Siding with a physician’s organization owned by private equity, Florida has recently made it legal for doctors to perform surgeries, including cesarean sections, outside hospitals. The group argues that the move would cut costs and allow many pregnant women a more relaxed delivery, which they prefer.

Although some Florida hospitals have abandoned their maternity wards in recent years, the hospital business and the major obstetricians’ group in the country argue that conducting C-sections in doctor-run clinics will raise the dangers for women and babies when complications arise.

A rule that permits “advanced birth centers” was passed this spring. At these facilities, doctors can perform vaginal births or C-sections on women who are judged to have a low risk of complications. The clinics would allow women to spend the night.

C-sections, which involve making an incision in the mother’s abdomen and uterus to deliver the baby surgically, account for about one-third of births in the United States. Physicians often perform the procedure when they believe it is safer for the mother, the child, or both compared to vaginal delivery. These medical decisions might be made in an emergency or months before the baby is born.

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

According to Harrell, who oversaw her husband’s OB-GYN practice, birth centers will need to adhere to the same strict guidelines as outpatient surgical centers for staffing, infection control, and other matters.

Although most insurers and Medicaid fund treatment at midwife-run birth centers, it is uncertain if insurers will cover the advanced birth centers. The advanced birth centers will exclusively treat patients whose insurance contracts with the facilities, meaning they are in-network, and will not take walk-ins in case of emergency.

The organization intends to construct an advanced birth center in the Tampa or Orlando region, according to Snow, a retired OB-GYN with Women’s Care. He stated that the idea of advanced birth centers is an upgrade over midwifery care, permitting births outside of hospitals since the facilities let women stay overnight and provide anesthesia and C-sections if needed.

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

No other state allows C-sections to be performed outside of hospitals.

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