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Launching a Birth Center

284 285 Launching a Birth Center CYNTHIA FLYNN AND BRIANNA HONEA BENNETT LEARNING OBJECTIVES Upon completion of this chapter, the reader will be able to: 1.    Assess community need and create a mission statement for a new birth center 2.    Understand the different kinds of business structures 3.    Explain the elements of a business plan 4.    Project start-up utilization, revenue, and expenses for a new birth center 5.    Anticipate the unique business challenges that birth centers may face   This chapter is a brief summary of the process of getting a birth center launched. The material is divided into three major sections. The Early Planning section describes a process for assessing the community’s need for a birth center and identifying and addressing any regulatory, financial, or other barriers to starting the birth center. Next, the Start-Up section identifies all of the resources needed before the birth center opens for business. Finally, the Business Plan section describes how the revenue and expenditures of the birth center will be accumulated and dispersed during the first 5 years of operation. After 5 years, the birth center’s volume of business has either reached its breakeven or, in some cases, the volume and profitability of the center are large enough to warrant creating a larger or second center. EARLY PLANNING Community Assessment 286 Starting a birth center requires an assessment of the community’s readiness to accept and grow the center. The Commission for the Accreditation of Birth Centers (CABC) has compiled a list of indicators that can be helpful in assessing the community (CABC, 2015). These include: •    Definition of the expected area that will be served by the birth center. Consider both distance and travel time at different times of the year in estimating the service area. •    Demographics and vital statistics of the population served, including race, ethnicity, cultural and religious background, socioeconomic status, education, and immigration status. Data from the National Vital Statistics Reports for 2013 showed that the percentage of non-Hispanic White births that occurred in a birth center was 0.66%, whereas the percentage of Hispanic births that occurred in a birth center was only 0.17%, or about a quarter of the rate for Whites (Martin, Hamilton, Osterman, Curtin, & Mathews, 2015). Understanding how demographic subgroups in the service area view birth center care and assessing their access to care is critical to sound planning for sustainability and growth (see Chapter 5 ). •    Current availability of and access to maternal and newborn services, including practitioners, hospital obstetrical and newborn services, home birth services, family-centered maternity care programs, birth rooms/suites, and clinics for underserved families, that is, a complete picture of services available for pregnant women. As these data are compiled, it is also useful to assess the availability of potential collaborators and assess whether there are other new services in planning stages. •    Availability of ancillary services, such as ambulance, ultrasound, laboratory, and medical waste disposal services. These services should be easily available to support the operations of a birth center. •    Total birth volume in the service area, perinatal outcome data. Nationally, birth center births comprise about 0.5% of the 4 million births each year. In some smaller communities, birth centers may accommodate as many as 30% of the births. However, now it is more common that after 5 years, the birth center(s) midwives in a community will be attending at most 1% to 3% of the births (2–6 times the national average of birth 287 center births), depending upon community receptivity. For planning purposes, calculating 3% of the total volume of births in an area gives a rough estimate of the likely maximum demand for birth center services. In communities with a single hospital that has a very high cesarean rate, the demand for birth center care may be greater.   It is also useful to consider whether women are choosing to leave the area in order to receive midwifery and/or birth center services, whether women currently choosing home birth would prefer birth center birth, or whether women are receiving suboptimal care due to the high cost of accessing currently available services; these factors can indicate that there is a need for a birth center in the community. At the national level, a well-designed study showed that about a quarter of women who gave birth in the hospital definitely want a birth center for their next birth and an additional 39% would consider it (see Chapter 5 ). However, there are not easy ways to gather such helpful information for a specific community; focus groups or formal surveys may be needed to obtain these data. Taking the time to do a thorough community assessment will ensure that the assumptions made in the business plan will have a sound basis in reality. The assessment will also be helpful in preparing for accreditation. Periodic updates of the community assessment make it more likely that the birth center staff will continue to be aware of any changes that may occur in the service area. Mission Statement A mission statement is a statement describing the purpose of the birth center and what it intends to accomplish. Typically, it will appear on the birth center’s web page, Facebook page, press releases, and similar sources available to the public (see Box 13.1 ). The mission statement also forms the basis of the strategic plan, which includes specific, measurable, attainable, realistic, and time-specific (SMART) goals and a design for achieving them. McMurry University (n.d.) suggests nine components to consider in constructing a mission statement: 1.    