( The closure of a well-known Takoma Park...)Natural-Birth Centers In U.S Pulling Down The Shutters,Health

The closure of a well-known Takoma Park midwifery practice and a Bethesda birth center have sparked an outcry. Those protesting this are some Washington area women who say they are worried by the dwindling number of opportunities to give birth outside a hospital or with a midwife's help.

At least seven other birth centers and midwifery practices, many citing rising malpractice insurance premiums and lagging insurance company reimbursements, have folded in the Washington-Baltimore area over the past decade.

Says Mary Beth Hastings, board member of the new Birth Options Alliance: 'There are countless women scrambling to find out-of-hospital birth support.'

The group, with about 300 members, will advocate 'for a full range of birth options' in the Washington area, says Hastings, who had her 4-year-old daughter at the Bethesda birth center and her 2-month-old daughter via a midwife at her Takoma Park home.

For a relatively small but devoted group of women, the idea of giving birth in a hospital with a physician conjures up unwelcome images of being strapped to machines, talked out of natural childbirth or talked into a non-emergency Cesarean section. A birth center, they say, provides a more relaxed, homelike environment without anesthesia or C-sections. Others say they want the option of an epidural for pain relief in a hospital but believe midwives will provide more personal support and be less likely than physicians to intervene with machines, surgery or medication.

Yet, finding a midwife delivery in the Washington area, either in a birth center or hospital, is increasingly difficult. In addition to the higher malpractice premiums, birth centers have found themselves competing with hospitals offering delivery rooms designed to give mothers a more homelike experience.

Last month, the Takoma Women's Health Center shut down when its physicians group owner folded the midwifery practice. At the end of thi
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