Charlotte’s first non-hospital birth center debuts this weekend

Elizabeth Brooks delivered her first baby in a hospital. But for the second, due in January, she and her husband, Erik, wanted a more homelike setting, with a nurse midwife attending the birth.

They’ve signed up to use Charlotte’s first non-hospital-based birth center, which opens this weekend on Providence Road, about a block from Novant Health Presbyterian Medical Center.

It’s a spa-like setting, staffed by three certified nurse midwives who’ll support mothers in natural childbirth, without the drugs and interventions they might get in the hospital.

For low-risk pregnancies, the midwives provide everything from prenatal checkups to deliveries to followup care. And they have support from Novant Health in case something goes wrong.

Brooks, 22, learned about the center through social media, where some mothers were considering natural childbirth at home instead of high-tech hospital births. “So it’s nice that we now have this in-between option,” Brooks said.

The new center is a collaboration between Novant Health and Baby+Company, a Cary-based firm that operates five freestanding birth centers. Its year-old center in Cary, a partnership with Wake Med Health & Hospitals, has delivered about 125 babies and attracted patients from 60 miles away.

Twenty-eight pregnant women, including Brooks, have already arranged to give birth at Baby+Company in Charlotte, with due dates starting around Christmas, said Stephanie Godfrey, the lead midwife. She’ll be working with midwives Becky Yates and Alice Ann Hermanson as well as nurse and midwifery student Rebeca Moretto.

Only women who expect to have uncomplicated vaginal births will be accepted. “We keep the lowest of the low-risk here,” Godfrey said.

If women should develop complications during pregnancy, such as gestational diabetes or high blood pressure, they’ll be referred to an obstetrician. And if there’s a complication during labor or delivery, patients will be transferred to Presbyterian, where more than 5,000 babies were born last year. Doctors from Novant Health Providence OB/GYN will be on call and ready to take over.

“We want to make sure those patients can get to us in minutes,” said Dr. Chris Morris, the center’s medical director and one of the doctors at Providence OB/GYN. “We have tried to walk through every possible scenario…to make this as safe as possible for moms who choose to deliver there.”

Cara Osborne, founder and chief clinical officer of Baby+Company, said she has worked with Morris and Novant Health to make arrangements in case of emergencies, such as the need for a C-section. All patients will be registered with the hospital to make potential transfers “as quick and easy as possible,” she said.

“It is always the case that there is the risk of something not going well,” said Osborne, also a midwife. “We’ve done everything we can to manage that risk.”

Midwife laws vary

Midwives have delivered babies at home for centuries, before doctors began specializing in obstetrics and before hospitals began marketing maternity centers. They were often older women called “granny midwives.”

In 1900, almost all U.S. births occurred outside a hospital, and the vast majority occurred at home, according to a 2012 report from the National Center for Health Statistics. That fell to 1 percent by 1969, where it remained through the 1980s.

While still rare, home births have experienced a resurgence. After a decline from 1990 to 2004, the percentage of home births rose by 29 percent in 2009.

Options for midwives vary from state to state. Some, such as North Carolina, require them to be licensed registered nurses and have extra midwifery education and certification. N.C. midwives – 268 total – must have supervising physicians who can back them up in case of complications.

Other states, including South Carolina, issue licenses to lay midwives, also called certified professional midwives, and their educational backgrounds vary.

Proponents of home births have in years past tried unsuccessfully to persuade the North Carolina legislature to establish a licensing board for non-nurse midwives. The North Carolina Medical Society has opposed such a law, citing concern over patient safety.

In the Charlotte area, nurse midwives deliver babies at several hospitals. Novant Health has one nurse midwife at Presbyterian and four at Huntersville Medical Center. Carolinas HealthCare System has eight at its Pineville hospital, five at Carolinas Medical Center, and two at the system’s hospital in Shelby.

Not like Fort Mill

Besides Baby+Company, the nearest freestanding birth center in North Carolina is Natural Beginnings Birth & Wellness Center in Statesville, owned by two nurse midwives who also deliver babies at Davis Regional Medical Center.

These two centers – where nurse midwives have close collaborations with hospitals and doctors – are different from the now-closed Carolina Community Maternity Center in Fort Mill, where a baby died in January. A York County grand jury ruled the death a homicide, but there was no criminal investigation.

The Fort Mill center closed voluntarily in February, and returned its license to the state. Two years earlier, state regulators had temporarily suspended the center’s license, along with the licenses of two lay midwives, after a complicated delivery resulted in another baby’s death.

Leigh Fransen, a founder of the Fort Mill center and onetime midwife there, said she left the practice in early 2013 amid “growing discomfort with the industry in general.” As the center’s marketing director, she said she had promoted it as a safe place for natural childbirth and believed that was true.

“But I didn’t know what I didn’t know,” she said. “I was seeing more complications than I should have been seeing if it’s really safe.”

Today, Fransen believes birth centers should be operated only by certified nurse midwives who have formal transfer agreements with doctors and hospitals. “I finally came to the conclusion that birth isn’t that safe,” Fransen said. “The only reason it is is because of modern obstetrics. Doctors have made it a lot safer than it was before.”

‘Magic happens’

Baby+Company in Charlotte has three home-like labor and delivery rooms, complete with sleek white soaking tubs and large walk-in showers, big enough to “fit an entire family,” Godfrey said.

Each room is decorated in soothing grays and blues, with puffy white duvet covers on the beds and dark faux wood floors. Exercise balls and aromatherapy candles are provided, and water births are an option if the parents choose.

“This is where the magic happens,” Godfrey said.

Baby+Company has negotiated with Blue Cross and Blue Shield of North Carolina to reimburse for births based on “the entire pregnancy,” instead of separately for office visits and the delivery, said Osborne, the founder. That differs from typical reimbursement based on “things that you do,” she said.

One of the benefits of a birth center is that the cost is much less than a hospital. A typical vaginal birth in a hospital can cost about $18,000, according to a 2013 study by Truven Health Analytics. That compares to about $6,400 for a birth center visit, according to the American Association of Birth Centers.

Birth centers are less expensive because a midwife’s goal is to provide monitoring and support, with as little intervention as possible. For example, Baby+Company does not offer pain medicine or epidurals.

“We’re more high touch,” Osborne said, “and not so high tech.”

This story was originally published November 20, 2015 at 3:48 PM with the headline "Charlotte’s first non-hospital birth center debuts this weekend."