Customers: Who are the birth center’s customers? 2.    Products or services: What are the birth center’s major services and/or products? 288 3.    Markets: Where does the firm compete? 4.    Technology: What is the firm’s basic technology (For birth centers: What is the basic approach to caring for women, especially at the time of birth?) 5.    Concern for survival, growth, and profitability: What is the birth center’s commitment toward economic objectives? 6.    Philosophy: What are the basic beliefs, core values, aspirations, and philosophical priorities of the birth center? 7.    Self-concept: What are the birth center’s major strengths and competitive advantages? 8.    Concern for public image: What is the birth center’s public image? 9.    Concern for employees: What is the birth center’s attitude/orientation toward employees? Structure of the Business In most jurisdictions, a business license and/or occupancy permit is required before the business opens. In order to apply for a business license, decisions must be made about the legal structure of the business. In addition, programmatic decisions should be made about how the birth center will operate.   BOX 13.1 Sample Mission Statement Anytown Birth Center provides maternity services in the greater AnyCounty area for women who are expecting a normal pregnancy. Services include prenatal care, including childbirth education, childbirth at the birth center in a homelike environment, breastfeeding support, and postpartum care, including a home visit. We are committed to spending the necessary time throughout the maternity period to ensure that women feel supported to have a healthy pregnancy, safe delivery, and successful parenting experience. We strive to have the best maternity outcomes in the area for healthy women by providing personalized care for each woman using the midwifery model of care. We provide excellent care not only to our clients, but to our staff as well, with a generous benefit package and adequate time for them to be with their own families. 289 Types of Legal Structure The broad types of legal structure used by birth centers, some with several subcategories, are a sole proprietorship, an S-corporation, a partnership, a limited liability company, and a not-for-profit or for-profit corporation (C-corporation). Some states have an additional structure, a benefit corporation, which is a hybrid between a not-for-profit and a for-profit company whose success is measured both by sustainability and by the specific benefits it provides to society, rather than monetary returns to its investors (B-corporation). The Small Business Administration (SBA) has extensive, user-friendly information about each type of structure, which legal structures will work best in a specific situation (requirements, advantages and disadvantages), and how to get started with each one (SBA, n.d.-a). A question asked by many start-ups is whether to be for-profit or not-for-profit. The primary advantages of a not-for-profit are that they do not pay ordinary income taxes, and they can accept tax-deductible donations from individuals and grants from foundations. The primary challenges of not-for-profits are that there must be a board of directors that has final responsibility for all decisions, including employment of the senior management team—that is, the founder—and, in exchange for not paying income taxes, a 990 form must be filed each year. The 990 is a public document that includes detailed financial and other information about the firm, and verification that guidelines about the percentage of income that is used for various functions (including salaries) are being met. The primary advantages of a for-profit are that the founder retains control of the firm, its financials are not public documents, and the allocation of the company’s resources is determined by the center’s management team. The tax implications for the various forms of for-profit companies are discussed in the SBA monographs for each type of business structure (SBA, n.d.). Another resource is “Should Your Business Be Nonprofit or For-Profit?” (Chen, 2013). Board of Directors If the birth center is organized as a not-for-profit organization, a board of directors is required. Many for-profit corporations also have a board that serves similar functions. Selecting directors who possess the skill set necessary to do the job is important. Skills include being able to read and analyze financial statements, understanding contracts and the health care system, the willingness to be politically engaged on behalf of the birth center, and the ability to think about long-term goals and strategies. In the case of not-for-profits, board members are expected to make an annual 