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Achieving optimal maternal health is critical to mothers across the Commonwealth and affects future generations in our communities. Nationally, improving maternal health has been a focus area due to high maternal mortality rates across the country. Kentucky also experiences similar negative maternal health outcomes with our maternal morbidity rate being the second highest in the country.
In 2018, Kentucky’s maternal mortality rate was 40.8 per 100,000 live births. This is significantly higher than the national rate of 17.4.
In 2021 Kentucky was among the states with the most c-section deliveries, which increases risk for maternal mortality.
Kentucky also has some of the largest disparities within maternal health, with Black women in Kentucky experiencing maternal pregnancy-related death at a rate three times that of White women.
Despite these outcomes, evidence shows that more than 90% of maternal mortality cases in Kentucky are considered preventable. Recently, Representative Moser in the recent IJC health services meeting wrote an Act relating to maternal health with bipartisan support. The Act focuses on preventative strategies such as establishing the Kentucky Psychiatric Access Program, expanding HANDS, strengthening the Kentucky Maternal Infant Health Collaborative, expanding Medicaid, special enrollment periods for mothers, and more. However, one of the items not addressed in the act was free standing birthing centers which has been a source of discussion in the legislature before the upcoming budget year.
Although there are now more than 400 freestanding birth centers in 40 states, Kentucky does not have any freestanding birth centers. Due to the lack of access to birth centers, women in Kentucky choose to cross state lines into Indiana,Tennessee, and West Virginia to receive this care. Recently, the Certificate Of Need (CON) task force heard discussion on removing the Certificate of Need requirements to establish free-standing birthing centers in Kentucky. The task force heard testimony about the trends around birthing centers across the country and birthing center outcomes.
Kentucky is one of eight states that does not offer free standing birthing centers.
Some states, such as South Carolina, have passed laws that eliminated CON requirements for ALL healthcare facilities including birthing centers and West Virginia amended their CON laws to exempt birthing centers and hospitals.
Studies have found that women that gave birth in birthing centers had fewer medical interventions and lower cesarean rates.
The American College of Obstetricians and Gynecologists recognizes accredited birth centers as an integral part of regionalized care.
Studies show significant cost savings for mothers utilizing birthing centers, particularly among Medicaid patients.
Maternal health is a complex issue that requires different strategies to improve the outcomes for future generations. By removing the Certificate of Need requirement for freestanding birth centers, Kentucky can expand access to an alternative to hospital delivery in a safe environment. This can remove current barriers to care for mothers and increase accessibility for safe birthing practices and improve maternal health within our commonwealth.
Yelena, of Lexington, Ky., is a member of the McConnell Scholar Class of 2024 at the University of Louisville. She is studying public health and political science.