{"title":"Financial Barriers to Expanded Birth Center Access in New Jersey: A Qualitative Thematic Analysis","authors":"Rebecca H. Ofrane DrPH, Slawa Rokicki PhD, Leslie Kantor PhD, Julie Blumenfeld CNM, DNP","doi":"10.1111/jmwh.13732","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Birth centers are an underused care setting with potential to improve birth experience and satisfaction. Both hospital-based and freestanding birth centers operate with the midwifery model of care that focuses on safe, low-intervention physiologic birth experiences for healthy, low-risk pregnant people. However, financial barriers limit freestanding birth center sustainability and accessibility in New Jersey, especially for traditionally marginalized populations. This qualitative study explores the financial barriers faced by freestanding birth centers in order to expand access and choice for pregnant people in New Jersey.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Semistructured interviews were conducted with participants from 4 sectors: (1) birth center or health system, (2) policy-adjacent philanthropy or research, (3) state departments, and (4) health insurance. Coding and analysis followed a reflexive thematic analysis process, resulting in the identification of 4 financial barriers to birth center access.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Facility Medicaid reimbursement rates are a primary barrier for birth centers, along with startup and operating costs and, more indirectly, low supply of midwives and low patient demand for birth center care.</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>New Jersey is well-positioned to enact critical policies and programs that can improve out-of-hospital birth center access, based on the findings and recommendations from this research. Other states can follow suit in pursuit of solutions to improve maternal health access and equitable birth center sustainability.</p>\n </section>\n </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 3","pages":"494-501"},"PeriodicalIF":2.3000,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13732","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of midwifery & women's health","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jmwh.13732","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Birth centers are an underused care setting with potential to improve birth experience and satisfaction. Both hospital-based and freestanding birth centers operate with the midwifery model of care that focuses on safe, low-intervention physiologic birth experiences for healthy, low-risk pregnant people. However, financial barriers limit freestanding birth center sustainability and accessibility in New Jersey, especially for traditionally marginalized populations. This qualitative study explores the financial barriers faced by freestanding birth centers in order to expand access and choice for pregnant people in New Jersey.
Methods
Semistructured interviews were conducted with participants from 4 sectors: (1) birth center or health system, (2) policy-adjacent philanthropy or research, (3) state departments, and (4) health insurance. Coding and analysis followed a reflexive thematic analysis process, resulting in the identification of 4 financial barriers to birth center access.
Results
Facility Medicaid reimbursement rates are a primary barrier for birth centers, along with startup and operating costs and, more indirectly, low supply of midwives and low patient demand for birth center care.
Discussion
New Jersey is well-positioned to enact critical policies and programs that can improve out-of-hospital birth center access, based on the findings and recommendations from this research. Other states can follow suit in pursuit of solutions to improve maternal health access and equitable birth center sustainability.
期刊介绍:
The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed