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Bold move: Doctors sanctioned for off-site C-sections

Doctors sanctioned for off-site C-sections

United States:  Siding with a physicians organization owned by private equity, Florida has become the first state to permit doctors to perform caesarean sections outside of hospitals. The group claims the shift will reduce expenses and provide pregnant women with the more comfortable delivery environment that many prefer.

Private Equity-Backed Initiative

Performing C-sections at doctor-run clinics will raise the risks for women and newborns when issues emerge, according to the hospital sector and the top obstetricians’ group in the country, despite the fact that some Florida hospitals have closed their maternity units in recent years.

Cole Greves, an Orlando perinatologist and the chair of the Florida chapter of the American College of Obstetricians and Gynecologists, stated in an email to KFF Health News that a pregnant patient who is deemed low-risk one minute may need lifesaving care the next. The new birth clinics are unable to provide the same level of patient safety as a hospital, “even with increased regulation.”

Risks and Concerns

A rule that was passed this spring permits “advanced birth centers,” where doctors can perform C-sections or vaginal births on patients.

Women’s Care Enterprises, a physician organization primarily located in Florida but also with offices in California and Kentucky, is owned by private equity and successfully lobbied the state government to implement the change. Women’s Care was acquired by London-based investment group BC Partners in 2020.

“We have patients who don’t want to deliver in a hospital, and that breaks our heart,” stated Stephen Snow, who spoke in front of the Florida Legislature in 2018 and recently retired from Women’s Care as an OB-GYN.

C-sections, which include making an incision in the mother’s abdomen and uterus to deliver the baby surgically, account for nearly one-third of births in the United States. Physicians typically do the treatment when they think it is safer for the mother, the child, or both during vaginal delivery. These kinds of medical decisions might be made in an emergency or months before the baby is born.

Legislative Changes and Response

The birth center bill’s Republican author, Florida state senator Gayle Harrell, noted that while having a C-section outside of a hospital may seem like a drastic departure, so did the establishment of outpatient surgical centers in the late 1980

Patients may mistake advanced birth centers for the free-standing, low-risk birth centers that have been in operation for decades and are managed by midwives, according to Kate Bauer, executive director of the American Association of Birth Centers. According to her, there are 411 free-standing birth centers in the US and 31 licensed birth centers in Florida at the moment.

Criticism and Comparison

According to Bauer, “this is a radical departure from the standard of care.” She called it a “bad idea” since it might put mom and the unborn child at greater risk.

Other than in hospitals, no other state permits C-sections. The only place providing comparable care is a birth clinic in Wichita, Kansas, which is attached to Wesley Medical Center, a hospital, via a short hallway.

Approximately 100 infants are delivered monthly by staff members in the “hotel-like” maternity suites at the clinic, as opposed to the 500 that are delivered monthly in the hospital.

The idea functions well, according to Morgan Tracy, a maternity nurse navigator at the center, because patients can be promptly sent to the main hospital in the event of difficulties and staff and medication access can be shared between the hospital and birthing suites.

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