Florida Hospital Association.
Mary Mayhew, CEO of the Florida Hospital Association, said it is wrong to compare birth centers to ambulatory surgery centers because of the many risks associated with C-sections, such as hemorrhaging.
The Florida law requires advanced birth centers to have a transfer agreement with a hospital, but it does not dictate where the facilities can open nor their proximity to a hospital.
“We have serious concerns about the impact this model has on our collective efforts to improve maternal and infant health,” Mayhew said. “Our hospitals do not see this in the best interest of providing quality and safety in labor and delivery.”
Despite its opposition to the new birth centers, the Florida Hospital Association did not fight passage of the overall bill because it also included a major increase in the amount Medicaid pays hospitals for maternity care.
Mayhew said it is unlikely that the birth centers would help address care shortages. Hospitals are already struggling with a shortage of OB-GYNs, she said, and it is unrealistic to expect advanced birth centers to open in rural areas with a large proportion of people on Medicaid, which pays the lowest reimbursement for labor and delivery care.
It is unclear whether insurers will cover the advanced birth centers, though most insurers and Medicaid cover care at midwife-run birth centers. The advanced birth centers will not accept emergency walk-ins and will treat only patients whose insurance contracts with the facilities, making them in-network.
Snow, the retired OB-GYN with Women’s Care, said the group plans to open an advanced birth center in the Tampa or Orlando area.
The advanced birth center concept is an improvement on midwife care that enables deliveries outside of hospitals, he said, as the centers allow women to stay overnight and, if necessary, offer anesthesia and C-sections.
Snow acknowledged that, with a private equity firm invested in Women’s Care, the birth center idea is also about making money. But he said hospitals have the same profit incentive and, like midwives, likely oppose the idea of centers that can provide C-sections because they could cut into hospital revenue.
continued from page 6
“We are trying to reduce the cost of medicine, and this would be more costeffective and more pleasant for patients,” he said.
Kate Bauer, executive director of the American Association of Birth Centers, said patients could confuse advanced birth centers with the existing, free-standing birth centers for low-risk births that have been run by midwives for decades. There are currently 31 licensed birth centers in Florida and 411 free-standing birth centers in the United States, she said.
“This is a radical departure from the standard of care,” Bauer said. “It’s a bad
idea,” she said, because it could increase risks to mom and baby.
No other state allows C-sections outside of hospitals. The only facility that offers similar care is a birth clinic in Wichita, Kansas, which is connected by a short walkway to a hospital, Wesley Medical Center.
The clinic provides “hotel-like” maternity suites where staffers deliver about 100 babies a month, compared with 500 per month in the hospital itself.
Morgan Tracy, a maternity nurse navigator at the center, said the concept works largely because the hospital and
birthing suites can share staff and pharmacy access, plus patients can be quickly transferred to the main hospital if complications arise.
“The beauty is there are team members on both sides of the street,” Tracy said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF at https://www.kff.org/about-us
