Giving birth at an out-of-hospital birth center is rarely covered by insurance plans. If it is, coverage is usually minimal. A bill under consideration by the Oregon Legislature would increase access to birth options and midwifery care.

Oregon House Bill 2388 would require equitable insurance coverage for care in all birth settings, including home births and free-standing birth centers.

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AlexAnn Westlake is a midwife and director of the nonprofit Our Community Birth Center in Lane County. She says there are often cases where someone has insurance, but it doesn’t cover their preferred birth location.

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“So someone might know that midwives in a birth center are safe and that would be their preferred option, but they can’t always access it because if their insurance won’t pay for it,” says Westlake. “And if they can’t pay out of pocket, then it’s not really an option for them.”

Oregon currently regulates the practice for three different kinds of midwives, and if the bill passed, midwives would be allowed to contract with insurance companies. Families would then not have to pay out of pocket for out of hospital birth services.

Westlake adds that the bill would especially help women of color, who have disproportionately high rates of birthing complications and unnecessary cesarean sections.

“I think that the COVID-19 pandemic and the upsurge of the Black Lives Matter movement have both highlighted why we need equitable access to birth options,” Westlake says. “Families are seeking birth options outside of the hospital right now to reduce their risk of COVID exposure and to be able to have extra support.”

Because medical resources are often consolidated in cities, Westlake says the bill would also increase access for rural communities. The bill cites data that shows equal access to home-births and birthing centers leads to fewer cesarean sections and premature births as well as lower costs to the health care system.

Rep. Rachel Prusak, D-Tualatin, is the sponsor of H.B.-2388. The bill is currently in the House Committee on Health Care.

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