290 contribution to the birth center. In the case of for-profits, boards frequently include the investors. Professionals with the skills for the board of directors may include accountants, lawyers, people with master of business administration degrees (MBAs), business owners, and other seasoned business professionals. Although business people can be immensely helpful, one of the most important attributes of a good board member is mission buy-in and understanding of the birth center culture. Choosing board members who are supportive and offer compassion, insight, and sound guidance is most important. Board members who have been a client or family member of a birth center client have a quicker learning curve than those who have not, and are often more invested in the mission of the organization. Birth centers are also encouraged to have a citizen’s advisory group composed of clients of the center, especially if they lack a board of directors. This group can provide feedback to management regarding marketing, client care, ease of use of the facility, and trends in the community that affect the birth center. Open and Closed Models Most birth centers are “closed models,” which means that the providers who practice at the birth center are its owners or employees. This model is advantageous because everyone provides care using the same protocols; the clients are all clients of the birth center, and therefore known to the providers and birth center management; and employees are required to participate in emergency drills and quality improvement initiatives as part of their job descriptions. Some birth centers use an “open model.” This means that providers who are not employees of the birth center can attend births at the facility. This model is particularly helpful in communities that already have several independent practitioners, especially early on before the birth center is filled to capacity. These independent providers would bill insurers separately. However, the birth center can bill a service fee for the use of the facility, just as a hospital would, which is a supplemental source of income. Open model birth centers do require additional management skills. Each midwife must be credentialed as a birth center provider, and it is recommended that they sign a contract with the birth center stating their mutual obligations. In order to ensure that space is available for everyone planning to use the birth center, outside practitioners need to apprise birth center management of their clients planning a birth center birth by 30 weeks of pregnancy. Birth center management should review the prenatal record at about 36 weeks for consistency with birth center risk assessment policies, 291 and start a birth center record for the client. Original records of the period from admission to discharge remain at the birth center. When the mother and newborn are discharged from the practitioner’s care at about 6 to 8 weeks postpartum, notes from the postpartum period should be provided to the birth center so that the birth center has a record of the full episode of maternity care. All practitioners should participate in regular fire and emergency drills for mother and fetus/baby, and in quality improvement/peer review activities. A process should be documented for suspension or termination of privileges. Finally, decisions must be made about any enhanced services that are planned (see Chapter 10 ). Examples of such services offered by birth centers include childbirth education and related classes (e.g., parenting, car seat safety, and so forth), retail store, breastfeeding support for women who are not clients, milk bank, doulas, patient navigators, peer counselors, massage or chiropractic care, acupuncture, yoga or prenatal exercise, nutrition counseling, and social work. Choosing which services to offer, and deciding whether to contract for the services or hire employees, depends both on the space available and community demand, as well as the availability of management time to ensure the quality of such services. Space Considerations Licensure If the birth center is located in a state that requires licensure, there may be regulations about spaces the facility must include and their size. A common criterion is that birth rooms must be larger than a minimum square footage and the smallest dimension (width) must be at least a certain size. Although a birth center is a “maxi-home” rather than a “mini-hospital,” some states do require that hallways between the door that an ambulance would use and each birth room be a certain width. There may be Americans With Disabilities Act (ADA) requirements for the size of the bathroom, and other access factors. When choosing a space for the birth center, all such regulations need to be taken into consideration. Accreditation The CABC has indicators for space that show that the birth center is in compliance with the American Association of Birth Centers’ (AABC) Standards for Birth Centers. For example, birth centers must have adequate space for families, including a kitchen and a family room, with a place for children to play while awaiting the birth. Exam rooms must be large enough to accommodate family members. Most birth centers have 292 at least one large room that can be used for classes, a