July 14, 2000

New center increases area birthing options

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Numerous officials from VUSN, the Kellogg Foundation and Metro Government, including Nashville Mayor Bill Purcell (third from left) were on hand for the recent East End Women’s Health and Birthing Center’s grand opening. (photo by Tommy Lawson)

New center increases area birthing options

Not a week goes by that Certified Nurse Midwife Carlotta Crawford doesn't get a call about birthing options in the Nashville area.

Her advice on delivery choices boiled down to hospital deliveries with physicians or certified nurse midwives, or at home with a lay midwife.

Although many in the nurse midwifery field applauded Nashville for offering choices, there was still a void.

Now the first freestanding birthing center in Nashville is open and seeking to fill that void, hopefully providing the answer many women and midwifery professionals have been waiting for.

"While midwifery is not a preference for all, the birthing center is ideal for many," said Crawford, director of nurse midwives at the East End Women's Health and Birthing Center.

"There is a desire for this kind of care. It gives women one more option."

The East End Women's Health and Birthing Center, located in East Nashville, is the first of its kind in the area as well as the first in a network of centers expected to span the state.

Funded by a grant from the Kellogg Foundation, Vanderbilt University School of Nursing opened the center to increase the access to maternity and well-women services in the area.

Operation of the center was recently subcontracted to United Neighborhood Health Services, which has been providing primary care to the under-served residents of East Nashville since 1976 through the Cayce Family Health Center. Vanderbilt will continue to administer the grant monies as well as evaluate the center for the next three years. Metropolitan General Hospital will provide backup.

The center is located at 205 South 10th St.

"The center is ready for on-site births," said Mary Bufwack, CEO of United Neighborhood Health Services. "It's an expansion of services from what was previously available."

Bufwack said the center is a great opportunity to bring good prenatal care and women's services to the community.

"Our goal is to improve the infant mortality rate and the infant birth weight in this area. The full range of care we will be able to provide will have a significant impact on the health of women, adolescents and children."

The East End Women's Health and Birth Center was opened in December 1999. Midwives began seeing patients months prior in August in another location while the current building was under construction.

"The philosophy of the birthing center concept is that pregnancy is a normal, family-centered physiological event," said Crawford. "It's not a sickness. It's not an injury. It's a normal event for women.

"The birthing center offers an opportunity for all families of Nashville to experience birth in a different way. The birthing center is a maximized home, not a mini hospital."

The grant, $5.2 million for five years, provides for one urban center and four rural sites in Tennessee. The first rural center will open in Waynesboro later this year. The Nashville site expects to have at least 10 births a month.

A full range of services are offered, from prenatal to postpartum, newborn care and well-women check ups.

The center, a 4,000 square-foot building, has three birthing rooms, three exam rooms, a family waiting room and a counseling/classroom that also serves as a video room and a kitchen.

According to Dr. Peggy Alsup, the medical director of the AIDS Center for the state of Tennessee, the center is an important trend in delivery and birthing options.

"To say that this will be a model for other birthing centers is for certain," Alsup said. "It addresses the unmet needs which includes access to a variety of health services and it's an entry point into the health care delivery system."

The "birth" of such a concept sparks a sense of completion for Alsup. Although she has been retired for nearly 15 years from the Department of Health and the chair of the Board of Licensure of Health Care Facilities, it was under her tenure that the first birthing center in the state was established in East Tennessee.

The guidelines of the center are simple — no high-risk births, no epidurals and most classes are mandatory. An ongoing risk assessment is completed during each visit.

Any patient that is deemed high risk is required to birth in the hospital. Midwives will continue seeing the patient until hospitalization is needed.

There is another aspect of the center that is attractive to both clients and medical professionals — the cost of birthing and providing services.

"The cost is typically half that of a hospital and the outcomes are just as good," Crawford said.

The center will also be one of the clinical training sites for certified nurse midwife students.