One afternoon in the Georgia heat, Katie Chubb stands in front of an empty lot and points to the location where she has spent the last six years trying to open a birth center.
She describes her ideal location, saying, “We’d have parking along the road,” which would provide a more intimate setting than a hospital delivery.
In a state with some of the highest rates of mother and newborn mortality in the nation, Chubb works as a community organizer. She claims that there is a great need for a birth center in Augusta, Georgia, which is encircled by maternal health care deserts, where it can be challenging to receive prenatal care and there aren’t many options outside of hospitals.
Her idea is a stand-alone clinic that collaborates with obstetricians and mostly employs midwives.
But Chubb has faced one challenge after another in her quest to provide women with safer birth options, even in the face of strong community support and even investment proposals.
American births can be risky.
Americans should have more children, according to the Trump administration. However, for years, activists have warned that the high rates of mother and newborn death in the United States demonstrate the dangers of childbirth. Nationwide, there is also an increase in mistrust of hospitals and medical facilities. Others desire further choices.
Clarissa Viens did not want to give birth in a hospital while she was pregnant. She was concerned that physicians might try to induce labor with medicines or force her into a cesarean section. In Alaska, where she once resided, Viens gave birth to children both at home and in a birth center. “A birth center is a better place for you,” Viens explains. “Being more at ease at birth makes the infant better. They immediately make skin-to-skin contact. She says, “They don’t get bright lights.”
Viens chose to give birth at home because Augusta did not have a comparable facility. She did to the hospital when things started to go wrong, but it was too late.
In the car, her kid was born.
She claims that her son suffered a brain injury as a result of an accord prolapse that occurs during birth and deprives the baby’s brain of oxygen.
He had a feeding tube and a ventilator when he returned home from the hospital. According to Viens, doctors are still evaluating his diagnosis at 18 months.
She claims that looking back, she would have chosen differently. “But there is only one way to go and that is forward from here.” Viens says she still doesn’t want to visit the hospital for the next child, even though she and her husband intend to have more. She wishes she could have attended a birth center for the birth of her son, and she would gladly visit one.
“If we had had a birth center, it would’ve changed his outcome,” Viens adds.
In the United States, birth centers are still rare.
The American Association of Birth Centers reports that there are approximately 400 birth centers spread across more than 40 states in the United States. Although they are still very uncommon, demand for these facilities, which can offer low-risk pregnancies a safe substitute for hospitals, has been rising nationwide in recent years.
When Katie Chubb was pregnant, she wanted to locate a birth center, but none were in her area. In order to give birth to her kid, she drove almost two hours. She recognized the need, established her own organization, secured an ambulance transfer agreement, found a physician to collaborate with her, and even went so far as to successfully push for a change in Georgia law that would let birth centers to exist without the consent of nearby hospitals.
However, in order to transfer patients when needed, birth centers need to collaborate with obstetricians and hospitals.
Hospitals are unwilling to cooperate.
According to Chubb, hospitals don’t want to forfeit possible income by turning over patients to a birth center. “They are putting their profits over patient needs,” she claims.
Requests for interviews were not answered by any of the three Augusta hospitals; however, one hospital, which is a part of the bigger Wellstar Health System, sent out an email stating that they provide their own “complete women’s health services.”
There are other communities that struggle with nearby hospitals besides Augusta. Similar difficulties in opening birth centers have occurred in Alabama, Mississippi, Kentucky, and Iowa, among other states.
The fear of malpractice is another factor contributing to reluctance. According to Andrea Braden, an obstetrician in Atlanta who treats both hospitals and midwives, obstetricians are more likely than other specialists to be sued.
“That is really unfortunate, but that is where a lot of the resistance comes from,” she continues. The initiative to establish a birth facility in Augusta does not involve Braden.
According to her, obstetricians frequently choose not to collaborate with midwives out of concern that they may be sued for negligence if they are assigned patients who are already experiencing a crisis. “The obstetricians who have really high malpractice rates end up being stuck with the liability,” she claims. OB-GYNs often receive 162 liability claims for every 100 physicians, according to the American Medical Association.
Generally speaking, high-risk pregnancies are not seen as suitable candidates for birth center deliveries.
Black women face a distinct set of issues.
According to the CDC, Black women are three times more likely than white women to die from pregnancy-related causes, making childbirth significantly riskier for them. In recent years, the gap has gotten worse.
Sanders-White, Jonquettewent into labor with her fourth child two years ago and was admitted to the hospital. Sanders-White underwent a hysterectomy and a cesarean surgery, but the baby was unharmed. She remembers that hours after the procedure, her tummy was “getting more distended by the second.”
She was bleeding. It was missed by the nurses and doctors. One of the main causes of maternal death is postpartum hemorrhage.
“All I remember,” she recounts, “is that doctors and nurses come running into my room, yelling and screaming, and calling out, ‘She’s crashing.'” She’s dying and collapsing. “She’s dying!”
Her husband, Treston White, recalls one nurse coming in to tell him “it wasn’t looking good,” and to “be prepared to tell her goodbye.”
White claims that instead of believing the nurse, he decided to pray. He didn’t think God would take his wife. “I had no room for doubt at all,” he says.
Though Sander-White made it, she is now suing the hospital and practice of surgeons who operated on her. The complaint alleges she still has serious complications from the event two years later. NPR reached out to attorneys for the doctors and the hospital and did not hear back. Medical records included in the legal complaint show she was hemorrhaging the day of the birth.
Reflecting back on the event, Sanders-White says one of the many upsetting things on that day was that she never interacted with a staff member of color.
” I do think if I was another race, they would’ve been proactive,” she says. “A little more quick to react versus waiting until I’m crashing and dying.”
Sanders-White says her experience has shown her that hospitals are not necessarily the safest place to be. She believes a more holistically minded birth worker would have been more attentive to her needs and prevented her near-tragedy. “We absolutely need options outside of hospitals,” she says. “My eyes are open now.”
It’s stories like this that motivate Katie Chubb to keep fighting for her birth center. She says she gets weekly calls from people asking when it will be open.
Chubb grew up in the U.K., where births attended by midwives are more common. She moved to Augusta after she met her now-husband on a vacation to the U.S. She says she never imagined this would be her life’s work, but says she thinks her outsider perspective helps. ” It makes me see the amount of injustice and inequality there is in the U.S. healthcare system,” she says.
“Especially with lack of patient autonomy,” and choices.
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