Meeting Public Comments

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HF 887

A bill for an act removing birth centers from the meaning of institutional health facility. (Formerly HF 277.) Effective date: 07/01/2025.

Agenda

Subcommittee members: Warme-CH, Pike, Trone Garriott

Date: Tuesday, April 1, 2025

Time: 12:00 PM - 12:30 PM

Location: Senate Lounge

Comments Submitted:

The purpose of comments is to provide information to members of the subcommittee.

Names and comments are public records. Remaining information is considered a confidential record.

03-28-2025

Rebekah Jacobs

HF 887 removes barriers of certifications, licensing, and staff requirements for birthing centers by removing it from the list of Institutional Health Facilities (The certificate of need (CON) is not the only one and legislation could have been written to simply remove the CON requirement). I understand that these are "low risk" pregnancies. But about 30% of low risk pregnancies have complications during Labor (I attached the source). Women die. These regulations help save women's lives. Please vote OPPOSED to HF 887.

Attachment

03-28-2025

Rachel Bruns

Please vote yes to HF 887. This bill with remove an unnecessary barrier for maternity providers to open a freestanding birth center, which is evidence based to improve outcomes and reduce costs. See attached for more information on birth centers and the impact CON has on limiting birth centers. Iowa is only one of a few states with zero birth centers. Please vote yes to remove this barrier for maternity providers.

Attachment

03-30-2025

Benjamin Larson [Nebraska Cardiac Care]

This bill should be shot down for a majority of reasons, and one of them isn't simply just that these regulations are written and scrawled in the blood of those lost before them but because Nurse Midwives, Doulas and Paramedics already exist that can preform births outside of hospitals. What's the point of removing a law, if you can still have other proven options available to you?

03-31-2025

Caitlin Hainley [Des Moines Midwife Collective]

CON legislation stifles innovation and raises costs. CON legislations prevents FREEDOM of CHOICE for Iowans. AABC has shown a direct link to Birth Center CON legislation and lack of birth centers. We have seen that in our state as Iowa currently has no birth centers. Statistics have shown a steady decline in Iowa maternal choice and health what if we did something different? Something shown to improve myriad outcomes? Birth centers have been shown time and time again to be safe and improve outcomes for moms and babies. Please support HF 887 and show Iowans that you believe in improving Iowa maternity care outcomes as well as birth freedom and family choice for maternal health care.

03-31-2025

Julie M

Please support birth centers in Iowa and allow women the ability to decide how they want to birth. I live in a birth desert and would have to drive upwards of an hour to give birth in a hospital. We NEED birth centers in rural Iowa!!

03-31-2025

M Ree

Please support HF 887. Allow Iowans choice for maternal health care, minimize the barriers of receiving care as many studies and articles show Iowa as a maternal health care desert. Many birth centers and hospitals have closed OB centers. I live an hour away from any large hospital would appreciate a middle ground for maternity care. Please support HF 887 and show Iowans that you believe in improving care outcomes and family choice for maternal health.

03-31-2025

Tracie Ahrens

I am writing in support of this bill that would remove the CON from birth centers. I am an RN and a mother of two children, one born in the hospital and one born at home, both delivered by Iowa certified nurse midwives. I and many mothers I know would have appreciated the option of giving birth in a birth center. Women deserve choice in where they give birth.

03-31-2025

Emily Terlouw

Removing birth centers from the CON will give the women of Iowa more quality healthcare options. Women should be able to give birth to their babies where they feel safest, and for some of us, that is not in a hospital setting. Birth centers in Iowa are one way to combat the ongoing issue of maternal deserts, which is a real problem for Iowa women."Childbearing people in the United States have less opportunity for midwifery care than in other highincome countries. In the United States, there are 4 midwives for every 1000 live births, whereas, in most other highincome countries, there are between 30 and 70 midwives. Furthermore, these countries have lower maternal and neonatal mortality rates and have consistently lower costs of care" (Combellick et al., 2023, p. S983). The evidence continuously demonstrates that women and babies have better outcomes with midwives and that women have better birth experiences. Please support HF 887

Attachment

03-31-2025

Amanda Lundstedt

Iowas maternity deserts and maternity care in Iowa needs to be addressed and improved. This legislation will help open access to birth centers and safe maternity care in Iowa and improve care. Please support this legislation to improve maternity and infant care throughout ALL of Iowa.

03-31-2025

Emily Lundgren

Please vote YES for HF 887 to remove this unnecessary hurdle to opening birth centers in Iowa. We NEED birth centers. Women deserve the right to CHOOSE how and where we give birth. Please vote yes to remove this hurdle to the opening of birth centers and support women in Iowa!

