California is losing places to give birth

Stay up-to-date with free briefings on topics that matter to all Californians. Subscribe to CalMatters today for nonprofit news in your inbox.

The March closure of California’s first licensed and accredited birth center underscores not only the state’s “de facto ban” on licensing birth centers (as one lobbyist put it), but also the uphill battle expectant mothers in California face when seeking the health care they need.

In the past decade, nearly 50 maternity wards have closed across the state, with more than half shutting down in the last four years — creating “maternity care deserts.”

In lieu of hospitals, some patients pursue alternatives. But California midwives who could help close the care gap can barely keep their businesses afloat . And in the past four years, at least 19 birth centers have either reduced services or shut down — including Best Start Birth Center in San Diego, founded in 1989.

As CalMatters health reporter Kristen Hwang explains, birth centers are run by midwives handling low-risk births. Despite the number of planned out-of-hospital births overseen by midwives doubling in the past decade, and research that shows midwife-led deliveries for low-risk pregnancies are safe, these clinics struggle to stay open.

One factor is the set of financial and regulatory standards California centers must meet to get licensed, which are some of the toughest in the country.

Midwives and advocates argue that the licensing process often takes years, is pricey and at times doesn’t make sense for the scope of their practice. For example, some centers spend tens of thousands of dollars to retrofit buildings to accommodate high-risk patients who would need to be transferred to a hospital regardless.

• Roberta Frank , Best Start founder: “The system is just a mess. It’s flawed. It’s set up to prevent providers that can provide really good care from even getting started.”

The president of the state chapter of the American Association of Birth Centers says that to prevent more birth centers from closing, the state needs to reform its licensing process. Exempting birth centers from certain health building codes, for instance, would require legislative intervention. Other advocates also want the California Department of Health Care Services to increase reimbursement rates for low-income patients on Medi-Cal.

In an unsigned statement to CalMatters, the health department said that licensing requires facilities to meet “minimum standards” for patient care. It added: “We cannot speculate or comment on any reason why providers chose to close these facilities, aren’t seeking licensure for new (birth centers), or what could be done to improve the process.”

Learn more about birth centers in Kristen’s story.

November election: Keep up with CalMatters coverage by signing up for 2024 election emails. Check out our Voter Guide , including updates and videos on the 10 propositions and a FAQ on how to vote . And read up on the history of ballot measures in California.

Other Stories You Should Know

CA legislators’ slog to adjournment

It’s the final week of the legislative session, and lawmakers have been busy debating and voting on bills before the Aug. 31 deadline.

Last week, a proposal by Gov. Gavin Newsom’s administration to amend a trailer bill ultimately fizzled out. The proposal would have delayed — for as long as four more years — deadlines for oil and gas companies to comply with a 2022 law concerning where oil and gas wells could go . Though Newsom is reversing course, environmental groups have little reason to celebrate , writes CalMatters environmental reporter Julie Cart .

That’s because when the administration withdrew its proposal, it also eliminated funding in the budget bill to enforce the law. The law bans new oil drilling within 3,200 feet of schools and homes, and requires safety measures at existing wells.

Environmental groups argue the governor’s actions are contradictory: While California won’t delay the setback law outright, gutting the funding to implement the law would result in more delays.

Learn more about the issue in Julie’s story.

In other state Capitol happenings:

• School security: The Senate is expected to consider a bill this week that would undo state rules that require public school teachers to report to police if a student assaults them , writes CalMatters politics intern Jenna Peterson . Republican senators remain strongly opposed to the bill , calling it a “ lose-lose ” for students, teachers, parents and police. Backers say teachers may have reasons to keep police scrutiny out of kids’ lives. Read more on the bill in Jenna’s story.

• Non-disclosure agreements: Another Republican effort to prohibit lobbyists, legislators and other public officials from using non-disclosure agreements when creating legislation died last week, reports KCRA . Assemblymember Joe Patterson of Rocklin attempted to rewrite a previous bill of his to include banning the practice, but the effort was shot down by Senate Democratic leaders for being too similar to a measure that failed in April .

