HMH outlines opposition to birth center

Hardin Memorial Health officials on Monday defended their opposition to an alternative birthing center in Elizabethtown, saying the center’s presence could place hospital obstetricians in uncomfortable positions of unfamiliarity.

Dennis Johnson, president and CEO of HMH, said he is “very strongly opposed” to the thought of a new center in the city because HMH would be responsible for emergencies arising with the center’s patients.

Mary Carol Akers, a local certified nurse midwife, has proposed The Visitation Birth and Family Wellness Center at 2813 Ring Road, offering low-risk, expectant mothers a “home-like setting” to deliver their babies and recover away from the environment of sickness found in a hospital. Akers has applied for a certificate of need with the Kentucky Cabinet for Health and Family Services and has been granted a hearing Feb. 20-21 at the Kentucky Bar Association in downtown Frankfort. A time for the hearing had not been released to Akers as of Monday morning.

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

Dr. Stephen Toadvine, chief medical officer at HMH, said the need for emergent care may be rare from the birth center, but every emergency poses serious risks.

“When there is one emergency, that’s a mother and her baby, and that’s life and death,” Toadvine said.

Both Johnson and Toadvine said obstetricians have raised concerns about treating women transferred from the birthing center because they did not play a part in the management of the pregnancy and have no patient-doctor relationships with the women.

Akers in response said she would provide HMH or any other hospital with all medical records and pertinent information needed to assist them in caring for patients.

“Patients aren’t helped if I’m withholding information,” she said.

Akers also pointed to other emergency circumstances in which a pregnant woman may need treatment at a hospital where the physicians have no prior working knowledge of her pregnancy.

“If a woman is coming down I-65 and wrecks, they don’t know anything about her,” she said.

HMH is expected to oppose the center during the hearing later this month. Flaget Memorial Hospital in Bardstown and Twin Lakes Regional Medical Center in Leitchfield also object to it, according to CHFS documents reviewed by The News-Enterprise. Representatives for Flaget and Twin Lakes have not replied to requests made by the newspaper for comment on the center.

Akers’ certificate of need application states the center would offer care by a dedicated midwife from admission until discharge. 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 application states the birth center would be more than 5,800 square feet and cost more than $850,000. The full structure would finish around 18,000 square feet and cost roughly $2.5 million, Akers said.

The remainder of the facility would house accompanying elements, such as clinical space, a large educational room and sleep rooms for staff on duty, she said. Akers said the facility would be developed on a “green model” minimizing excess disposed at a landfill.

Akers has not acquired the Ring Road property because the status of the certificate of need is unknown.

The center has received letters of support from several 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.

According to CHFS, regulations are in place for alternative birthing centers but no facilities of this nature are licensed in Kentucky.

“We welcome competition, but this is the only birthing center in Kentucky,” Johnson said. “And I’d rather the only birthing center in the state not be in our back yard.”

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