Choices plans city's first birthing center

A vacant Crosstown medical building is on track to house two groundbreaking services for Memphis.

It will contain the city's first freestanding birthing center, where midwives are the primary caregivers.

And it will have the nation's first nonprofit comprehensive reproductive health center that offers under one roof birth care  and abortions as well as sexual and reproductive healthcare, gynecology, testing and treatment for sexually transmitted diseases, and mental health services.

Choices - Memphis Center for Reproductive Health in April purchased for $285,000 the one-story office building at 1203 Poplar with plans to renovate and expand it. The brick building with a distinctive row of arches fronting its east side is a mile west of Choice's current facility at 1726 Poplar.

"We are doing something that really has not been done in this country before,'' Choices executive director Rebecca Terrell said.

Since 1974 in Memphis, Choices has been providing reproductive health care, including abortions. "We realize that this idea of helping women and giving respectful birthing care is just as important as all the other services we provide,'' Terrell said.

"We are one of the first clinics to be able to offer both birthing center services, abortion services, gynecology, all kinds of sexual and reproductive health care,'' she said. "Mental health services will be available at this new center.''

One other center, in Buffalo, New York, offers a similar array of services, said Kate Bauer, executive director of the American Association of Birth Centers. "But I believe it's privately owned. So yes, (the Memphis center) would be the first nonprofit. It's a new model of bringing all of women's reproductive health together.''

The planned facility may lead the nation for the range of services it provides, but the birthing-center component follows a national trend. The number of birthing centers in the U.S. has grown by 60 percent, to 320, over the past five years, Bauer said.

"There is consumer demand for freestanding birth centers,'' Bauer said. "It's something women are seeking. And also (insurance companies) are seeing the value proposition for low-risk maternity care that birth centers offer.''

Now in Memphis, women generally have two choices:  Deliver at home under the care of a midwife or, as the vast majority of women do, in a hospital with physicians or with midwives overseen by physicians.

A freestanding birthing center offers a middle path:  A more home-like birth experience aided by midwives but in a facility better equipped than a residence for any unforeseen medical issues.

Choices has just hired Dr. Susan Lacy as its director of obstetrics and ambulatory gynecology. The board-certified obstetrician-gynecologist will also oversee the midwives at the new birthing center.

"In the last 15 or 20 years the hospitals themselves have gone to a more comfortable, homelike setting because patients have requested that,'' said Lacy, who had been in private practice 19 years. "And Memphis is lucky to have great obstetrical care.

"We have hospitals that have women's hospitals and private rooms and all the type of amenities that a lot of women want. A birth center sort of takes it to the next step,'' Lacy said.

Birthing centers provide "the medical side and the midwife model for birth but also the needed ability to have medical intervention if things don't go exactly as planned,'' Lacy said.

And the new center will meet a need for Midtown, which has lost so much gynecology care to the suburbs the past few decades. "If you're a patient with private insurance, basically you deliver predominantly on the outskirts of the city,'' Lacy said. "... So we're trying to provide a service in Midtown that isn't really there.''

The new center does face some hurdles, involving money and politics.

Choices will launch a campaign to raise $3 million for the project that would not only renovate the 8,000-square-foot building at 1203 Poplar, but add 4,200 square feet to the front and 2,900 square feet to the back as well as provide some operating funds.

Choices also acquired the vacant lot immediately south of the old office building, and has gotten the city to vacate the public right-of-way of an alley separating the vacant lot from the office building.

Choices will go before the Board of Adjustment on Oct. 26 to obtain some zoning variances:  Since a small part of the building appears to be zoned residential, Choices needs permission to operate a medical facility. Choices also needs an exception to rules governing how far the building is set back from property boundaries.And Choices asks that the variances stay in place for up to five years before construction starts in case it takes longer than expected to raise the $3 million.

Another hurdle involves Tennessee law. Choices prefers to move all its services -- including abortion -- into the planned facility to be more efficient and make access to care easier for patients, Terrell said.

"One of the impediments to that could be that right now if you offer abortion services you have to be licensed as an ambulatory surgical center, which our current facility is,'' Terrell said.

But under current state law, establishing abortion services at 1203 Poplar would require a certificate of need from the state because of the requirement to provide hospital-like standards.

Applying for a certificate of need would be a lengthy process so expensive as to be cost-prohibitive, Terrell said.

But the U.S. Supreme Court in June struck down a similar law in Texas, ruling that the hospital-like standards provided few if any health benefits to women and posed an obstacle to women seeking abortions.

"We have challenged our Tennessee law in the same way,'' Terrell said. "Given the Supreme Court ruling we are confident this law in Tennessee will be overturned.''

The nonprofit is funded mostly by the fees it charges for its services, and also by grants.