Remove Obstacles for Midwife Led Birth Centers in New York

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To Governor Cuomo and Members of the New York State Maternity Task Force,

We are a group of midwives, birth professionals, organizations and stake-holders in support of increasing access to Midwife-Led Birth Centers (MLBCs) in locations across New York State. 

MLBCs were legalized in 2016 and regulations for them were passed in 2019, but it wasn’t until grassroots efforts and the Task Force's intervention after the peak of the COVID-19 pandemic and appeal to the Governor that demanded that the Department of Health complete the licensing process for MLBCs in New York State that the Department of Health, following your deadline, released guidelines for the New York State’s Certificate of Need (CON) process required for licensure. We have found the new application process to be cost prohibitive and excessively cumbersome for what a Midwife-Led Birth Center is and we are asking for your help to ease this burden.

We urge the NY Maternity Task Force and Governor Cuomo to use executive authority to exempt independent Midwife-Led Birth Centers from this onerous Article 28 Certificate of Need Application Process, and instead grant all MLBCs deemed status for the Article 28 Certificate of Need to those that meet CABC Freestanding Birth Center accreditation guidelines, thus honoring the intent of the Task Force to create safe alternatives for out-of-hospital birthing sites during the COVID-19 pandemic and beyond.

  • The CON process requires significant upfront investment – with estimates ranging up to $75,000 – in order to secure architectural drawings, legal information, and a designated consultant to navigate the complicated process before an approval for construction is even issued. 
  • This, in addition to the numerous regulations that Article 28 facilities are under (i.e., FGI requirements and NFPA Codes), significantly increases construction costs which create significant hardships for project completion. 
  • It is well known that midwives receive less compensation than obstetricians and MLBCs are financially independent from the industrial hospital systems within their communities, so there are substantial hindrances in access to large amounts of capital to meet the demands of these requirements.
  • This CON process was meant to keep industrialized healthcare facilities from spreading too rapidly and increasing costs in each community. Placing MLBCs in the same category as industrialized hospital systems is like comparing an independent small business to a corporate chain. They are in two very different types of facilities  offering very different types of services. While Birthing Centers focus on care for low-risk clients, hospitals focus on care for those with much higher risks, using higher amounts of medical interventions for care.
  • Many states in the US utilize the rigorous accreditation by the Commission for the Accreditation of Birth Centers (CABC) as the only requirement of licensure for birth centers.   As the basis for accreditation, the CABC uses the Standards for Birth Centers, developed by the American Association of Birth Centers, and rooted in evidence-based practice. In multiple studies, these standards have proven to promote safety along with the numerous positive outcomes that freestanding birth centers are known to achieve for birthing people.  Additionally, the research clearly indicates health care outcomes are not improved by applying CON processes in the birth center setting, and instead hinder their ability to become established.
  • While the state has admirably fast-tracked the opening of the temporary Jazz Birthing Center, NYC and the Refuah Health Center in Valhalla, both are temporary Physician-Led Facilities; do not fall under NYCRR Part 795; and are required to go through this onerous CON process as well.

 Without such an order it will be years before any MLBC is able to open, which during a pandemic and crisis in maternal mortality is unacceptable. 

We cannot afford delay. If we truly value innovative change and real solutions to the maternal mortality epidemic  in our state, we must create inroads that allow for that innovation to thrive without being weighed down by costly, ineffectual CON processes.This is especially true in the under-resourced locations where lack of access to capital is a reality making an expensive CON process even more prohibitive for those MLBCs.

We are grateful for the immense work you have done thus far to achieve these advances for MLBCs, and we urge you not to relent in your work until the opportunity embodied by MLBCs is feasible and begins to be realized for midwives and birthing people across our state.

This petition is led by: 

Neelu Shruti, Love Child Yoga & Haven Midwifery Birthing Center
Bridget Strub, Radiant Wellness & Birthing Center
Myla Flores, The Birthing Place 
Bruce McIntyre, Save A Rose 
Katy McFadden, Brooklyn Grows 

Interested in joining or supporting our advocacy work more in the future? Get involved here!

With support from:

Trinisha Williams LM, NPH

Shar La Porte CNM, LM


Andrea Diamond CNM, LM, CLC, HBCE, CHP

Neelu Shruti, Midwifery Student, RPYT, CBC

Haven Midwifery Birthing Center, NYC

Myla Flores, CD(DONA), LCCE, SpBPCE, CLC

Nubia Earth Martin, MS in Midwifery Nuranisa Rae, LM, CNM

The Birthing Place, Riverdale, Bronx NYC

Danielle Assibu-Gilmore, MSN, CNM Bridget Strub, CD(DONA), LCCE

Radiant Birth Center & Wellness Care, Rochester, NY

American Association of Birth Centers (AABC)

Jennifer Seymour, BA, BSN, CNM, LM, MSN

Cocoon Wellness & Birth, Waverly, NY

Lisa Benedetto, MSN, CNM, LM

Indian Creek Midwifery & Birth Center, Ithaca, NY

Sunday W. Smith, CNM

MidwifeSunday, P-LLC, Potsdam, NY

Carmen Mojica, CPM Evelyn Alvarez, CD, CLC

Nicole JeanBaptiste, CD, CLC

Bx (Re)Birth and Progress Collective, NYC

LaShanda Dandrich, IBCLC

Uptown Village Cooperative, NYC

Emilie Rodriguez

Janee Aiken

Ariel de Roche

Guramrit LeBron, CD, CLC

Ashe Birthing Services, Bronx NYC

Samantha Huggins CD(CHB), CBC Lindsey Bliss CD(CHB)

Carriage House Birth, Brooklyn, NY

Ithaca Doula Collective, Ithaca, NY

The Doula Cooperative of Rochester, Rochester, NY

LaKeisha Washington, MPA, CD(DONA)

Flower City Doula Services, LLC, Rochester, NY

Helene Thompson-Scott, CNM

UR Midwifery Group, Rochester, NY

Amy V. Haas, BCCE

Healthy Birth of Rochester, Rochester, NY

Brigitte Rhody-Garrison, CNM

MS Seasons of Life Women's Health, Rochester, NY

Bruce McIntyre

Save A Rose Foundation, Bronx NYC

Mimi Niles, PhD, MPH, LM Whitney Hall, LM, CM, MA, MS

New York State Birth Center Association (NYSBCA)

Takiya Sakina Ballard, CNM, LM, IBCLC, MA

Sakina Health

The Savvy Black Birther Podcast, Hempstead, New York

Monique Colón, Full Spectrum Birth Keeper

CPC Birth and Body Wellness