by Elizabeth Darling
When the small "Do not disturb" sign was hung on the front door of the Birth Place on Menlo Avenue in Menlo Park, passersby would usually know that an expectant mother and father were inside going through the throes of childbirth.
The sign is gone, however, and all has been quiet in the tiny blue-and-white house since it closed its doors for good earlier this month. The house and garden, which now are for sale, sit on a tiny piece of land sandwiched between office buildings.
The childbirth center, founded by a group of doctors and volunteers in 1979, was a pioneer in the Bay Area.
"It was the first to open and the last to close," said practicing midwife June Whitson, who used to practice at the Birth Place. The closure, she said, "is taking away a choice for women."
Local hospitals are beginning to catch on to the idea of providing alternatives to the traditional labor and delivery room, but there are no independent birthing centers left in the Bay Area.
Stanford Medical Center has recently begun to offer midwifery services at the hospital, under the supervision of midwife Jean Rasch, and Stanford and other hospitals continue to market their childbirth services vigorously.
While the trend in the Bay Area seems to be away from independent birthing centers and toward hospital-based programs, a major health care provider in San Diego has just purchased a birthing center, planning to promote the idea of an independent birthing center as a hospital alternative, said Dr. Joe Hopkins, who was one of two founding physicians who delivered babies at the Birth Place. Hopkins, a family practitioner, is now the director of Stanford Family Practice and the medical director for health plans at Stanford Medical Center.
It was not one thing that led to the Birth Place's closure, but changes in health care and health insurance, Hopkins said.
"It was a series of blows that stretched out over a number of years," he said, starting with the fact that liability insurers were reluctant to cover the facility in the case of an adverse medical incident, although one never has occurred at the center. With the exposure to liability, it was difficult to maintain a board of directors, he said.
The next difficulty was that more and more people were covered by managed care health plans with prescribed hospitals they could use for deliveries. Patients were not as free to choose the Birth Place unless they wanted to pay out of their own pockets. Until the mid-1980s, private insurers were willing to cover Birth Place births because they were significantly cheaper than hospital births. It also was more difficult for midwives to get coverage for births they performed outside of hospitals.
"There's really been a change of mood among women," Hopkins added. "There is less interest in natural childbirth." When the Birth Place and its accompanying Resource Center for Pregnancy and Childbirth opened in 1979, the team of people involved was committed to non-medicated births, "which is not a matter of (deciding) what wallpaper is on the wall," Hopkins said. He said hospitals' attempt today to create homey atmospheres for labor and delivery but continue to tout technology and painkillers. "The outcomes (at the Birth Place) can be very, very good."
In its heyday, through the mid-1980s, the Birth Place did about 100 births a year, and "became kind of a focus for social support for pregnant women and new mothers," he said. Palo Alto resident Pam Marsh delivered the second of her four children at the Birth Place. Her daughter, born in 1979, was the fourth baby born at the center. "The birth I had at the Birth Place was far, far different (than her three other hospital births). It was amazing. It was very warm, and family-oriented," she said.
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