August 14, 2013

Labored decisions

State denies plan for an Elizabethtown birthing center, but the push for expanded birthing options in Kentucky has just begun

It happens often enough that there’s a name for the phenomenon. About a year and a half after giving birth, a new mother who gave birth via cesarean walks into a support group meeting and begins to express feelings of sadness, anxiety and anger over her birthing experience. The International Cesarean Awareness Network (ICAN) calls it “the 18-month cry.” They say that’s how long it takes a woman to process her birthing experience and realize she wishes things had been done differently.

They say it happens more than most realize.

When compared to other industrialized countries, the state of maternal health care in the United States is abysmal. Pregnancies cost more. Insurance plans cover less. The risk of death to mother and infant during childbirth is greater. Average cesarean (aka c-section) rates are twice what they should be. Here in Kentucky, the rates for these measures of health care fall below the national average.

The crisis requires a complex solution, one facet of which involves taking a look at the places women give birth.

An hour south of Louisville, in Elizabethtown, that place is almost always a hospital. That’s because, outside of a home birth, a hospital is the only local option. Mary Carol Akers, a midwife, wants to change that. Earlier this year, she designed plans for what would be Kentucky’s only standalone birthing center, the Visitation Birth & Family Wellness Center. More common in Europe and other parts of the world, birthing centers are minimal-tech health-care facilities that eschew epidurals, IVs and electronic fetal monitors for natural childbirth experiences. Staffed by certified midwives and nurses, these centers are seen as a flexible option for women with low-risk pregnancies who want something that feels homier than a hospital but isn’t literally a home.

Akers received immediate, harsh opposition from regional hospitals as she made her case to the Kentucky Cabinet for Health and Family Services for a certificate of need, a mandatory step for most health-care facilities. The News Enterprise in Hardin County reported attorneys from Hardin Memorial Hospital in Elizabethtown, Flaget Memorial Hospital in Bardstown and Twin Lakes Regional Medical Center in Leitchfield argued that birthing centers are unsafe alternatives and questioned the presumption of need Akers projected. Akers’ proposal anticipated that as many as 90 percent of home births in Jefferson County could become clients of the birthing center.

In a ruling handed down in late July, the state sided with the hospital lawyers, citing doubt that enough expectant mothers would travel the hour to Elizabethtown for a birthing center.

Akers has said she will appeal, telling The News Enterprise the decision is “a huge blow to the rights of mothers.”


Plenty of women have expressed their worry, fear and shock to Damara Jenkins over the lack of birthing options in Louisville and rural Kentucky. Jenkins, a certified nurse-midwife who works out of Clark Memorial in Indiana, estimates that 50 percent of her pregnancy patients come from Kentucky, some from as far out as Campbellsville.

Jenkins says she speaks to a lot of first-time mothers who are afraid they aren’t going to get what they want, as well as second-timers not satisfied with their first experience. According to data compiled by the American Association of Birth Centers, the majority of women in hospitals receive IVs. A third are restricted to bed. More than half are not allowed to eat or drink. Almost half of first-time moms have labor artificially induced.

Advocates of natural birth and birthing centers cite medical research showing that such measures are at best unnecessary and potentially harmful. “The big misconception is that these women are making these decisions selfishly,” says Jenkins. “All our experience and research shows otherwise. It’s good for the baby, too.”

Jenkins is a board member of Friends of the Louisville Birth Center, a group formed last year whose goal is the creation of a freestanding birthing center in the city. Their plans aren’t formalized or far along, but the group has their eyes focused on Elizabethtown.

“It helps us know where the potential pitfalls are,” Jenkins says. “We’re grateful (Akers) is going first. We weren’t 100 percent shocked (by the state’s denial). We were taken back by the amount of opposition.”

Each Labor Day the national advocacy group Improving Birth holds Rally to Improve Birth events in cities across the country. Last year, groups in Louisville, Elizabethtown and Bowling Green held signs outside hospitals to raise awareness of birthing issues. This year, Louisville’s family-friendly festivities will be at Brown Park in St. Matthews. The focus will be on sharing information on evidence-based care, such as the rates of vaginal birth after cesarean, called VBACs. The U.S. rate of VBACs is only 7 to 9 percent, despite studies projecting that three to four out of five women who’ve undergone a cesarean can successfully give birth vaginally.

“This isn’t about hospital births vs. home births. (Many families) just don’t know choices. The goal is to let women know what choices they have and help them make well informed decisions,” says Stephanie Boyd, one of the co-coordinators and a board member for the Friends of the Louisville Birth Center. “I’ve seen their eyes light up, seen that bulb go off. It doesn’t take much to get them excited.”

As the system is currently set up, Boyd says, pregnant women are automatically put on the defensive when planning their birthing experience. She adds, “It shouldn’t be that way. We have growth to do, but it can occur. People need to demand it. Then the market will shift.” 

