Developments in Brief : Birth Centers Rated as Safe Alternative

A new California study of statewide independent birth centers has concluded that they offer safe, low-cost care to prospective mothers who expect to have normal deliveries.

But the future of the centers, which provide out-of-hospital birth services by physicians and certified nurse-midwives, depends heavily on their obtaining coverage by health plans and liability insurance, according to researchers at the UCLA School of Public Health. They conducted the study for the California Department of Health Services.

The study authors, Dr. Gary Richwald and Pamela Eakins, said the growth in the number of birth centers from three in 1979 to 25 in 1985 has caused a “major transition in the way childbirth and health care in general is done.”

They said that the centers, when following strict medical protocols, offer “safe, highly personalized care, informed consent and a more active role for the patient in decision-making in a medically safe environment.”

Despite that record, however, the difficulty in obtaining malpractice insurance ranked first among the problems facing the centers, the study found. By the end of 1985, 13 of 22 centers in the study were practicing without professional liability coverage.