American doctors have warned of safely risks after a law recently passed in Florida that will allow some Caesarean sections to take place outside a hospital setting.
The legislation passed in March will allow “advanced birth centres” to perform planned, low-risk, C-sections as part of an effort to expand access to maternal healthcare in the state, reports The Independent.
Some 19% of Florida counties were classed as “maternity care deserts” in a 2023 report after multiple hospitals closed their maternity wards.
But medical professionals are warning of the potential risks of the new scheme, part of Florida’s “Live Healthy” legislation package.
“We have serious concerns about the impact this model has on our collective efforts to improve maternal and infant health,” Mary Mayhew, CEO of the Florida Hospital Association told KFF Health News. “Our hospitals do not see this in the best interest of providing quality and safety in labour and delivery.”
Florida’s maternal death rate was 40.2 per 100 000 births in 2022, nearly twice as high as the national average of 22.3 per 100 000 births.
The state’s C-section rate was 35.9% in 2022, also slightly higher than the national average of 32%.
Under the new law, an advanced birth centre can operate so long as it has a board-certified obstetrician and board-certified anaesthesiologist as its medical directors; enters into a written agreement with an emergency blood bank service; has written protocols for managing obstetrical haemorrhaging; and follows the state’s healthcare agency rules.
The law also requires the centres to have an obstetrician with admitting privileges at a “nearby hospital” – but does not stipulate how close that must be to the centre.
Along with low-risk C-sections, an advanced birth centre can also perform vaginal deliveries between 37 and 41 weeks’ gestation, and vaginal deliveries on patients who have previously had C-sections.
Those with high-risk pregnancies are not allowed to use advanced birth centres for C-sections, and could be turned away due to potential complications.
But even low-risk patients “can suddenly need lifesaving care”, said Dr Cole Greves, chair of the Florida chapter of the American College of Obstetricians and Gynaecologists.
“Even with increased regulation, [advanced birth centres] cannot guarantee the level of safety patients would receive within a hospital,” he said.
So far, no advanced birth centre has opened in Florida but at least one facility, Women’s Care Enterprises, is exploring the option. The facility helped propose amendments to the new legislation.
See more from MedicalBrief archives:
Surge in the number of C-sections around the world
Hospital-led interventions slash Caesarean delivery rates
Tokophobia levels rise, linked to early births – US study