reception area, a lending library, the family room, and/or staff meetings. Space is also provided for clean and dirty utility areas, laboratory equipment and supplies, a staff lounge, work areas for all staff and contractors, secure records storage, plenty of storage for supplies, medicines and equipment, adequate hand-washing facilities, and bathrooms. Some centers have one exam room large enough to include a rocking chair and supplies for breastfeeding support. Other Space Guidelines The American Institute of Architects (AIA) has specific building guidelines for birth centers that are different from either a midwifery office or a hospital (American Institute of Architects Academy of Architecture for Health & Facility Guidelines Institute, 2011). Another resource is the National Fire Protection Association (NFPA) Life Safety Codes, available at no cost by registering at their website ( www.nfpa.org ). Beginning in section 3.3.33, the Code states that birth centers that do not provide sleeping facilities, and have fewer than four patients at a time (not including infants) be classified as business occupancies (NFPA, 2015). Therefore, they do not require the same fire protection controls as hospitals and ambulatory surgery centers. Some state or local jurisdictions require adherence to AIA and/or NFPA recommendations for licensure or occupancy permits, or they have developed their own guidelines. Learning what is required in advance facilitates the constructing or remodeling of the intended space and prevents rework and delays. Planning for Growth Expected Volume at Capacity The community assessment gives a good indication of the potential demand for birth center services in the service area. Consider having one birth room for approximately 100 births. If the facility is built to fire standards for a birth center (business occupancy), there will be at most three birth rooms (~300 births/year at full capacity) and possibly a “swing” room that is ordinarily used another purpose, such as breastfeeding support, and that can be used before admission for women in early labor on busy days. Some birth centers that do not provide well-woman care use birth rooms for prenatal and postpartum visits. Exam rooms can be smaller than birth rooms and do not need showers and/or tubs, or emergency and other birth equipment. It is usually more cost-efficient to plan for at 293 least one exam room per two birth rooms. If the birth center provides well-woman care for its clients, consider one exam room for each birth room. Number of Employees and Contractors at Capacity Many birth centers begin with a single entrepreneurial midwife who has no employees or contracted help. Although this model provides a needed service to the community while containing costs, it can limit the growth of the center because the management burden in the early years is especially large. Hiring independent contractors during the early growth phase can help to provide flexibility and increased capacity until there is sufficient volume to hire regular employees. Examples of tasks that can be contracted include billing, answering service, childbirth education, doula services, birth assistants, and accounting. As the birth center grows, it becomes cost-efficient to bring some services in-house. Birth centers that only offer prenatal and birth care can anticipate each provider will attend about six to seven births per month, or up to 75/year per midwife. Beyond this volume, quality care may be diminished. If the birth center also offers home birth, the annual number of births will likely need to be reduced in order to account for travel time to homes and the necessity to provide coverage in multiple locations. If the birth center also offers hospital birth, the need to cover two locations and to attend women who have longer than usual labors (such as induction) may again necessitate a reduction in volume per midwife. Location Ideally, the birth center would be located near a hospital in case there is a need for an emergency transport. Access by public transportation is a plus, as is street visibility. Parking is important and some jurisdictions have requirements about the number of parking places needed based on the square footage of the facility. Own Versus Lease Once an approximate idea of the space required is calculated, a decision must be made about whether to lease office space, purchase an existing structure, or build a new facility. The primary advantage of leasing space is that the initial capital necessary for getting started is significantly less than purchasing or building. Also, many amenities may already be in place, such as ADA bathrooms, parking, and floor covering, and the landlord 294 may also be willing to make certain tenant improvements as a part of the contract. Longer leases ensure that the birth center will not need to renegotiate its lease or move frequently, but there will be a penalty for terminating the lease early. In considering the cost of the lease, it is important to understand which costs, such as housekeeping, maintenance, security, and utilities, are the responsibility of the landlord versus the tenant, and the conditions under which these expenses can increase. If the space is leased, the primary asset of the business is the equipment