Minutes from Tuesday 3/29 meeting

The meeting at St. Joseph's Neighborhood Center was a success! There were 19 attendants (2 adorable baby boys) including midwives, doulas, nurses, childbirth educators, and interested parents. A lot of different topics were discussed!

We opened with a brief presentation by me (Katherine, volunteer doula/future midwife, blog mistress) about birth centers in general. Most of the information in the presentation was borrowed from www.birthcenters.org - the American Association of Birth Center's website, and I showed some pictures from different birth centers.

Rochester Birthplace (1993-1999)

Joan Brenner CNM then shared a little bit about the Rochester Birthplace, which was open from 1993-1999 and owned by Rochester General Hospital. The first year, there were about 50 births in the center, and the last year there were around 100. One interesting thing about the center is that it drew a lot of rural women in - a population that wasn't expected. This was often due to the fact that women from rural areas were not close enough to a hospital to have a home birth but still wanted a home-like environment, or didn't want to birth in the hospitals that were close to them...but this unexpected population also reminds us that the people who we *think* might use a birth center (urban inhabitants of Rochester) might not, for different reasons, and this is why it is important to run focus groups and conduct needs assessments before going further in this project. That being said, the reason that The RBP closed was purely financial, NOT safety or quality issues. The year that it closed, RGH also closed around 10 other outpatient clinics. As far as safety at RBP, hospital transfers were very quick and efficient and there were very few emergency transfers.

-The Rochester Birthplace did not have things like childbirth classes, parenting classes, or a boutique which could be possible sources of revenue in the future.
-The RBP followed rules & regulations established for birth centers by the NAC which is now the AABC (linked above), and though they were owned by the hospital did not have quite the same rules -for example "failure to progress" was not declared by the number of hours a woman was in labor.

General Birth Center Discussion:

Other participants shared their knowledge and ideas about other birth centers. One attendant described a birth center where she'd worked in California as a childbirth educator - Sage-Femme Midwifery. This birth center had parenting classes, childbirth classes, and a very welcoming environment. Another nurse/doula had been to a birth in an in-hospital birth center (as opposed to freestanding) in Syracuse at St. Joe's. This birth center was housed in and owned by the hospital but had its own staff and some of its own regulations, and a very different feel from the labor & delivery floor of the same hospital. It made transfers for complications or labors that are not moving along as expected much easier, as in birth centers they do not use pitocin to augment labor or anything above nubain for medical relief of pain - rather, they suggest many other modes of pain relief.

-We discussed pros and cons of having a freestanding versus hospital-owned birth center -
Pros of hospital-owned: Mainly financial benefits, also typically allows for easier transfer to hospital if needed. Cons: Hospital may have more control over the birth center's policies, and it can be closed without much notice if hospital decides to
Pros of freestanding: Run on its own policies (compliant with AABC policies of course), can still have agreement with hospitals for ease of transfer. Cons: Larger financial and legal risk upon opening

-As far as affiliating with a local hospital in Rochester, the feel Lois has gotten is that while they are not opposed to the idea, many hospital administrators don't know what a birth center is exactly. We are brainstorming for possible spaces depending on what the need is. Rochester Birthplace was on Culver Road, on the floor below where the Strong Midwives currently have office space, but the space is no longer set up as a birthing center. Across the street there is a small-ish senior home that has been vacant for some time, with an ambulance bay and lots of office space, and rooms with bathrooms, which shows potential, but details are unclear.

Somali Community:

-Sadiya O shared some of her perspective; she is a CNA and works as a translator for Somali women in our community. Before this meeting, she and many other Somali women did not know that there were birthing options outside of the hospital in Rochester (e.g. home birth). In Somalia, she said, many women she knows would give birth with the assistance of lay (informally trained) midwives, and in the refugee camps this way as well, since hospitals were miles away. Sadiya feels that many Somali women would love a birth center, and a focus group will be planned soon to discuss this topic. I (Katherine) will be meeting with Sadiya and Sahra next week to plan questions for a focus group.

Next Step:
Lois spoke today (Thursday 3/31) spoke with a representative from the Finger Lakes Health Systems Agency about getting a certificate of need so this can be opened as a non-profit. The process may take around a year but he does not foresee many obstacles. A few people at the meeting have research experience and expressed interest in helping conduct focus groups and surveys as needed to get us started in this endeavor :) More to come soon!

Please let me know if I have missed anything, I can edit this after the first post.