Republican lawmakers fighting for freestanding birthing centers in Kentucky (again)

By: - January 10, 2024 4:56 pm

Sen. Shelley Funke Frommeyer (Kentucky Lantern photo by McKenna Horsley)

FRANKFORT — Champions of freestanding birthing centers are renewing their push in the Kentucky General Assembly with legislation that addresses concerns raised by opponents in the past.

Sen. Shelley Funke Frommeyer, R-Alexandria, and Rep. Jason Nemes, R-Middletown filed bills to, among other things, remove the certificate of need requirement for the centers in Kentucky. 

Funke Frommeyer, who filed similar legislation in 2023, said the legislature “made great progress last year” and she believes “we’re going to get it across the finish line this year.”  

Freestanding birth centers are health facilities for low-risk, vaginal births. These facilities, which are neither a hospital nor someone’s home, are usually staffed by midwives who help deliver babies and care for them and their mothers immediately after birth. Kentucky has none.  

Proponents say they would help improve maternal health in Kentucky, as people who want low-intervention births are more likely to have their babies at home than go to a hospital. Kentuckians now travel out of state to give birth in a freestanding center. 

A major obstacle to opening centers is the certificate of need requirement. It is in place to regulate certain health care services and lower costs, according to the National Conference of State Legislatures. Thirty-five  states and Washington D.C. had such laws as of December 2021.

The two new bills address some concerns lawmakers and hospital representatives have expressed in the past. They would:  

  • Require the Cabinet for Health and Family Services to have regulations on licensure standards for freestanding birth centers by Dec. 1. 
  • Require freestanding birth centers be accredited with the Commission for the Accreditation of Birth Centers
  • Require a plan for transfer to a hospital should the need arise. 
  • Require medical malpractice insurance for the centers
  • Allow hospitals to run freestanding birth centers
  • Remove the need for freestanding birth centers to obtain a certificate of need if there are four or fewer beds. 
  • Prohibit any center from providing an abortion. 

“We have pregnant women in Kentucky who want a holistic approach to what’s a physiologically natural … experience,” Funke Frommeyer said on the Senate floor Wednesday. 

She said Kentucky’s health care deserts and shortage of providers contribute “a crisis of biblical proportions.” 

Rep. Marianne Proctor, R-Union, also filed legislation this week seeking to reform the certificate of need laws in Kentucky. One of three bills she filed Tuesday also seeks to pave the way for freestanding birth centers to open in Kentucky. 

“Freestanding birth center opponents,” Funke Frommeyer said in a statement, “have relied on the lengthy and arduous certificate of need process that has allowed hospitals to essentially block their development, regardless of the benefits to women in Kentucky looking for another birthing alternative.” 

Mary Kathryn DeLodder, the director of the Kentucky Birth Coalition
Mary Kathryn DeLodder is the director of the Kentucky Birth Coalition

Mary Kathryn DeLodder, the director of the Kentucky Birth Coalition, has fought to get the centers in Kentucky for four years. The increased public awareness of what certificate of need is and does is helping to turn the tide in favor of reform, she told the Lantern. 

The Kentucky Birth Coalition worked with both Nemes and Funke Frommeyer on their bills, she said, and considers that legislation “our bills.” 

“When we first started working on our center issue, there wasn’t the broader conversation about certificate of need, and that has definitely picked up a lot of momentum,” she said. “So I think there’s a lot more knowledge around certificate of need in general. So I think that has definitely increased the appetite for this.” 

The state’s increased focus on maternal health, too, is helping with the conversation, DeLodder said. 

“This issue of birth centers,” she said, “really brings both of those things together.”


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Sarah Ladd
Sarah Ladd

Sarah Ladd is a Louisville-based journalist from West Kentucky who's covered everything from crime to higher education. She spent nearly two years on the metro breaking news desk at The Courier Journal. In 2020, she started reporting on the COVID-19 pandemic and has covered health ever since. As the Kentucky Lantern's health reporter, she focuses on mental health, LGBTQ+ issues, children's welfare, COVID-19 and more.