Our Community Birth Center in Lane County aims to provide midwifery care

In 2019, the Nurse Midwifery Birth Center in Springfield closed. Now, people giving birth in Lane County have a new option. Our Community Birth Center hosted its grand opening in October. We hear how midwives and birth centers can help improve birth outcomes from AlexAnn Westlake, the executive director of the center and a certified nurse midwife.

This transcript was created by a computer and edited by a volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Two years ago, Peace Health closed its Nurse Midwifery Birth Center in Springfield. As we talked about at the time, there was a huge outcry from patients and providers who saw that closure as a blow to access to midwife-assisted births. But now Lane County has a new standalone midwifery center in Springfield. It’s called Our Community Birth Center, and it just celebrated its grand opening. AlexAnn Westlake is a certified nurse midwife and the executive director of the center. She joins us now. It’s good to have you on Think Out Loud.

AlexAnn Westlake: Hi, thank you.

Miller: You worked at the Peace Health Nurse Midwifery Birth Center before it closed. What was that closure like for the community?

Westlake: The Nurse Midwifery Birth Center has been part of Lane County for over 40 years. So, it was a big impact on the community when that service and that option for birth was lost in 2019. Over 40 years worth of parents and babies really loved the midwives and the services that were offered there. So, it was a really sad time.

Miller: What exactly was lost when the center closed? It’s one thing to say ‘I have memories of, that’s where I had my baby 30 years ago’. But in 2019, what did the closure mean?

Westlake: In Lane County, it was the only birth center at the time. So at this moment, actually, there are no birth centers, although Our Community Birth Center is very close to opening as we’ll talk about today. What that meant was a loss of options for pregnant families. They could no longer choose a birth center birth in their community. The closest they could go was all the way to Corvallis to access that option for their care. It limited options that were available to families and it made it so that they didn’t have that choice, which is particularly significant because there is evidence that shows that birth center care improves health outcomes for parents and babies.

Miller: In what ways? What does the data show about birth center care?

Westlake: The study that we look at is called The Strong Start for Mothers and Newborns. It was conducted by Centers for Medicaid and Medicare and published in 2018. Of course, I’m excited to see more studies available in the future, but this is the one that we talk about the most right now. The study looked at outcomes of families getting birth center care compared to other traditional carers such as hospitals, and showed that there were fewer unnecessary C sections, that there were fewer preterm births, fewer low birth weight babies, lower cost to health care system, and higher client satisfaction with their care. This was all done with a study that matched people based on risk. They were matching the different participants in the study based on their risk and comparing people with the same amount of risk during their pregnancy and still seeing those better outcomes in the birth center.

Miller:  Better outcomes and less money.

Westlake: Yes. Yes.

Miller: Two of the big headlines there. I’m curious about this because it is possible, in many parts of the country, in a number of parts in Oregon as well, to have a largely non-medicalized birth inside a hospital. Plenty of Oregonians can have their babies delivered by nurse midwives at hospitals without necessarily having it be unnecessarily medicalized. What’s different about a stand alone birth center?

Westlake: Thank you for asking that. I have experience working at birth centers and hospitals, so I’m very familiar as a nurse midwife with both options and what that feels like in the types of care we provide. A birth center is community-based and also community-focused. It’s set up to be a home-like space that is specially for healthy pregnancy and birth. We have a smaller staff and a smaller space, and that allows us to provide more personalized care and more one-on-one care to our clients. Also, it’s more home-like. It’s more relaxing and comfortable. People are able to get their prenatal care in the same space where they’re ultimately going to give birth, which helps them develop that extra level of comfort and safety and security, and for going through an event like birth, it’s so important to feel safe and secure. That really helps promote a normal, healthy physiologic birth process. The birth center sets that up and makes it easy for people to feel safe and secure and relaxed in their setting.

Miller: What did it take to actually create this new center after the old midwifery center was closed down by PeaceHealth?

Westlake: The most important piece that’s led to Our Community Birth Center opening is the outpouring of community support that we’ve received. It just happened naturally. It’s so important to people to have this option available that as soon as we announced that we’re starting a nonprofit and opening a birth center, everyone stepped up. Volunteers stepped up. We have a Board of Directors that’s made up of birth center parents who really care about the work we’re doing, and having this option available. We had over 800 donors step up over the past two years to help fund getting this new birth center open. That was really the most key, important part, and I think that’s how it happened and why it happened, because of the community support that we have here in Lane County for midwifery birth center.

Miller: One of the striking things, if I understand this correctly, is that organizationally the members of your nonprofit’s Board of Directors are actually birth center parents. What’s the idea behind that?

Westlake: The idea behind that is that it’s important that the people who the care is being made for are the ones also saying what they want and need and helping guide how it’s developed and how it’s delivered. It’s really important to the organization to have birth center parents in those leadership roles so that they could be guiding what’s going to be available and how it’s going to serve the community. I’ve seen that really play out in a positive way in the development of Our Community Birth Center. It’s had a positive impact on our development and has influenced how we’ve set things up in a way that’s positive and beneficial to the families who we’ll be caring for.

Miller: How did the pandemic affect people’s birth plans or desires?

Westlake: We’ve had more than usual people in Oregon seeking community birth. When I say community birth, I mean birth center or home birth options during the pandemic. And for good reason. People are looking for where they can get personalized care, where they can have their support network, and where they can reduce their risk of exposure to COVID-19. I know from talking with other birth centers and home birth midwives in Oregon that there has been an increase in demand. There was already a good demand for birth center and home birth throughout Oregon and always has been, but there’s been an increase during the pandemic.

Miller: Do you think that that’s going to continue even as, and hopefully this will continue,  COVID-19 rates fall?

Westlake: I’m confident we’ll continue because it’s always been there. There’s always been a desire and a demand for community-based care. Midwifery care in birth centers and home birth has always been something that families in Oregon have sought out and desired. What I’ve actually seen, looking at the data and the history, is what impacts the number of people giving birth in a birth center is more about the access to that care -- whether or not there is a birth center in a community or whether or not people can afford to go there. That’s what really impacts where people are giving birth. There’s definitely the desire for that option.

Miller: I mentioned in my intro that you had a grand opening just a couple of weeks ago. There was a very colorful cord-cutting, kind of symbolic, instead of a piece of tape. When will you actually start having your first pregnant patients there giving birth?

Westlake: We actually have our first clinic visit scheduled next week. So we’re opening as a clinic only first, and that’s starting next week. We’re in the process of getting our facility license with the Oregon Health Authority so that we can start births. Early 2022 is our goal.

Miller: And how many patients or how many babies do you think you’ll be able to have delivered over the course of the year?

Westlake: Based on the demand and also our capacity and our facility, we’re anticipating that it will grow up to average 100 births a year.

Miller: AlexAnn Westlake, thanks for joining us today.

Westlake: Thank you.

Miller: AlexAnn Westlake is a certified nurse midwife and the executive director of the new nonprofit-run Our Community Birth Center in Springfield.

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