Birthing Centers Aren't Always An Option For Women On AHCCCS

By Stina Sieg
Published: Friday, March 24, 2017 - 10:12am
Updated: Friday, March 24, 2017 - 10:24am
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(Photo by Stina Sieg - KJZZ)
Amy Ouzoonian is sure she wants to have her baby in a birthing center, even though it won't be covered by AHCCCS. None of the birthing centers in the Valley accept AHCCCS insurance.

About two dozen people were arriving, plates of cookies and hummus in-hand, at an art gallery in downtown Phoenix. It might not sound like your typical baby shower. But the mom-to-be at the center of it isn’t your typical person.

Pregnant Amy Ouzoonian – her eyelids sparkling with glitter and gems – is a yoga instructor and singer-songwriter, and all-around familiar face in Phoenix’s underground art scene. Right now, she’s also unemployed, after getting laid off early in her pregnancy.

So, like many pregnant women in Arizona, the 38-year-old is on the state Medicaid program – known as AHCCCS. But Ouzoonian doesn’t think that should have any effect on the birth of her daughter, Maitri.

“I feel like it’s really important to me that the experience be a really positive and loving and nourishing experience,” she said.

And for Ouzoonian, that means an unmedicated delivery, aided by a midwife and doula, at the birthing center of her choice. It means being able to eat during the birthing process, being able to move into any position, even give birth in water, if she wants.

Those are all often no-nos at many hospitals, but standard features at many birthing centers. There’s just one big, pricey catch to Ouzoonian’s plan. Because she’s an AHCCCS patient, Ouzoonian’s care at a hospital would be free. But the sticker price at her birthing center is $4,500.

The problem is none of the half-dozen or so birthing centers in the Valley accept AHCCCS insurance. And only a handful in the entire state do, which is not uncommon across the country. This holds true even as the number of birthing centers is greatly increasing – more than 50 percent between 2007 and 2014, according to the Centers for the Disease Control and Prevention.

Ouzoonian knew it would be hard, but she wasn’t ready to give up on her dream delivery. So she set up a GoFundMe account and hoped for the best.

“I wasn’t sure how supportive people were going to be,” she said.

That’s a kind of uncertainty Julia Hall wishes women didn’t have to deal with. As the executive director of Babymoon Inn, one of the oldest birthing centers in the Valley, Hall’s a big believer in the kind of care her center offers – and thinks it should be available to all women.

Hall said the emphasis on postpartum care and help with issues like lactation make birthing centers a good choice for women on AHCCCS, who might benefit from additional resources.

“We would really, really like to serve that population,” she said. “But right now the reimbursement rate is too low.”

The amount of money her center would be given for each mom on Medicaid wouldn’t even cover the cost of a birth, Hall said – far below it, in fact. That’s just not sustainable for her center. It’s a shame, Hall said, because it means she has to say “no” a lot.

“I used to keep a counter, you know, the kind of counter when people walk into a parade or something or like, like a little clicker," Hall said. "I used to keep it by our front desk phone and click off every time a woman who is covered by AHCCCS would call in for information, and it was crazy, the numbers we had."

But the exact number of moms on AHCCCS looking for a birthing center is kind of hard to gauge – even by those within the agency.

“We haven’t heard directly from members that that’s their preference,” said AHCCCS spokesperson Heidi Capriotti.

Capriotti explained that if you’re a mom-to-be on AHCCCS and a birthing center experience is something you want, you should definitely contact her agency. But that’s probably not enough.

You’ve got to contact managed care provider - your health-care plan. They’re the ones who set the reimbursement rates. And Capriotti said they’re the ones who ultimately choose whether or not to include birthing centers in their coverage.

“But we are actively working with our managed care providers to explore options to expand the number of birthing centers available to our members,” she said.

For now, that means many pregnant AHCCCS members in the Valley are still out of luck. But don’t worry about Amy Ouzoonian. She got most of the money she needed from her crowd-funding campaign, and is making payments on the rest.

The donations came from fellow artists, neighbors, friends – some of the very people who came to her baby shower, where they sat in a circle, giving Ouzoonian their best advice, and some diapers, too.

“It’s a beautiful thing when people all come together, and there’s really, a wonderful exchange. It’s just so wonderful,” Ouzoonian said, before breaking into a giggle. “I mean, no health-insurance company will ever give you that. You know?

Baby Maitri is due next week.

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