Birth centers illustrate how Certificate of Need (CON) laws restrict access to safer maternal care. Katie and Nick Chubb aimed to open a birth center in Augusta, Georgia after a positive experience at the Atlanta Birth Center during Katie’s pregnancy. They were frustrated by the lack of similar services in their city, especially since Georgia has the fifth-worst maternal mortality rate in the nation. The Chubbs envisioned a facility offering personalized, midwife‑led care and community-based support for families, including prenatal and postnatal services, educational classes, and a “baby box” for safe infant surrender under the state’s Safe Haven Law. Local enthusiasm was widespread, and the Georgia Department of Community Health determined the project was needed, financially feasible, and cost-effective. However, CON law blocked the effort. The regulation requires new healthcare facilities to obtain approval from existing hospitals for emergency transfer agreements. Although federal law already mandates hospitals to accept all patients in emergencies, Augusta’s three hospitals refused to sign such agreements, effectively banning the birth center from opening. With support from the Pacific Legal Foundation, Katie challenged the CON law in court.
Birth centers have better outcomes
- Georgia’s CON framework delayed access to safer maternal care despite demonstrated need and local support.
- The case highlights a tension between state regulatory controls and federal emergency access mandates.
- Legal challenges continue to question whether CON laws unnecessarily constrain health options for families.
Author’s summary: CON laws can impede access to safer, community‑oriented maternal care despite proven need and local support, prompting legal challenges to reform regulatory barriers.