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Birthing center seeks state approval

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First center of its kind in state opposed by HMH, area hospitals

By Marty Finley

Mary Carol Akers believes women need more birthing options in Kentucky, but she will have to ward off three hospitals in the region to establish the first alternative birthing center in the state on a proposed Ring Road site.

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Akers, a certified nurse midwife, has applied for a certificate of need with the Kentucky Cabinet for Health and Family Services to establish The Visitation Birth and Family Wellness Center in Elizabethtown.

Securing a hearing on Feb. 20 and 21, Akers had not been issued a venue for the hearing as of Friday but said she has lined up experts to testify on her behalf and performed the necessary research to defend the center.

Certificates of need are required in Kentucky to safeguard against the proliferation of healthcare facilities, health services and major medical equipment that would raise the cost of health care.

Beth Fisher, public information officer for CHFS, said the state has regulations in place to license alternative birthing centers but none are currently licensed in Kentucky.

According to Akers’ application, the facility would be a non-hospital based, freestanding birthing center serving low-risk, expectant mothers who wish to avoid the confines of a hospital but need more support than their homes provide.

“I want you to know that women deserve another option,” she said Friday.

Akers’ certificate of need application states the center would offer care by a dedicated midwife from admission until discharge, offering safe and comfortable deliveries in a home setting. The certified nurse midwife would have the authority to prescribe medication, provide prenatal care to the mother, manage the birth and care for the mother and child post-delivery, according to the application. The facility would serve mothers for a two-day period of labor, delivery and recovery.

“The Birth Suites are spacious and home-like, but have immediately available supplies to support normal uncomplicated births,” the application states. “The VBFWC will not confine mothers to beds or even to their rooms, they are not encumbered with monitors or IVs and can move freely as they want during labor. Even the choice of birth position is the mother’s.”

Akers said there is a deprivation of alternative birthing options in Kentucky compared to adjoining states, which have several birthing centers to choose from.

But she has a fight on her hands as Hardin Memorial Hospital, Flaget Memorial Hospital in Bardstown and Twin Lakes Regional Medical Center in Leitchfield publicly oppose the application, according to documents submitted to the cabinet. Akers expects all three hospitals to testify against the center during the hearing.

“Hardin Memorial Hospital is opposing the application due to legitimate patient safety concerns,” said Michelle Murphy, director of marketing and public relations for HMH, in an e-mail. “It is our understanding that other hospitals are also opposing The Visitation Birth Center.”

Murphy did not expound on what safety concerns the center’s existence poses and declined to comment further. Representatives for Flaget and Twin Lakes did not return calls made by The News-Enterprise seeking comment for this story.

Akers believes the center and hospitals can co-exist, saying it would look to HMH in particular for medical transfers when needed. However, she said, they don’t seem interested in a partnership.

“I like doctors,” Akers said. “I think if you’re sick or need surgery, they’re the best thing in town.”

HMH has spent millions in recent years on the acquisition of private medical practices as it looks to expand its footprint and increase revenue with the advent of health care reform. This strategy, though, has created detractors who view HMH’s plans as an attempt to monopolize local health care.

Akers has heard from opponents who believe hospitals will be forced to clean up the center’s mistakes. But few mistakes are made after 32 years in midwifery, she said.

If licensed by the state, Akers will acquire 2813 Ring Road for construction of the facility, which would take approximately a year to complete.

“I don’t own that property, and there’s no sense in buying it if I don’t get the center,” she said.

The application states the birth center will stand at more than 5,800 square feet at a capital investment of more than $850,000, but Akers said the full structure will be around 18,000 square feet and cost roughly $2.5 million. The remainder of the facility will house accompanying elements, such as clinical space, a large educational room and sleep rooms for staff on duty, she said.

Some of the center amenities noted in the application are a sitting area for families, a family retreat/meeting room, a scrub area, a clean/sterile work space, laundry room, a soiled linens area and a business office.

Akers, who is referred to as executive director in the application, expects to start with a staff of roughly 10, around three of which would be midwives. The center will have a physician’s presence, she said.

As it develops over time, staffing numbers likely would increase. The center has applied for 501 (c)(3) status and will retain a lawyer and financial advisor, she said.

Akers said mothers are “begging” for more options as she receives roughly one phone call a day in favor of the center’s licensing.

Carrying around a thick binder detailing each step of the application process, Akers touted letters of support from notable institutions, including the University of Minnesota School of Nursing, Vanderbilt University School of Nursing, the American Association of Birth Centers and Frontier Nursing University of Hyden. Those letters will be submitted as evidence during the hearing, she said, and several friends, colleagues and supporters are traveling to Kentucky to support her.

Melissa Willmarth, a practicing midwife and a midwifery educator for the University of Cincinnati College of Nursing, penned a letter of support for the center in October. Willmarth argued the center’s existence could give student midwives a suitable environment to study outside of a hospital as midwifery has shown to be a cost-effective and safe alternative to traditional forms of medicine.

“There are very few opportunities in the state of Kentucky in which students can obtain this valuable experience,” Willmarth stated in the letter. “As a midwife, I believe it is also important to support the voice of the women that we serve. Many women are choosing safe, low-intervention options for birth in our state. Hospitals are often the place for ill or injured patients. Birthing women and families are experiencing a normal physiologic process in their lives and the birth center would allow them a safe, nurturing environment in which to choose.”

Marty Finley can be reached at (270) 505-1762 ormfinley@thenewsenterprise.com.