03-31-2025

Taiylor Laning

Please support birth centers and womens right to choose how they want to give birth. Low risk pregnancies should have the option to deliver in a more comfortable, supported, slower paced environment that feels like home. This would be a wonderful option alongside home births.

03-31-2025

Lauren Delgado

Please vote in favor of this bill & to remove the CON. Research supports birth centers & the positive impact it can have in communities. Iowa currently has no freestanding birth centers in our state & we could greatly benefit from one. As a nurse midwife and mother who has given birth in the hospital and at homewomen need choices. They should birth where they feel safest & most supported.

03-31-2025

Kayla Brown

The lack of birth centers in Iowa, a direct result of restrictive Certificate of Need (CON) legislation as highlighted by the AABC, is limiting Iowans' maternity care choices and contributing to a decline in maternal health indicators. However, there is a proven solution: birth centers. Repeatedly shown to be safe and to improve outcomes, supporting HF 887 will enable the establishment of these vital facilities. By passing this bill, we can demonstrate a commitment to enhancing Iowa's maternity care outcomes, expanding birth freedom, and providing families with greater choice in maternal healthcare.

03-31-2025

September Madison

Midwives and birth centers are essential to our community. My own experience twice over proved this. I was a 40 year old woman with my first pregnancy being told by doctors that they were going to do certain things to take my baby early only because of my age. I had a perfectly healthy pregnancy without any issues. The midwives and birth center gave me the opportunity to have both my daughters naturally while consistently keeping me safe and my babies safe.

03-31-2025

Shannon Lee

Iowa has too many rural maternity care deserts. Supporting this bill will allow providers to open birth centers to give better access and care to the women of Iowa. Please support this legislation to remove the CON for birth centers.

03-31-2025

Sarah Pimlott

I am a Birth and Postpartum Doula in the area and see the want and need for Birth Centers in our community firsthand. I gave birth myself at home and had a birth center with midwife care been an option to us we would have used one. We looked into going out of state to Nebraska, but with how quick my labors are it wasnt feasible. There are limited midwife groups in hospital setting in the area and they are all known to have waitlists. In many of the online forums I see moms recommending these midwives only to see other moms saying theyve called and they arent taking new patients with their due dates or comments like to get into them you have to call immediately after learning your pregnant.Iowa currently has 0 birth centers. Midwives have tried to open birth centers, but have been denied because of the certificate of need law. Iowa ranks 50th in the nation for number of maternity care providers per capita. We have several maternal healthcare counties with no maternity care. The certificate of need process thats currently in place is allowing the competitors to be the deciding factor on if there is a need or not. The same hospitals that are at max capacity, turning women away, and closing their L&D units are the ones saying there is not a need thus preventing freestanding birth centers from opening. We have midwives in our community who would open birth centers if only we would let them. We have families and women who want the option of a birth center and would benefit from having the option. As of 2021, there are 37 states in the United States that have freestanding birth my centers. Iowa should be added to this majority.

03-31-2025

Abby Nees

Please remove HF 887. Women deserve the right to birth where they feel most comfortable. Midwives are experts in birth and should be able to offer their services in a birth center to better serve our community. Statistics dont lie; women and babies have far better outcomes when supported by midwives. Please remove this unnecessary barrier for freedom of birth, women, and the future.

03-31-2025

Jennifer Leonhard

Please support this bill. Women need more options for maternal care. Hospitals are often overcrowded in particular months. I was rushed and pressured during hospital birth to give birth faster because they had too many women to care for. That was NOT good healthcare. Birth centers are a safe and lovely place for Birth. WE must remove the certificate of need.

03-31-2025

Emily Meyer

Please support HF 887 to give Iowa women the freedom to choose where they give birth. Expanding access to the birth center model of care is especially crucial for rural communities. The midwives leading this effort in Iowa are highly qualified and compassionate healthcare professionals committed to safe and personalized maternity care.

03-31-2025

Madison Beener

Please remove HF887. Women deserve to choose where they feel most comfortable to birth. Sometimes, personal home is not an option for mothers. Birth centers provide this space for those who need it. Midwives should be able to provide their services in a birth center. This is yet another unnecessary hurdle that women have to face to access birth freedom.

03-31-2025

Madison Beener

Please support HF887. Women deserve to choose where they feel most comfortable to birth. Sometimes, personal home is not an option for mothers. Birth centers provide this space for those who need it. Midwives should be able to provide their services in a birth center. This is yet another unnecessary hurdle that women have to face to access birth freedom.