• Physician mental health: After passing the Senate floor last week, a bill to prohibit the Medical Board of California from requiring applicants to disclose information about their mental health as part of the board’s physician licensing process heads to the governor’s desk. According to the California Medical Association, including such mandates could further stigmatize mental health conditions. The board last week amended its application to “ make clear to physicians that seeking care is encouraged .”

CalMatters covers the Capitol: We have guides and stories to keep track of bills and your lawmakers ; find out how well legislators are representing you ; explore the Legislature’s record diversity ; and to make your voice heard .

Newsom big-foots Oakland on crime

In addition to signing into law an anti-crime bill package championed by Democratic legislative leaders, Gov. Newsom is sending a strong message to cities this election year to do more to rein in crime. That includes Oakland, where concerns over crime from residents and business owners have fueled recall campaigns of both Oakland Mayor Sheng Thao and Alameda County District Attorney Pamela Price .

In the past six months, the governor sent National Guard attorneys to assist Price’s office in prosecuting drug cases and deployed more California Highway Patrol officers to Oakland. But as CalMatters’ Felicia Mello explains, not everyone’s happy with Newsom’s approach to Oakland crime . With the city’s troubled police department already under federal oversight since 2003, police accountability groups are raising additional alarms about how Newsom’s actions are impacting residents, particularly within communities of color.

In July, Newsom weighed in on an Oakland policy that limits law enforcement’s ability to engage in vehicle pursuits with suspected criminals. He fired off a letter to Oakland officials urging them to reconsider its rules. The CHP, for example, grants officers wider discretion for car chases.

But James Burch, a spokesperson for the Anti Police-Terror Project, argues that the crime issues plaguing Oakland residents, such as gun violence and burglaries of small businesses, won’t be solved with CHP’s focus on traffic stops and recovering stolen vehicles.

• Burch: “We don’t see CHP having the skills, the experience, the technical know-how to address these issues.”

A 2023 study by the think tank Police Executive Research Forum also found that more than 90% of police chases rarely lead to arrests for serious crimes , and about a fifth of serious injuries during chases are inflicted on innocent bystanders.

But Newsom has a different take. At a July press conference, he said CHP officers can help free up local police officers so they can focus on other crimes. And Oakland Police Chief Floyd Mitchell said traffic stops “create a high visibility presence” of police that can depress crime in an area for hours.

Read more about Newsom’s approach to Oakland crime in Felicia’s story.

And lastly: Gen Z voters

With 41 million eligible Gen Z voters, the 2024 election could see unprecedented youth participation. As part of our partnership with PBS SoCal, CalMatters’ Jenna Peterson and producer Robert Meeks have a video segment on Jenna and Matthew Reagan’s story detailing how this new wave could alter California’s political landscape. Watch it here .

SoCalMatters airs at 5:58 p.m. weekdays on PBS SoCal .

California Voices

CalMatters events: The next is Sept. 12 on the battle over California’s groundwater. Register here to attend virtually. On Sept. 19, CalMatters economy reporter Levi Sumagaysay , who is covering the homeowners’ insurance crisis , will interview California Insurance Commissioner Ricardo Lara. Register here to attend in person at our Sacramento offices or virtually.

Other things worth your time:

Some stories may require a subscription to read.

Kamala Harris’s Berkeley neighborhood is now a struggle for middle class // The Mercury News

Feds, CA AG Bonta sue software firm for enabling collusion on rent // Politico

What is the CA bill to limit self checkou t really about? // San Francisco Chronicle

Californians can now add digital driver’s licenses to Google Wallet // CBS San Francisco

Caltrans carries out most homeless encampment sweeps in CA // The Sacramento Bee

Jewish legislators not giving up on more ‘guardrails’ on ethnic studies // EdSource

CA judge issues novel ruling to rein in groundwater pumping // San Francisco Chronicle

State scientists union ratifies contract after four years of bargaining // The Sacramento Bee

Calls for OC Supervisor Andrew Do to resign grow amid federal probe // Los Angeles Times