An independent birth center has reopened in Asheville, ending a period of nearly two years without such a facility in Western North Carolina. Lilac Health Asheville Birth & Wellness Center is in the same location as Western North Carolina Birth Center, which closed in July 2021.
The South French Broad Avenue birth center is staffed by certified nurse-midwives and nurses, and facilitates childbirth in a less clinical, more homelike setting than a hospital’s traditional labor and delivery unit and with more resources available than with an at-home delivery.
Lilac Health welcomed its first baby on May 14 — Mother’s Day — via a water birth. Staff members have delivered two babies since opening, says interim clinical director Gazelle Lange.
Restoring a service space
Some faces at the center will look familiar. Melissa Poole, a certified nurse-midwife, worked for the center’s predecessor until the very end. “You could walk in and have a baby the day we closed — everything was all set up, up to code. We just had been credentialed again,” she says. The employees had only 30 days’ notice of the WNC Birth Center’s closure, and they helped transition patients who hadn’t yet given birth to other providers and staff members found jobs elsewhere.
During the year and a half after WNC Birth Center’s closure, CNMs and nurses who had worked there primarily worked at local hospitals. “There was a lot of grief when the old birth center closed, and we really felt the loss of it,” says Poole. “It was a really good reminder of what role it held in the community and the hole it left. I think the community had taken it for granted a little bit.” During this time, the CNMs encountered low-risk, healthy people who wanted out-of-hospital births and “would have been great candidates [for a birth center] but there just wasn’t an option,” Poole says.
Local real estate developer David Case, who tells Xpress he cares deeply about providing dignified, intimate settings for major life transitions, tried to help WNC Birth Center stay open. He found that keeping the business going would be too difficult given the financial realities of operating an independent birth center that primarily provides one service and is therefore strongly dependent on insurance and Medicaid reimbursement rates for childbirth.
Instead, Case purchased the property, thinking it could become a location for The Center for Conscious Living and Dying, a hospice care agency he is closely involved with. When the hospice found a better location in Swannanoa, Case says he wanted to keep the South French Broad Avenue space a birth center. “Not every mother wants to run up to Mission to have their baby,” Case explains, calling the birth center “something that Asheville needs, deserves — something to give [mothers] and fathers choice in Asheville.”
Now Chase owns the property and rents it to Lilac Health, a company owned by Yossi Schlussel of New York that has birth centers in several states.
A fresh approach
The birth center still provides three themed rooms: the waterfall room, the mountain room and the forest room. Each contains a large bed, a changing station and dresser. Babies are “less than 3 feet away at all times” from their mother, says Lange.
The mountain room has a Pilates bar and a hammock-sized sling hanging from the ceiling. These tools can be used for squats or leg lunges to coax labor along or to ease pain by resting in a different position. Lilac Health also uses rebozos, “a traditional Mayan wrap,” says Paige Schneider, birth assistant manager and administrative director. “If we’re needing to help rotate a baby during labor, we’ll put it around [the mom’s] belly, and we’ll do little shimmies and shakes and stuff to get the baby in a good position,” she continues. Women also can hang from a rebozo wrap on the Pilates bar to ease lower back pain.
“The midwifery model of care is that we really believe that [birth] is a natural event, that women’s bodies know how to do this,” Lange says. “So, sometimes when babies aren’t quite in the right position or labor’s taking a little too long, instead of moving into that medical model [as may be pursued in a hospital], we know lots of tricks to help get babies in the right position.”
Schneider adds that the birth center might soon offer the pain reliever nitrous oxide, also known as laughing gas, as “a little extra something we can use for women.”
Water births are another option for clients and are available in each room. Previously, the birth center’s rooms had inflatable tubs, which resembled small swimming pools. Lilac Health’s new water birth tubs resemble jetted bathtubs and were designed by a midwife specifically for laboring or delivering, says Lange. Its depth offers comfort to the laboring mother, and “midwives can reach in without totally breaking their backs,” she adds.
Each room has a private bathroom, which sometimes serves dual purposes if an infant decides it’s time to arrive quickly. “I was doing an orientation for new clients, and we had a woman come in who’d had her previous babies here,” Lange recalls. “She’s like, ‘Both my babies were born in the shower!’”
Meeting a need
Until Lilac Health opened, the only birth center in the state was in Statesville, a two-hour drive from Asheville. A Chapel Hill birth center closed in mid-2022, according to the Daily Tar Heel.
Locally, expectant parents could pursue a home birth or at one of the local hospitals. Certified nurse-midwives could attend to births at these facilities, and some labor and delivery units have birthing suites with spa tubs and birth balls.
However, the staff at Lilac Health say a free-standing birth center offers a different experience. The space is cozier with more artwork, quilts and books. Medical equipment, while present, is not as prominent as it would be in a hospital. Women who have given birth at birth centers say the setting is more relaxed, provides more one-on-one care and support, and exerts less pressure to pursue medical interventions during childbirth.
Like other birth centers, Lilac Health works with clients with low-risk pregnancies. “We were very careful with whom we accept into care,” Lange says. Those with prior cesarean births, pregnancies of multiples or pregnancy complications are advised to pursue their labor and delivery elsewhere. (Mission Hospital has WNC’s only level 3 neonatal intensive care unit.)
The American Accreditation of Birth Centers requires birth centers to regularly drill on skills. Lange says the team undergoes drills every two weeks or so, which creates the “muscle memory that you need.” Recent training topics included dealing with blood loss and neonatal resuscitation. “That’s a huge part of our philosophy — making sure we drill regularly because we don’t see complications that often,” says Lange.
Lilac Health will be inspected in August for compliance with standards from the Commission for the Accreditation of Birth Centers, which offers accreditation of free-standing birth centers. “When a birth center wants to be accredited, that means they want to be held to the highest standards possible,” explains Lange, who has served as an accreditation specialist for the Commission for the Accreditation of Birth Centers.
More than birth
While Lilac Health is foremost a birth center, it’s also a wellness center that can provide other reproductive health care, Schneider says. Patients range from adolescents to women who are post-menopause.
All the midwives can see patients for preconception care, family planning, fertility awareness, mammograms and annual checkups, including pap smears, as well as treat urinary tract or yeast infections.
For new parents, the team also supports breastfeeding and chestfeeding. The latter is “a more inclusive term for breastfeeding,” Poole explains. “If they don’t identify as women,” breastfeeding “sometimes seems more feminine oriented.”
The current staff isn’t yet trained in gender-affirming health care for transgender patients, says Poole. However, workers have experience coordinating with other people in the community who work with that group.
The team at Lilac Health also wants to provide education for assisting out-of-hospital births. Buncombe County currently has 22 certified nurse-midwives, Haywood and Henderson counties each have three, and Transylvania County has two, according to Sara A. Griffith, chief nursing officer of the N.C. Board of Nursing.
Demacy Monte-Parker, who works at Lilac Health’s front desk, is trained as both a birth and postpartum doula, and is training to be a birth assistant. The clinic plans to add midwifery internships, fellowships or preceptorships where a student is assigned to an instructor. Says Lange, “We recognize the importance of bringing up the next generation.”
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