03-31-2025

Brianna Boston-Kemple

Iowa needs more places for women to give birth, especially those who are low risk. I have had two births at the university of Iowa and had to drive 45 minutes to get there just for there to be no beds available on the labor and delivery unit. (2022 & 2024) having birth centers would increase options for women who are low risk and free up space for those with high risk pregnancies at the major medical institutions in our state.

03-31-2025

Taryn Temple

I moved to Iowa after giving birth to my first child in Colorado, where I had a good variety of options for care. I chose to give birth at a birth center there where I had a safe and empowering birth with highly skilled professional midwives and was very surprised to find that I didn't have that option anywhere in the state of Iowa. Just about any woman who has been pregnant here will agree that we need more options for care for women with lowrisk pregnancies. Birth centers can safely fill that need, especially when we have respected midwives who are ready to do the work of running them. Please support this bill.

03-31-2025

Jessica Block

Please support HF 887. Removing the CON for birth centers is critical for the state of Iowa. Many counties in the state are maternity care deserts. Additionally, passing this bill will open avenues of apprenticeship type training for young Iowans who want to pursue birthwork as a career. Women in Iowa want options when it comes to their well woman and maternity care, this bill gives hope to seeing those options become available.

03-31-2025

Dana McKeever Kent

Please support HF 887 to remove freestanding birth centers from the definition of institutional health facility thereby exempting them from the Certificate of Need.I am a mother who benefited from Iowas last freestanding birth center and associated midwifery services in Des Moines. Two of my 3 children were born at that birth center and I had a wonderful experience. I was looking for a middleground option between hospital and homebirth. Removing barriers to maternity care providers (such as our licensed midwives) who want to open birth centers in Iowa would increase access and options for quality maternal health care. I hear of many women who want this type of option, and women who are already traveling for care. We know this is a need in Iowa as birthing units close across the counties.

04-01-2025

Allison Doying

Please support HF 887. It would be a win for Iowa. Iowa is one of the few states that do not have birth centers. I gave birth to my first at a birth center in WI. Please give Iowa moms the right to choose another safe way to deliver a child. At home births are an option, but waste time and tire out providers with the amount of travel. Allow birth centers as a concentrated, high quality place of care.

04-01-2025

Sarah Sorvillo [Heaven Sent Homebirth]

Please vote in favor of this bill! There are already regulations for how licensed midwives practice in out of hospital settings. All the con does is create a monopoly and prevent freestanding birth centers from opening. Licensed midwives are trained for handling emergencies in out of hospital settings, and quite frankly are already doing the work of serving these rural maternity care deserts. We travel large distances to take care of families who have no birthing units near them. Opening a freestanding birth center in these areas would increase access to safe care without costing local hospitals a penny. Midwives are willing to open their own pockets and open these centers that we know can improve healthcare in Iowa and families WANT them!

04-01-2025

Jessica Koebrick

Please vote yes in support of HF 887 when it comes to the Senate HHS committee. This bill would remove birth centers from the definition of institutional health facility.This would effectively exempt freestanding birth centers from Iowas Certificate of Need law, which is a barrier to maternity care providers that want to open birth centers. Iowa is one of only a handful of states that currently has zero birth centers. Currently 30% of Iowa counties are classified as a maternal health desert, which could benefit from a freestanding birth center.HF 887 passed out of the Iowa House unanimously 950. This is a bipartisan bill and would reduce barriers for maternity care providers wanting to establish a birth center.Sincerely,Jessica Koebrick

04-01-2025

Jessica Koebrick

04-01-2025

Kari Ney

Please support this bill! Please take birth centers out of the certificate of need. Freestanding birth centers, provide an additional choice for women and provide a costeffective option that can save our state money and improve outcomes.

04-01-2025

Dawn Bollhoefer

As a birth doula and childbirth educator in central Iowa, I see firsthand the anxiety of women who have to travel to the hospital to deliver their baby because their local ob unit has closed. I see the stress on everyone involved when hospitals are so busy with delivering babies that women feel pressured and forgotten. Yes, homebirth is a wonderful and perfect option for some women, but other would feel more comfortable in a birth center setting and because of CON, birth centers are nearly an impossible option here in Iowa. Please support HF 887 and remove the barriers that Iowa midwives face in Iowa so that women can have more birthing options and the freedom to choose what is best for them.

04-01-2025

Dawn Bollhoefer