On Thursday, the Alabama Department of Public Health (ADPH) passed regulations for privately owned and operated birth centers, despite an ongoing lawsuit challenging the rules.

For over a year, ADPH has courted a series of rules designed to regulate birth centers, drawing ubiquitous protest from birthing advocates nationwide.

The proposed rules would require birthing centers to acquire a hospital license and operate within 30 minutes of a hospital, among other things.

Opponents of the rules offer varying critiques, ranging from lack of accessible birthing care in rural areas, restrictions on those who do not want to labor in a hospital but cannot access a home birth, unrealistic and cost-prohibitive measures placed on birthing centers, and more.

Last year, ADPH also introduced similar regulations on birthing centers that those within the birthing community opposed. After saying it would address opponents' concerns, ADPH suggested the current rules, which are equally unacceptable to those assisting in out-of-hospital births.

Alabama previously had regulations for birthing centers, which it repealed in 2010 due to the lack of centers in the state.

Opponents said ADPH is proposing to essentially reinstate the previous rules that existed before midwives were permitted to deliver babies in Alabama, evidenced by the rules' antiquated language and terminology.

On Thursday, ADPH director Scott Harris said the new rules were tweaked to make them less restrictive, allowing them to go forward without further public comment.

When representatives from the Alabama State Board of Midwifery, The American Association of Birth Centers, the American College of Nurse-Midwives, and other similar organizations spoke during public comment, they claimed the ADPH did not consult them when formulating the rules.

ADPH's full response to the public comments can be found below.

August2023SCPHMeeting-Birth... by Craig Monger

Earlier this month, the American Civil Liberties Union (ACLU) sued ADPH on behalf of several birthing center owners over the proposed rules.

Many women nationwide have been switching to alternative methods of birthing children other than in the hospital, often choosing to have a midwife, doula or both attend their birth.

RELATED: Alabama advocates continue struggle for birthing rights

The reasons for choosing midwifery care over hospital care are many. Some have had previous negative experiences with hospital birth. Others prefer a less medical approach to what they consider a natural bodily function that requires no medical intervention outside of emergencies. 

Birthing centers offer a middle ground between a hospital birth and home birth. According to one speaker, birth centers allow a "home-like environment" for mothers to give birth while still having access to certain medicines and interventions in the case of an emergency. Otherwise, the mothers can give birth as they see fit, in line with their preferences.

While there are various levels of certification for different kinds of midwives, they all require extensive training, and licensed midwives have stringent regulations dictated by the state.

Alabama has only allowed certified professional midwives (CPM) to perform births for five years, although they are still excluded from participating in hospital births.

Among other things, the proposed rules would exclude CPMs from delivering babies in birthing centers, which is not the practice for other birthing centers nationwide.

To connect with the author of this story or to comment, email craig.monger@1819news.com.

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