It’s all fun and games until its not! Working through this process to update our birth center regulations in the state of Colorado has been many things; tedious, inspiring, infuriating, hard-fought. It has also brought together a vibrant community of birth workers and created a network of supporters. Personally, this work has been enlightening on how our systems work and I have gained invaluable knowledge and skills for the future. Working through government systems takes persistence, patience, passion and compassion, clear communication, organized effort and good self care for all involved. Thankfully, the residents of the state of Colorado have a group of dedicated folks who have all of these traits!
In preparation for the February meeting, it seemed likely to be a smooth process. The outlined topics to discuss were basic, non-controversial items such as; Medical Waste, Linen and Laundry and Waste Storage and Disposal. The controversial topics we had, sometimes hotly, debated previously had been settled and agreed upon. We had a perfectly lovely presentation by some CDPHE (Colorado Department of Public Health and Environment) employees about medical waste disposal and proper disposal of pharmaceutical waste. The discussion was moving along nicely and it appeared that we may finish the meeting early, for the first time ever! Then we arrived at the Physical Plant Standards section and the ride became very bumpy. To understand why this caused rancor, we need a short history lesson.
There is an organization of architects, the Facility Guidelines Institute (FGI), who have put forth a set of guidelines on the physical structures of hospitals and outpatient facilities. These have been approved on a national level through the federal government and several states have also adopted these guidelines as well. The Colorado state legislature voted to adopt these guidelines as law in 2010. In these guidelines, there is a chapter dedicated to the regulation of birth centers. You can read a little about the history of FGI here. It appears that the guidelines were written and adopted with very little public input and very little, if any, input from anyone who actually worked at or in a birth center. Some of the guidelines make sense but many of them absolutely do not. Examples include; minimum square feet for birth rooms that is unrealistic and not necessary, hallways wide enough to allow two ambulance gurneys to pass each other, the inclusion of a nursery (this one is really out of line in a birth center setting) and escape windows in each birth room.
This is where tensions became inflamed and words became heated. There was intense debate and at one point it appeared that this entire process of regulation updating may be halted all together. Thankfully, cooler heads prevailed and we were able to move through this issue. Unfortunately, CDPHE has very little power to change this requirement as it has been adopted through the state legislature. However, there is a section in the FGI guidelines that appears to allow for exceptions. With this in mind, CDPHE agreed to form a subgroup to evaluate and clarify this potential process for exceptions. Whew! We were then able to move past this important section in a positive manner.
These rules will not affect any currently open birth centers, but and this is a big one, any future birth centers that try to open will potentially have a very difficult time meeting these standards. This is where the work that the Colorado Birth Center Coalition (CBCC) is doing serves the community as a whole and not simply our individual needs. This is why I refer to those of involved as your Warriors, we are fighting for the rights of all CO families to have access to choices in birth!
- Want to get involved? Please contact Elephant Circle
- Important Date to Remember: July 19, 2017 is the day that we will be asking consumers to be present at CDPHE and let their voices be heard! These voices will need to be organized and prepared so if you are willing and able to help, please block off this day and contact Elephant Circle to learn how to become involved in this way.
- Curious about the history of this process? You can read the first post in this series here, the next one here and the third one here.