Birthing centers bill clears first legislative hurdle in 2025 session

Republished from Kentucky Lantern

FRANKFORT — A bill that could pave the way for Kentucky to get freestanding birth centers sailed out of a Senate committee Wednesday. 

Senate Bill 17 would, among other things, remove the certificate of need requirement for freestanding birth centers, which advocates have said is the main hurdle blocking them in the state. 

Members of the Senate Standing Committee Health Services passed the bill 10-0-1, with the one member who passed being Sen. Donald Douglas, R-Nicholasville, a physician. 

For years, advocates — and at least one lawmaker at a time — have pushed the legislature to make it easier to open a freestanding birth center in Kentucky. Advocates have blamed the state’s lack of freestanding birth centers on the certificate of need laws, which mandate a process that attempts to hold down health care costs by certifying that there is a need for a service, be that extra beds in a hospital, an extra MRI machine or a new facility altogether, like a freestanding birthing center

If a facility like a hospital is already providing birth services, advocates have said, it’s impossible to prove a need exists, thus why some call CON rules the “competitor’s veto.” 

The version that Sen. Shelley Funke Frommeyer, R-Alexandria, put forward requires centers to have a physician medical director and a hospital transfer agreement, which helped garner support. SB17 also says freestanding birth centers would have to be within 30 miles of a hospital. If a hospital closed after a center opened within 30 miles, that birth center would be exempt from the distance requirement, essentially grandfathered into the place.  

Mary Kathryn DeLodder, the director of the Kentucky Birth Coalition, previously expressed concern that the physician requirement would pose a barrier to opening birth centers in light of Kentucky’s physician shortage.  

Sen. Julie Raque Adams, R-Louisville. (Kentucky Lantern photo by Sarah Ladd)

Sen. Julie Raque Adams, R-Louisville, when explaining her yes vote, said, “this is a great day for options for pregnant women in the commonwealth.” 

Sen. Karen Berg, D-Louisville, who is a physician and voted in favor of the bill, said, “If you’d come to me a couple years ago and asked me what I thought about freestyle birthing clinic, I would say, no. I chose to have my children in a facility where there was an ICU attached to the building, in case, God forbid, that was necessary.” 

“But the paternalism in medicine is ending, and it is a patient’s right to decide where and how they want to deliver their children,” Berg added. “So even though, honestly, this is a decision I would never make for myself, nor is it a decision I would ever encourage a family member to make … for those people that are so desperately wanting an alternative, they deserve it.”  

After the passage, Funke Frommeyer said “It’s a great day for our moms, for our families.” 

St. Elizabeth Healthcare in Northern Kentucky, which had expressed some opposition in the past, took a neutral position on the legislation after negotiations over the bill’s details.  

Sen. Karen Berg, a Louisville physician, told a legislative committee that “paternalism in medicine is ending, and it is a patient’s right to decide where and how they want to deliver their children,” Feb. 5, 2025. (Kentucky Lantern photo by Sarah Ladd)

In a Wednesday statement, the hospital said, “St. Elizabeth has been supportive of freestanding birthing centers if they are required to operate in a manner that assures the safety of the mother and baby. Having a physician on staff as medical director is a key component of this.”

“A medical director can ensure that only appropriate level births are considered with the center, can provide quality assurance and help guide procedures around transfer,” Emily Wherle, the director of communications and public relations for St. Elizabeth, said in a statement. “Further, the current language in the bill requires that the birthing center be located close to a birthing hospital and have transfer agreements with hospitals and ambulance providers — both are additional safeguards. The latest version of the bill as filed has all of these provisions, and thus St. Elizabeth has taken a neutral position on the bill.”

Terry Brooks, the executive director for Kentucky Youth Advocates, praised the committee passage. 

Should the bill become law, he said, it “will remove barriers to critical perinatal care options so that more Kentucky moms and their babies have the chance to thrive.” 

Supporters of birthing centers gain some political ground in Kentucky

SB17 can head to the Senate floor for a full chamber vote now, which could happen this week. 

A surprising fiscal note

Before the committee began, Gov. Andy Beshear’s office sent over a fiscal note on the bill, which Funke Frommeyer and others found odd. Funke Frommeyer said the administration estimated the bill’s cost to state government at about $400,000. 

“I’m a little surprised, quite surprised, because this has been on the agenda for two weeks, and why they didn’t send something anytime over the last two weeks,” Funke Frommeyer told the Lantern. 

Majority Whip Rep. Jason Nemes, R-Middletown, who’s sponsored freestanding birth centers legislation for years and has a sister bill in the House, also slammed the timing of the fiscal note. 

“I will note that we have filed this bill for five years in a row and the morning that it’s coming to committee, we get an email from the governor’s office. I do not accept that as professional nor acceptable,” he told committee members. “We will work with them, but I call to question the good faith of that after this has been filed for five years and it’s gone through the House.” 

Beshear’s office did not respond to a Lantern request for comment on the timing of the note.

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