Safer, Healthier Birth Options

By Cristen Pascucci
Great article! Moms deserve a voice in this discussion! Here's a link to a research article by Lexington's own Rebecca Dekker, PhD, RN, APRN, on the safety and efficacy of birth centers: Her bottom line: "Expecting families who choose the birth center setting in the U.S. can expect high-quality, family-centered care with a Cesarean rate of approximately 6%." And my bottom line? The needs of mothers and babies should come before Big Business. Birth centers are safe, cost effective, desperately needed, and desperately wanted. It's incredible to me that the competition -- hospitals -- gets to decide who joins the market for childbirth. Families should be making that decision, and the state of Kentucky should listen to its families. Cristen Pascucci, Lexington, KY Vice President,

I really appreciate this

By ronan1122
I really appreciate this wonderful post that you have provided for us. I assure this would be beneficial for most of the people. safety jogger

Thank you so much for

By ronan1122
Thank you so much for sharing this great blog.Very inspiring and helpful too.Hope you continue to share more of your ideas.I will definitely love to read. Partner With Anthony Review

Useful information shared. I

By ronan1122
Useful information shared. I am very happy to read this article. thanks for giving us nice info. Fantastic walk-through. I appreciate this post. bubblegum casting

I am intrigued on the way

By celen
I am intrigued on the way you record this point can be so clear.robotic vacuum

When it comes to healthcare,

By vicd84
When it comes to healthcare, the authorities seem to have less and less respect for people! Now it's this, with the maternal care, a couple of years ago it was something with the recovery clinics... it's awful! I remember trying to get to one of those medical recovery clinics, but had no luck... I was in luck a friend recommended Thera-Band and I solved the problem this way, but otherwise, what would I have done?

My partner and I stumbled

By patterson204
My partner and I stumbled over here different website and thought I might as well check things out. I like what I see so now i’m following you. Look forward to checking out your web page repeatedly.

Im no expert, but I believe

By ronan1122
Im no expert, but I believe you just made an excellent point. You certainly fully understand what youre speaking about, and I can truly get behind that. telecharger cube world

I really appreciate this

By ronan1122
I really appreciate this wonderful post that you have provided for us. I assure this would be beneficial for most of the people. zoek jobs

Birth center should be safe

By clockdon
Birth center should be safe and provide all facilities to family there is need of proper care for baby and mother i think govt should more focus to make best birth center visit interior designers london

Your blog provided us with

By zion1122
Your blog provided us with valuable information to work with. Each & every tips of your post are awesome. Thanks a lot for sharing. Keep blogging.. review boost your bust guide

Caring for the ones who care

By avebroz
Any project aimed at informing future mothers about their choices is a welcomed sight. Every hospital, emergency care clinic or any other type of health care establishment should be involved in such a project. Healthier children means a healthier nation.

This is really a nice and

By ronan1122
This is really a nice and informative, containing all information and also has a great impact on the new technology. Thanks for sharing it,

i got

By clockdon
It is fair to say that most small to medium sized GILT (Globalization, Internationalization, Localization and Translation) companies have professional looking and informative brochure web sites. What is interesting is that more and more of these companies are now following in the footsteps of the industry giants and revamping their sites to facilitate online translation services. Dental implants hungary

Hello there, You have done a

By zion1122
Hello there, You have done a fantastic job. I’ll definitely digg it and for my part recommend to my friends. I am confident they will be benefited from this website.

It is an interesting

By garniet
It is an interesting decision, you will do the right thing for sure! jeanneau

feast your fat away

By athletecows
Good!!!!!!!!!!! feast your fat away


By rajaoui
WoW nice Great !! Thank you for thisss beeautiful Artiicle friend Best flash games العاب تلبيس بنات

Cool article it's really.

By ronan1122
Cool article it's really. Friend on mine has long been awaiting just for this content. Look for Allectio Cyprus Here

It is their decision and we

By dansoto
It is their decision and we should respect it! At least that is my opinion!

Hi there, I found your blog

By ronan1122
Hi there, I found your blog via Google while searching for first aid for a heart attack and your post looks very interesting for me. carte playstation network

My partner and I stumbled

By setyadwi
My partner and I stumbled over here different web address and thought I might check things out. I like what I see so i am just following you. Look forward to exploring your web page again. I like the valuable information you provide in your articles. I'll bookmark your blog and check again here frequently. I am quite certain I will learn lots of new stuff right here! Best of luck for the next!

Women should know better

By Hugh
Women should know better what works for them, they should definitely get the chance to choose. A birth center would also have doctors and nurses wearing uniforms just like these ones on, the difference being that they will take care of births only, thus the women will receive undivided attention during their labor.

By windii
Contain posting as I am going to peruse it ordinary.This is a famous blog posting furthermore exceedingly beneficial.

I bear you bookmarked to tab

By windii
I bear you bookmarked to tab external unprecedented crowd you courier pleasant announce, thanks for sharing.

You've managed to write this

By obat herbal
You've managed to write this article quite efficiently, I must say. This is really very good stuff from you and I think that you can manage to give more articles like this. I hope to see that in the future. obat herbal stroke obat herbal wasir

Its actually propitious. I

By celen
Its actually propitious. I wanted to bless you for this extraordinary interpret.sign board

By celen
It is extremely amend to joyous to treasure your fantastic boulevard of essay the notify.

By celen
I've everyone reserve prominent your fabric scene to appearance against the most up-to-day accounts you blog dispatch.

Obat asam lambung akut

By sisidin
Terapi pengobatan penyakit asam lambung akut dengan obat asam lambung akut yang efektif mengobati asam lambung dan penyakit maag yaitu jelly gamat gold-g sea cucumber

PSN code generator

By rgahdh
Every one users of the Playstation know the advantages of PSN codes, but as well as make out the fee that these kind of expenditure codes. And just because everyone is not in the capacity to pay a massive sum to buy them, not to mention just because everyone requires access to his favourite game, as well as simply because people are passionate after you Playstation, we you propose our means to fix have free PSN Codes. PSN Code Generator is a no cost application that lets you create 100% free PSN Codes for Playstation Shop. Is available everything the games that you would like, you can play online with others around the world. FREE PSN CODES