and furniture. Purchasing an existing building or house provides a “hard” asset for the business that may prove useful if a loan is needed for construction/remodeling in order to get started, or a line of credit later. However, purchasing ties up cash that could be used as a reserve for the inevitable variations in monthly income that occur with a new business, and the asset cannot necessarily be sold easily when necessary. Building a new facility is similar to purchasing an existing building. One difference is that it is likely to be more expensive per square foot, since it is new. Also, the time from purchase of the land to opening is longer than the time from purchase of an existing building to opening in the best of circumstances. On the positive side, a new facility can be built so as to ensure that all licensing and accreditation requirements are met, and that the desired amenities are included. Zoning A critical consideration in choosing property is the zoning. In most jurisdictions, commercial zoning is required for a birth center, so most residences cannot be used as a birth center. Rezoning a residential property can be a lengthy, time-consuming, expensive process with uncertain results. When a properly zoned house in a good location that meets budget constraints is found, applying the previous considerations ensures that the space is adequate and that it can be licensed and accredited. The budget will need to include all of the normal expenses of home ownership, such as taxes, insurance, yard work, pest control, repairs and maintenance, and any other local fees, such as for irrigation. Most office space is zoned commercial, so leasing space for a birth center is not straightforward. However, some local jurisdictions have several types of commercial zoning, which may restrict where the birth center can be located. The local zoning regulations should be examined prior to negotiating the lease. With new construction, it is best to have the local zoning office provide a letter in writing that the property that is being considered can be used for a birth center. Early Planning Budget 295 Producing a complete financial plan requires time, energy, and resources, all of which require a budget. For the early planning budget, most of the time and expense budgets relate to gathering data. Formal surveys or focus groups, or the engagement of a consultant to gather information, may require cash expenditures. An example of an early planning budget worksheet is shown in Table 13.1 . START-UP Introduction to the Financial Plans 296 Building a realistic budget for a birth center presents challenges because the industry is still small and there are many variations from center to center in terms of local costs for the major expenses, the amount reimbursed by payers in different areas, the design of the space, and the programs offered. Budgeting also involves making assumptions regarding growth, inflation, staffing, payer mix, and service mix. Therefore, it is important to be clear about the assumptions that are being made. As soon as possible, these assumptions should be tested against actual experience and adjusted accordingly. Following is an example of the process used to construct a financial plan for launching a birth center in Anytown, USA. Once the thought processes behind the elements of the plan are described, examples of spreadsheets can be constructed to incorporate these elements. Spreadsheets should be constructed using formulas that allow the assumptions to be modified as needed. Start-Up Expenses Expenses that will be incurred before the first day that clients are seen are grouped as start-up expenses. In the best of circumstances, once the early planning is completed, there are usually still at least 3 months of work to do prior to opening. Certificate of Need Many states have a Certificate of Need (CON) program . These programs were originally developed to ensure that hospitals did not overbuild, and then charge more for beds that were used in order to cover the costs of empty beds. More information about CONs and a map of the states that require a CON for health care facilities is available from the National Conference of State Legislatures (2016). Some of these states have a CON process for other health care facilities, but do not require that birth centers go through this process. Each state’s regulations have to be checked to know whether a CON is needed and the specific requirements to obtain one. Ordinary Business Expenses 297 Setting up a birth center is similar to setting up any other business. Space must be purchased or leased, and constructed or built out for birth center use, all according to federal, state, and local regulations and AABC’s Standards for Birth Centers so that CABC accreditation is possible. Regulatory fees for incorporation, occupancy, licensure, and accreditation must be paid. Accounts need to be set up to pay local, state, and federal taxes, along with workers’ compensation and unemployment taxes. Some types of revenue received by the birth center prior to opening must be treated as income for tax purposes. An accountant can help with setting up a chart of accounts and a cost accounting system. Bank accounts with appropriate signatories need to be opened. Business insurance