Meeting Public Comments

Rachel Bruns [International Cesarean Awareness Network of Central Iowa]

Please vote yes for this bill. Certificate of Need is outdated and is keeping freestanding birth centers from opening. As of 2021, less than 15 states (including Iowa) require CON for birth centers. See attached map.Removing birth centers from the Certificate of Need process would increase access to freestanding birth centers and improve access to care options. Numerous studies reaffirm that midwifeled care in community settings (birth center or home) have similar or better outcomes than those who give birth with medical providers in hospitals. This 2019 report confirmed that birth centers deliver improved health outcomes at a lower cost, averaging 21 percent lower cost of birth and 15 percent lower cost for care for women and infants for the first year after birth. https://www.birthcenters.org/news/strongstartnationalreportAnother 2013 study found the cesarean rate for women in birth centers is more than four times lower than what is seen among lowrisk women in the U.S., creating significant cost savings and reducing preventable cesareans that otherwise could lead to other health problems and challenges with future births. https://www.birthcenters.org/news/nbcs2The Institute for Medicaid Innovation's 2020 report on Improving Maternal Health Access, Coverage, and Outcomes in Medicaid indicated that midwifeled careincluding in freestanding birth centersresults in improved care, better outcomes, and costs less.