Not a hospital, not a home birth: The rise of the birth center

Story highlights

  • There are 313 birthing centers in the U.S.
  • Birth centers are covered by many insurers the same way a traditional hospital birth is covered

Greenville, South CarolinaKristen Shorey gave birth to her second baby this summer in a marble-lined bathtub surrounded by LED candles and rested afterward on a queen-size mahogany bed. She received no pain killers, never saw a doctor and was home with her newborn son, Rowan, seven hours after birth.

It was nothing like the hospital experience where she had her first son two years ago, she said. In fact, the June birth wasn't in a hospital at all but at the Greenville Midwifery Care & Birth Center. She delivered with help from a midwife instead of an obstetrician. Shorey, 25, labored in a water-filled tub rather than a small bed while hooked up to intravenous tubes and a fetal heart monitor -- her 27-year-old husband, Taylor, by her side.
"This was the most empowering experience of my life," she said.
    The upstate South Carolina facility is one of 313 birthing centers nationally and one of 113 opened since 2010, almost a 57% increase. It's also among a small but growing number of centers owned or affiliated with hospitals.
    There are nearly 4 million births a year in the United States and 98% still arrive in hospitals, but the increase in birth centers run by midwives has obstetricians, health insurers and hospitals taking notice. The number of babies born annually in birth centers has jumped 56% since 2007 to about 16,000, while total U.S. births have dropped nearly 10% in the same time, according to federal data.
    The Affordable Care Act has played a role in their growth. The 2010 law required state Medicaid programs to pay birth centers a facility fee, in addition to paying the midwives. Since Medicaid pays for nearly half the births in the United States, the extra funding has made running centers more economically feasible.
    Birth centers are covered by many insurers the same way a traditional hospital birth is covered. Since the length of the mom's and baby's stay in a birth center is so much shorter — hours instead of days -- and does not involve doctors or anesthesia, the costs of a normal delivery are about half those in a hospital, birth center officials say.
    They can be more economical for families, too, compared to hospitals, although how much depends on insurance coverage. Women who have health plans with high deductibles may save money at a birthing center, while others could have a health plan that will cover most of their hospital