Let’s just get this out of the way up front — the Charleston Birth Place is not going to get shut down.
“We are not threatening to close anybody,” says Catherine Templeton, director of the state Department of Health and Environmental Control. Instead, the center has until Dec. 7 to prove it is in compliance with a state statute that requires it to have a doctor on-call and within 30 minutes of the facility at all times.
If the center doesn’t provide documentation, then DHEC will talk to them about how to clear this up.
But they won’t close the center’s doors, Templeton says.
That’s a pretty clear-cut statement that should put folks at ease.
But on Monday, a lot of people showed up at the College of Charleston to show support for the Charleston Birth Place — one of six facilities statewide that provides midwives to families who want to have their babies somewhere other than a hospital.
Those folks, most of them families who have used the Birth Place, made it clear they don’t want the state shutting down the facility. But that’s exactly what Lesley Rathbun, owner of the Birth Place, says she has been threatened with.
So what’s going on here?
Well, it’s either a terrible misunderstanding or bureaucracy at its finest.
In August, tragedy struck at a York birthing center.
A woman developed complications during delivery and the midwives took her to a nearby hospital, where the baby died.
DHEC looked into the case, as it should, and was alarmed that the center’s on-call doctor was in Greenville — more than two hours away.
The state shut down the center and sent a letter to all other facilities asking to provide proof that they had contracts with on-call doctors who were a little closer than the other side of the state.
Rathbun got that letter in September and was told by DHEC inspectors it was not a regulation change, the agency was just clarifying state statute. Rathbun relaxed.
Fact is, the Charleston Birth Place is next to Trident Hospital. They have local doctors on-call. They have never been out of compliance. It is a fine establishment, owned by Rathbun — president of the American Association of Birth Centers.
Rathbun says she submitted enough paperwork to DHEC to choke a dinosaur: copies of contracts, the licenses of her consulting physicians, a letter from Trident, transport agreements.
But she never heard back from DHEC. So she got a little worried, especially when folks at other birthing centers said now the state would require a doctor on-site at these facilities. Which would be a change in the law. Templeton says the state never said that.
A few weeks later, Rathbun received notice that she had to submit the information she had already given them. When she tried to talk to DHEC, she says “they were very disrespectful to what we had to say.”
They simply kept repeating the state statute.
And then, she says, the Birth Place got a notice that it was out of compliance and must respond within 15 days.
Templeton says the Birth Place has not submitted proof of compliance with the on-call doctor statute.
And she says DHEC has issued no citation.
So what’s going on?
Well, it appears what we have here is a failure to communicate.
“They say one thing one day, and the exact opposite the next,” Rathbun says.
Templeton has nothing against birth centers — in fact, she has used one herself. But she says it is not unreasonable to have a doctor on-call within 30 minutes of travel time. And she wants proof. It’s the law, but says they aren’t being bullies.
“We’re about compliance, not enforcement,” she says.
Templeton says that the Charleston Birth Place is probably just fine — it’s accredited, it’s not had problems in the past, it’s next door to a hospital — the state just needs to see the paperwork.
And Rathbun says she’s already provided it.
It is not surprising that birth centers would be wary of the state. South Carolina has a long history of squashing competition to big industry through regulations. It’s a tradition. And birth centers cut into the bottom lines of some big corporations.
But Templeton has no ax to grind with birth centers, clearly, and isn’t playing games. If her staff is, as Rathbun claims, Templeton apparently doesn’t know it.
Seems like the best thing here would be for both sides to just sit down at a table, try to wade through the incomprehensible language of state law, and agree that everything is fine. The Birth Place is in compliance.
Both sides here want the same thing: the safe delivery of healthy South Carolina babies.
Let’s not let red tape get in the way of that.
Reach Brian Hicks at firstname.lastname@example.org
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