such as property insurance (e.g., fire, hazards), general liability insurance (e.g., slip and fall), and directors and officers insurance must be purchased. An insurance broker can advise about other types of business insurance that are available, such as employee theft, data breaches, or income maintenance in case of natural disaster. AABC membership dues for a developing birth center may be paid by the time of opening, or may be paid sooner in order to be able to access the wealth of helpful information contributed by experienced birth center owners. Preparing the Space to Do Business A telephone system must be chosen, and accounts set up with a telephone carrier, water and sewer providers, an electricity provider, an Internet provider, garbage disposal, and a hazardous waste disposal provider. The space must be equipped with furniture, fixtures, furnishings, office equipment, medical equipment, office supplies, medical supplies, and information technology (IT) equipment. Examples of “shopping lists” for such items for a birth center with three birth rooms are provided in a sample worksheet in Table 13.2 . Hiring Staff Once a certificate of occupancy is obtained from the local planning office, employees may be recruited and hired. Salary Determination For the business to be successful and sustainable, everyone—including the founder(s)—needs to be paid a fair market wage. Undercapitalized birth centers are often tempted to “defer” the salary of the founder indefinitely and/or expect staff to work for less than they are worth. A better strategy is to time-limit any deferral and create a believable strategy for repaying the “loan,” and ensure that enough capital is in place to pay staff adequately. If job advertisements state that the birth center is offering competitive wages, some idea of what those wages should be can be inferred from the current wages of the applicants. Median salaries and the range for most jobs in most market areas can be found at this website ( www.salary.com ).   298 TABLE 13.2 Supplies and Equipment Worksheet   Capital Equipment Detail   Budget   Furniture/Fixtures      Tubs (3)      Beds/mattresses (3)      Exam table      Linens/pillows      Washer/dryer      Kitchen equipment      Rugs, lamps, décor items      Total       Office Equipment      Desks      Chairs      Telephone system      Work spaces      Copier/Fax (or lease)      Postage meter      Filing cabinets/safe storage      Computers      Total       Medical Equipment      Rocking chairs (3)      Birth instruments (5 sets)      Autoclave (reconditioned)      Microscope      Birth stool      Infant scales      Adult scale      Blood pressure cuffs (3)      Stethoscopes (3)      299 Dopplers (3)      Oto/ophthalmoscope      Oxygen tanks with regulators      Laryngoscope      IV pole      Fire extinguishers (4)      Glucometer      Total       Medical Supplies      Disposable infant bag & mask (3)      Laryngeal mask airways (3)      Medications      Suture      IV solutions      IV tubing/catheter/needles      Amnihooks      Syringes      Bulb syringes      DeLee mucous traps      Gloves (sterile and nonsterile)      U/A strips      Lancets      Doppler gel      Exam lubricating gel      Autoclave bags      Cleaning solutions for instruments, counters, tubs      Exam table paper      Patient drapes      Underpads      300 Gauze pads      Misc. supplies      Total            IV, intravenous; U/A, urinalysis     Consider how salary increases and bonuses will be determined from the start. Besides cost of living and merit increases, consider “step” increases for longevity and/or total years of experience as a mechanism for encouraging staff retention. Providing raises for well-trained, productive, loyal employees is preferable to the higher costs of replacing an employee, especially a midwife. Employees earning less than $50,000/year cost about 20% of their annual salary to replace, and a physician or executive director costs more than 200% of their annual salary to replace. Registered nurses and midwives fall somewhere in between (Boushey & Glynn, 2012). Benefit Determination Most birth centers offer the same benefits to all employees. Exceptions are the vacation and continuing education benefits for the clinical provider staff, which are often larger than for the administrative staff, in order to compensate for the fact that providers will be required to work weekends and holidays, and their licenses require continuing education. Birth centers that offer a health savings account (HSA) allow the employee to have some choice in how benefit dollars are spent. It is wise to state both the salary and the approximate current combined value of the benefits in a formal job offer. Few start-ups can afford to have the combined value of the benefits exceed 20% of the salary. Examples of benefits provided by birth centers include: 301 •    Health, vision, and dental insurance coverage/health savings account •    Short/long-term disability insurance/life insurance •    Vacation, sick, and parenting leave •    Retirement contribution •    Malpractice insurance/tail insurance •    Continuing education •    Licensing fees/Drug Enforcement Administration (DEA)-controlled substance license •    Profit sharing •    Bonuses •    Cell phone subsidy

