Florida law allows C-sections outside of hospitals

Within a new package of Florida healthcare laws is a debated measure to allow advanced birth centers to perform cesarean deliveries, permitting the surgical procedure outside of the hospital setting. 

The change is part of a package of healthcare laws signed by Florida Gov. Ron DeSantis March 21. Under the legislation, SB 7016, standalone birth centers that receive a new designation as an "advanced birth center" will be allowed to perform "planned low-risk cesarean deliveries."

The law permits advanced birth centers to conduct expected vaginal deliveries from the 37th to the 41st week of gestation, trial of labor after cesarean deliveries for eligible patients, and planned low-risk cesarean deliveries. The law does not specify what constitutes a low-risk cesarean delivery.

The new advanced birth center designation rests on several qualifications. The birth center must be operated and staffed 24 hours per day, 7 days per week; employ two medical directors — one obstetrician and one anesthesiologist; have at least one surgical suite for cesarean deliveries; employ and ensure at least one registered nurse is present in the center at all times; and have a written agreement with a blood bank for emergency services and written protocols for management of obstetrical hemorrhages.

In 2021, nearly 36% of total births were cesarean section deliveries in Florida, according to the CDC. That is the third-highest C-section rate in the U.S. compared to the national average of 32.1%. To address this, many hospitals across the state have implemented initiatives to lower C-section rates, particularly for low-risk, first-time pregnancies.

Lawmakers who spearheaded the healthcare legislative package, Live Healthy, that contains the measure to permit advanced birth centers to perform planned cesarean deliveries suggested the change is meant to increase access and address maternity care deserts in Florida. A 2022 report from March of Dimes showed 19.4% of Florida counties are defined as maternity care deserts compared to 32.6% of counties in the U.S. overall.

The measure was met with concern by the Florida Hospital Association and remains an area of disagreement. 

"FHA was opposed to the establishment of advanced birthing centers due to a deep concern about the safety and welfare of moms and babies," the association said in a statement shared with Becker's April 22. "We do not believe it is safe to perform C-sections at these free-standing centers. For this reason, we believe that C-sections should be performed in the hospital setting, where doctors, specialists, sophisticated equipment, and other critical resources are immediately available should complications arise." 

Some Florida lawmakers also expressed concern about the measure, before the bill was signed into law, about safety precautions at the centers and whether they would operate in rural areas, CBS News reported in January. 

Modern freestanding birth centers, unaffiliated with hospitals, date back to the 1970s. They originated in response to growing consumer concern about unnecessary medical interventions in hospital settings and desire for more control in the birthing process. 

There are currently 400 independent birth centers in 40 states and Washington, D.C., defined by the American Association of Birth Centers as "facilities designed to provide care to women with low risk pregnancies who want a choice between a hospital and home birth and want to participate in their own care." 

One other specific measure within Florida's Live Healthy legislative bundle that has drawn attention is a requirement for all hospitals with emergency departments — including hospital-based off-campus EDs — to submit a plan to the state that details how they will help patients access the appropriate care setting if and when they present to the ED with a non-emergent condition or do not have regular access to primary care.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars