Closing Of Washington, D.C.-Area Midwifery Practices Mirrors National Trend
Recent closings of two midwifery practices in the greater Washington, D.C., area have sparked an “outcry” from women seeking to give birth outside a hospital or with the assistance of a midwife, the Washington Post reports. The Takoma Women’s Health Center in Takoma Park, Md., closed last month shortly after its owner ended its midwifery practice, and the Maternity Center in Bethesda, Md., will stop delivering infants at the end of this month. According to the Post, at least seven other birth centers and midwifery practices in the Washington, D.C.-Baltimore area have closed in the previous 10 years, citing increasing malpractice insurance premiums and delayed insurance company reimbursements.
Maryland-, Virginia- and district-based midwives attended 12,500 births in 2002, American College of Nurse-Midwives statistics show. Those births accounted for nearly 8% of all Maryland births, 3% of district births and 7% of Virginia births. The closings of district-area birth centers mirror a national trend with about six birth centers closing annually in recent years, the Post reports.
Midwives said similar financial pressures are being felt throughout the health care industry, but birth centers especially are affected because they have smaller profit margins compared with most physicians. They also said that the increasing popularity of caesarean sections — which only physicians may perform — has affected their practices. According to the Post, midwives cannot compensate for lower insurance reimbursements for office visits by performing high-cost surgeries.
Some industry observers said the closings might signal the end of a “natural cycle” in the practice, as midwives who opened birth centers during the 1970s and 1980s start to retire, the Post reports. Observers said many young midwives do not want to deal with the financial strain of managing a practice (Shaver, Washington Post, 5/18).