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• Cost Outcomes and Finances of Freestanding Birth Centers
• Clinical Outcomes in Birth Centers
• Preparing the Workforce
• Birth Center Regulation in the United States

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Essential steps and resources.

Congratulations! You have come to the right place.  As the nation’s most comprehensive resource on birth centers, AABC works on multiple levels to provide you with a solid foundation on which to build your birth center.

The actions listed below are important steps to opening a birth center. Prepare for your success!

• Attend a How to Start a Birth Center Workshop .
• Become an AABC Developing Birth Center Member .
• Know your community.
• Know the national Standards for Birth Centers .
• Know the birth center regulations in your state.
• Develop your business plan.
• Plan for CABC accreditation from the start.
• Continue educating yourself .

Top Resources for Opening a Birth Center

Standards for birth centers.

Nationally recognized standards address philosophy of care; planning, governance and administration; human resources; facility, equipment and supplies; the health record; research; and quality evaluation and improvement. Learn more>>

How to Start a Birth Center Course

Offered in three formats: online, in-person, and customized. The course provides a comprehensive curriculum taught by industry leaders for everything you need to consider when starting an evidence-based practice in the wellness model of care. Learn more>>

Developing Birth Center Membership

An AABC membership specifically designed for those interested in opening a birth center to provide the foundation and support you need. Learn more>>

Curbside Consulting

Weekly virtual group consulting sessions with the How to Start a Birth Center faculty provide real-time guidance to support your practice. Learn more>>

Member Forums

An active member community with distinct discussion forums for birth centers, alongside midwifery units, and all members Learn more>>

Toolkits for Contracting

Designed to assist with contracting for your birth center including how to determine your break-even. Plus, attend monthly office hour sessions to problem-solve issues you may have. Learn more>>

Sample Policies & Procedures

Don’t reinvent the wheel. Use these samples to get you started. Learn more> >

Developed and tested by birth center personnel and quality management experts. Includes forms and instructions for implementing a CQI program in birth centers. Learn more>>

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• Resources for Entrepreneurs > Becoming an Entrepreneur > Opening a Business

Opening a Birthing Centers Business

Opening a Business

If you are thinking of opening a birthing center, step one is being sure to avoid the mistakes that other entrepreneurs learned the hard way.

Thinking about opening a birthing center? We tell you what you need to know to get started.

Proven Strategies for Birthing Center Business Plans

The idea of writing a business plan is intimidating to most aspiring birthing center owners. If it's comprehensive and well-written, however, your business plan will serve as a strategic anchor point and a calling card for external stakeholders.

After you have written you plan, you'll also need to develop a strategy for your next steps.

A business plan distribution strategy represents the backend of your business planning requirements. To help monitor your progress, you'll need to implement a system for tracking business plan distribution in your startup.

Look Over the Competition

Well in advance of opening a birthing center within your community, it's essential to see what the competition looks like. We've provided the link below to help you find competitors in your city. Just enter your city, state and zip code to get a list of birthing centers in your community.

• Search for Birthing Centers Near You

If there's too much competition, it may be wise to consider starting the business in a less competitive marketplace.

Finding a Non-Competitive Business Mentor

If you are interested in starting a birthing center, you really ought to speak with somebody who is already in the business. Local competitors are not going to give you the time of day, mind you. Why would they want to educate a future competitor?

On the other hand, an individual who has a birthing center in a different city may be willing to share their entrepreneurial wisdom with you, as long as they don't view you as a competitive threat. Many business owners are happy to give advice to new entrepreneurs If you are persistent, you can find a business mentor who is willing to help you out.

Where can you find a birthing center manager in another city who you can speak with?

Here's one way to do it. Just use our link below, find somebody and call them.

• Get In Touch With Birthing Center Owners

Leveraging the Branding Benefits of a Birthing Center Acquisition

Startup birthing centers typically suffer when it comes to brand recognition because unlike entrenched competitors, new brands lack visibility and history with their customers.

