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A couple of weeks back, I mentioned that Baby+Co., the natural birthing company that had moved into Cary in 2014, had stopped deliveries after three babies died in six years. Now, state Representative Nelson Dollar, a suburban Wake County Republican considered one of the year’s most endangered incumbents, is calling for a state investigation.

  • From the N&O: “Rep. Nelson Dollar, a Republican representing Wake County, said in an interview late Friday that he will ask the N.C. Department of Health and Human Services to conduct an investigation of the Cary site to assess the causes of the recent deaths and to guarantee public safety. Dollar said he expects Baby+Co. to cooperate even if the state health agency—which oversees hospitals, nursing homes, surgery centers and other facilities—doesn’t have explicit legal authority to inspect and review the birthing facility.”
  • Indeed, the bigger problem is that these centers aren’t regulated by DHHS, or really by anyone at all: “The deaths in Cary are prompting some in the state’s medical establishment to rethink the state’s hands-off policy toward natural birth centers. North Carolina is one of just eight states that allows natural birth centers to deliver newborns without a state license or state oversight. At the same time the state oversees more than 700 occupational licenses and permits, covering such professions as acupuncture, cosmetology, daycare and funeral services.”
  • Just to make clear: the state more closely regulates your acupuncturist than the center delivering your child.
  • However: “North Carolina does enforce strict oversight of nurse midwives. The N.C. Board of Nursing licenses only nurse midwives with master’s degrees, and does not allow other types of midwives, such as lay midwives, to deliver newborns. North Carolina is one of a handful of states where nurse midwives can’t practice without an endorsement from a sponsoring doctor. Nurse practitioners have lobbied over the years to eliminate the sponsorship requirement, especially now that public officials are looking for ways to increase health care providers in underserved rural parts of the state. Still, some doctors remain wary of out-of-hospital births, even though the American College of Obstetricians and Gynecologists has declared that birth center deliveries with midwives are a safe option for low-risk pregnancies.”

WHAT IT MEANS: There are seven of these birth centers in North Carolina, and their operators fear that a regulatory regime could elbow them out of business, especially if they were held to the same standards as hospitals that had to treat high-risk individuals. Which, I suppose, is fair. But is the only alternative a complete absence of regulation? For what it’s worth, nowhere in the N&O’s piece does Dollar indicate that he’s pushing for new regulations, just an investigation.