Elizabeth Seton Childbearing Center (ESCbC) Closure News and Information

About Friends of the Birth Center

Friends of the Birth Center (FBC) is a non-profit organization of community volunteers comprised of birthcenter families and supporters and coordinated by 2 former Elizabeth Seton Childbearing Center (ESCbC) staff members, Kristen Stehle and Maria Freytsis. The group (then known as Friends of ESCbC) was initially created with the simple goals of publicizing ESCbC projects and services in addition to gathering volunteer support from the community. As the forced closure of ESCbC was announced, it quickly changed its mission and evolved into the non-profit organization it is today. The Friends of the Birth Center maintains a site at http://www.friendsofthebirthcenter.org/

About Elizabeth Seton Childbearing Center

Elizabeth Seton Childbearing Center (ESCbC) is not only the first freestanding birth center in the country, but also the only freestanding birth center in Manhattan. It was formed almost 30 years ago as an option for women who wanted an alternative to hospital birth. It currently serves a diverse population of women and families from the 5 boroughs, Westchester, Long Island, New Jersey and Connecticut. 30% of these women hold Medicaid as their insurance providers.

Historically, ESCbC has provided not just prenatal care, but care to women throughout their life span. The birth center’s philosophy is based on the principle that women have the right to health care that is safe, fits their life-style, and recognizes and respects their individual, physical, social, spiritual, psychological and economic needs.

ESCbC sets the standard for family-centered maternity care. Birth at the birth center provides a safe option for healthy women with low risk pregnancies to experience childbirth.

On September 1, 2003, ESCbC was forced to close its doors due to an astronomical increase in malpractice insurance premiums that it could not afford to operate. As a result of this closure, the birthing options of women in New York City and the surrounding region are severly limited.

ESCbC's Operational Facts and Figures

• C-section rate of 10% - national c-section rate of 26% (according to CDC report in 6/03 - the highest since the agency began tracking the rate in 1989.)
• Episiotomy rate of 3% - national average approximately 40%
• Breastfeeding rate 99% - national average is 67% at discharge from the hospital. (The Surgeon General's goal for Healthy People 2010 is that 75% of women are breastfeeding at discharge and 50% are breastfeeding at 6 months.)
• Serves a client population that is 30% + Medicaid
• Is a single tiered system of care -- all patients receive the same quality, women centered health care regardless of their insurance status; there is no separate clinic for Medicaid patients.
• The birth center offers GYN and primary care services, as well as quality prenatal care for women with low risk pregnancies. We offer full scope contraceptive options, including teaching on fertility awareness, STD testing, Safer Sex Practice counseling.
• Other services: childbirth education, prenatal support groups, prenatal yoga, massage, acupuncture, post partum support groups, mothers groups, post partum depression support group, baby and toddler play groups, Spanish Language toddler play group HOLA!
• Open for 6 years at current location and 28 years, counting previous site of MCA birth center (oldest such free-standing center in the US).
• Employ staff of 9 midwives, a women's health nurse practitioner, 15 nurses, 6 administrative/support staff (all women).
• Home for Childbirth Education Association of Metropolitan New York, Metropolitan Doula Group.
• House 4 exam rooms, 3 birth rooms equipped with huge showers, jacuzzi tubs, plus necessary medical support equipment that is conveniently hidden in home like cabinetry.
• One of the only facilities in NYC that offer water birth as an option.

General Client Stats

• Average of 600 GYN clients seen per year
• Average of 420 prenatal clients seen per year
• 227 ESCBC clients delivered at the center in 2002
• 112 ESCBC clients delivered at Saint Vincent's in 2002
• 30% of ESCBC clients are Medicaid -- the rest have insurance or are self-pay

Facts and Figures About Certified Nurse Midwifery in New York

The following information was taken from the American College of Nurse Midwives (ACNM) website.

• Certified Nurse-Midwives (CNMs) have been practicing in New York since 1930. The first nurse-midwifery practice was established in New York City at the Lobenstein Clinic-School of Nurse-Midwifery.

Statistics

• There are approximately 1060 licensed midwives in the state of New York. New York has the largest CNM/CMs population in the United States.
• New York CNM/CMs practice in many cities throughout the state. These places include New York City, Buffalo, Rochester, Syracuse, Albany, Cooperstown, Cortland, Poughkeepsie, Kingston/Rhinebeck, Binghamton, Plattsburgh, Saranac Lake and Long Island.
• There are currently 402 nurse-midwifery practice sites throughout the state of New York.
• In 2002, New York CNM/CMs attended 27,954 births. These deliveries account for approximately 11% of the total births in New York for that year.

Education

• There are currently 44 accredited education programs offering post-baccalaureate certificate and masters degree programs in nurse-midwifery and midwifery. A number of these programs have distance learning education options. There is a graduate program in nurse-midwifery at New York University and at Columbia University in New York City, a graduate program in midwifery and nurse-midwifery at SUNY Downstate Medical Center in Brooklyn and a graduate program in nurse-midwifery at SUNY Stonybrook. Downstate has an internship program.

Practice and Reimbursement Issues

• Midwifery practice in New York is regulated by the State Board of Midwifery.
• New York licensed midwives were granted prescription writing privileges with the passage of the Midwifery Practice Act.
• Under state law, all insurance companies registered in New York must reimburse licensed midwives for their services.
• Under state law and regulations, all managed care organizations must contract with licensed midwives and provide direct access for Obstetrician/Gynecological (OB/GYN) services.

This information was provided by the midwives of New York.
Updated 9/02