ARI SHAPIRO, HOST:
Birth centers led by midwives are becoming more popular, but they're struggling to keep up with demand, and it's tough for some centers to manage rising costs. Bek Shackelford-Nwanganga of the Kansas News Service tells the story of a birth center in Kansas that went out of business, leaving an expectant mother with a last-minute decision.
BEK SHACKELFORD-NWANGANGA, BYLINE: When Kimberly Kleoppel envisioned the birth of her fourth baby, she pictured it at New Birth Company in Overland Park, Kansas, a midwife-led birth center for low-risk pregnancies with a home-like feel. She had her third baby there last year. Kleoppel told me about it while outside on a patio with her newborn.
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KIMBERLY KLEOPPEL: You walked in, there was essential oils. It's a very peaceful and calming environment. And it just felt more like, OK, maybe this is how it's supposed to be when you're having a baby.
SHACKELFORD-NWANGANGA: Kleoppel came to New Birth after two hospital births she says were really traumatic. She saw New Birth as a middle ground between having a baby at home and having one at a hospital. She liked that New Birth didn't feel clinical. But late this summer, when she was around eight months pregnant with baby No. 4, her midwife called and said the birth center was closing - eight days before her due date. Kleoppel says she hoped the baby would come early.
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KLEOPPEL: I don't want to go to a hospital. And when you're that late in the game, it's not exactly night and day to just change care teams.
SHACKELFORD-NWANGANGA: Ultimately, Kleoppel gave birth to her daughter at home in September with the help of a midwife she knew from New Birth. She says people in the area lost a lot when New Birth closed.
KLEOPPEL: Whether you deliver at home or whether you deliver in a hospital or whether you deliver at the birthing center, the luxury lies in having the choice. The luxury lies in having another option.
SHACKELFORD-NWANGANGA: New Birth Company was the only licensed birth center that wasn't part of a hospital in the Kansas City region. Kate Bauer is with the American Association of Birth Centers. She says although research suggests birth centers have better outcomes than hospitals with low-risk pregnancies, they're struggling to stay open.
KATE BAUER: We all know and have experienced firsthand inflation, and costs have gone up for birth centers to provide their services, yet their reimbursement has not gone up.
SHACKELFORD-NWANGANGA: Bauer says there's a lot of interest in midwife-led birth centers right now, but there aren't enough midwives or facilities to keep up. And there are shortages in maternal care in general. According to the March of Dimes, more than 35% of U.S. counties have no or limited access to any birth facilities or maternity care providers. Kendra Wyatt, New Birth Company's cofounder, says they had to close because the reimbursement rates from Medicaid and private insurance companies didn't cover their costs. She says when they closed, demand was at an all-time high. In Lawrence, Jodie Mayfield, a former New Birth Company midwife, is trying to fill the gap. Mayfield took me on a tour of the birth center she's working to open in a residential neighborhood. It will soon feature birth suites and a clinic.
JODIE MAYFIELD: A beautiful birth tub from - I got this from California.
SHACKELFORD-NWANGANGA: Mayfield says as interest in giving birth outside a hospital grows, women deserve more choices.
MAYFIELD: Women just - they're waking up to being more empowered. They want their own birth experience. They don't want to be told what to do. They know what to do.
SHACKELFORD-NWANGANGA: Mayfield says to do that, there need to be more birth centers, like Lawrence Birth and Wellness Center that will hopefully open early 2025.
For NPR News, I'm Bek Shackelford-Nwanganga in Kansas City.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.
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