As most young parents can attest, having a baby these days is a stressful affair. There’s a multitude of risks to be concerned about during the pregnancy — which doctors are quite happy to report, however minuscule — and it’s all but assured that the delivery will be a long, uncomfortable slog that will cost a gargantuan sum of money. Added to this is the unnatural and dehumanizing environment of the hospital, where patients are treated with the same consideration and sensitivity as a lifeless product on an assembly line.
It’s for reasons like these that parents who can have their children with a midwife at home or at a birthing center are so grateful and enthusiastic about it. Whereas most hospitals are loud and stressful environments, most birthing centers are homey, warm, and quite relaxing. And whereas personnel at the hospital prioritize efficiency and toeing the line on processes, the midwives and nurses at a birthing center prioritize comfort and keeping the birthing process as calm as possible.
However, as Covid revealed, what’s good for human beings is usually bad for established medical institutions. This is illustrated in the recent court case Chubb v. Noggle in which Katie Chubb, the director of Augusta Birth Center, filed a complaint against Caylee Noggle, the commissioner of the Georgia Department of Community Health.
According to a report in the Epoch Times, the birth center had shut down after “Georgia denied the Certificate of Need (CON) required for the clinic to operate when all three local hospitals refused to sign direct transfer agreements with Chubb’s center.”
Without a CON, birthing centers aren’t allowed to open, and without those transfer agreements, birthing centers can’t receive the CON.
Like many other states, Georgia requires that birthing centers meet certain guidelines to ensure safety and fit with the needs of the communities in which they are located. For this reason, most birthing centers are staffed with fully certified midwives and nurses and are usually near a hospital if a mother or baby experiences complications and needs emergency treatment—hence the requirement for a “transfer agreement” with the hospital.
Denying birthing centers CONs effectively gives hospitals the ability to “veto” the operation of a birthing center. And whether a birthing center receives a transfer agreement largely determines whether they are eligible for a CON.
In other words, the Georgia Department of Community Health relies on the hospital administrators’ opinion on whether the birthing center should be allowed to exist. In actuality, it should be the other way around, and the department should compel hospitals to cooperate with safe and compliant birthing centers.
According to the details of the case, the Augusta Birth Center met Georgia’s parameters and was set to serve an area with a critical need for more childbirth care. According to the law firm representing Chubb, the Pacific Legal Foundation (PLF), the childbirth outcomes in the Augusta area were abysmal and local nurses would tell “stories of a lack of beds and women giving birth in hospital hallways.” Moreover, the closest birthing center was over two hours away.
If the clinic was allowed to open, the Augusta Birth Center would have allowed women with low-risk pregnancies a more natural, far less unpleasant alternative that would allow them to have their children on their own terms. A young mother herself, Chubb experienced what it was like to have to travel so far just to have a non-hospital birth, and this motivated her to fix this problem by opening her own clinic.
The actual basis for the local hospitals denying a transfer agreement — also known as a “hospital veto” — is unclear. According to an emailed statement from PLF attorney Josh Polk, the hospitals could claim that “new services are unnecessary” or “that birth centers are unsafe,” but both rationales are “false and contrary to the conclusions reached by the Georgia legislature.”
By Georgia’s own standards, the birthing center was more than necessary for relieving childbirth care, and it met all the safety guidelines, which, Polk added, required a great deal of time and money.
According to Polk, “Katie and her team expended over a year, hired an attorney, secured financing, entered into a property purchase agreement, brought several medical professionals on board, and spent thousands preparing and submitting the CON application — only to be denied because the local providers don’t want any competition.”
This means that the most likely reason the hospitals vetoed the Augusta Birth Center was that “they are in direct competition for childbirth care.”
Despite offering mediocre care for mothers, hospital directors nevertheless wanted to maintain their control in Augusta. Although the power to veto the existence of new birthing centers is intended to promote high health and safety standards, this policy leaves out the crucial fact that hospitals are businesses with owners who want to make money.
If there’s a conflict of interests between what makes money and what helps patients, the former will win out almost every time.
Based on the evidence, Chubb and the Augusta Birth Center should win their case and be allowed to operate. This would be a just victory since it’s clear that Chubb did everything that was required of her and nonetheless fell victim to entrenched interests that shut her down simply because they could. She could then achieve her dream of helping mothers have a better experience bringing life into the world, and mothers could make use of the center’s services in full confidence that it’s safe and legal.
More importantly, however, it would be a victory for mothers. It’s well past time that mothers everywhere have options for how they handle their pregnancies and births. There are still too many parents being subjected to impatient doctors who are all too ready to induce them with drugs, numb them with shots, drag out labor, and hold them captive in the hospital for days on end.
Along with a host of other factors, this brutal approach to childbirth has understandably frightened many women out of starting families. Fortunately, birthing centers and the midwives who staff them are taking the trauma of childbirth and restoring it to something exhausting but beautiful. In the pursuit of promoting a culture of family and life, they should be encouraged and supported, especially when the self-interested medical complex tries to stop them.