Connecticut governor proposes expansion of maternity care amid closures

Connecticut Gov. Ned Lamont has proposed a bill to expand birthing care across the state after dozens of maternity health centers nationwide have shut their doors in recent years.

The bill was proposed in direct response to "several pending requests submitted by hospitals to close their labor and delivery facilities," according to a March 13 news release from the Connecticut Department of Public Health.

If passed, the bill would ease certification requirements for doulas and look into certification pathways for midwives, establish freestanding birth centers to operate as an alternative to hospitals, and create an Infant Mortality Review Program with the Department of Public Health to investigate infant deaths and how to prevent them.

The Connecticut Hospital Association supports the idea of expanded care, but ahead of the state Senate's hearing on the bill issued a letter highlighting several concerns about its proposed language.  

"While CHA and its member health systems and hospitals support the broadening of patient choice in all areas of reproductive health, including creating better infrastructure for home and out-of-hospital planned births, we have significant concerns about the language in the bill relating to birthing centers," the letter states. 

The concerns are two-fold: The CHA argues the creation of birthing centers is important, but not sustainable without structure and regulation in place before they are created. 

"Before any birthing center is approved, clinical thresholds and protocols, mandatory clinical guidelines, stakeholder review, public oversight and transparency must be in place — and accomplished in a way that would meet typical standards of administrative procedure," the letter states. 

It also argues that language in the bill is worded in a way that makes hospitals a "backup" plan to birthing centers and that hospitals cannot refuse a contract with these centers, which CHA says is an approach that "lacks sufficient due process or legal procedure and should be rejected by the legislature." 

It notes that hospitals will treat any patients who transfer from birthing centers if that is needed, but underscores that "patients are not served by a broad mandate that requires hospitals to become the backstop for birthing centers but does not have sufficient developed structures or the necessary features in place to monitor, oversee, and track birthing centers' operations."

Mr. Lamont's proposed bill is also supported by Connecticut state Sen. Saud Anwar and Reps. Robyn Porter, Cristin McCarthy Vahey and Trenee McGee.

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