To compensate, one of the techniques entrepreneurs use is to buy a business to get an established brand . As a startup, the best you can hope for is to gradually develop brand awareness over a period of months and years.

However, a birthing center acquisition can put you at the helm of a brand that is already highly trusted by your target market.

Is Franchising the Right Option?

Many entrepreneurs recognize that there are many efficiences gained by buying a franchise.

Before starting a birthing center, it's worthwhile to investigate whether franchise opportunities in your space might help you on your entrepreneurial journey.

The link below gives you access to our franchise directory so you can see if there's a franchise opportunity for you. You might even find something that points you in a completely different direction.

• Nation's Largest Health Franchise Directory

Related Articles on Starting a Company

These additional resources regarding starting a business may be of interest to you.

Consideration Before Buying a Franchise

Coming Up With Good Business Ideas

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How to Open a Birth Center or New Midwife Practice: Identifying Community Needs

By Lesley Rathbun

So, you think you want to open a birth center or start a Midwifery service? Understanding the challenges and opportunities of developing either model by performing a Community Needs Assessment is essential to success.

More than a decade ago, I attended the American Association of Birth Centers workshop on how to start a birth center. It was at this workshop where I learned the basics of what it takes to start a birth center business. These events are still held today and are a great place to learn in a supportive setting from knowledgeable instructors.

As a midwife and entrepreneur planning to start your own birth center, it is important to collect all of the education and information you can. Developing this knowledge is essential, but eventually the rubber is going to have to hit the road.

If you’re like I was back then, this is both an exciting and frightening proposition. Starting your own business is a huge step in anyone’s life and you want to make sure you are moving in the right direction from the beginning.

To do this, you need to know what your target community’s needs are. A need could be concrete, such as the absence of a freestanding birth center or Midwifery practice, or a need could be more abstract like a lack of low intervention birth options.

Performing a community needs assessment is the first essential step in determining gaps of services, leading to opportunity and potential in a successful practice. For any business to be successful, it must provide a need to the community that is not currently being met and compliments resources that are already available. It’s a basic business concept, the relationship between demand and supply that you probably weren’t taught in school.

To determine viability for this practice, a community needs assessment is a logical, efficient, integral part of your business plan and should be conducted early in your planning. This allows you to engage community members from the very beginning of the process.

If done well, you will learn more about your target community than you thought possible. Identifying needs and resources will go a long way toward eliminating unpleasant surprises down the road.  By collecting this information before starting a midwife business, you will know what you are dealing with from the beginning, and are less likely to be blindsided later by something you didn’t expect.

Needs and resources are really two sides of the same coin. In order to achieve a comprehensive view of your community, it is important to look at what it has as well as what it needs. With this information, you will be positioned to positively impact the women you serve as well as grow a successful business.

When the time comes to approach hospitals regarding partnership and banks regarding loans early in the process, this information will set you apart as not just an expert midwife, but an expert on the community in which your business will operate.

When I first thought about opening my own birth center in Charleston, South Carolina, I was on my own standing in front of high foot traffic areas (think grocery stores and beaches), clipboard in hand, talking to the women I would eventually serve about their perception of midwifery, natural birth, and birth centers. This is commonly known as a windshield survey method.

Going in, I thought that no more than 15% of the women I talked to would give a positive response to what I was proposing. I was surprised by what I found. After dozens of hours talking to hundreds of women, my survey found that more than 80% of those I talked to were in favor of a birth center in their community. 

While I was performing my survey, I even met an OB-GYN from another part of the state who was impressed enough with my community needs assessment that he asked me if I was interested in moving to partner in starting a birth center.

Performing that first community needs assessment helped me understand the demographics of my community and determine whether or not a birthing center was a viable option. The community needs assessment helped me develop a plan for identifying the gaps and resources in maternity/women’s health care and helped me understand how much interest there was in Charleston for midwife services.

We held a webinar on  Wednesday, December 20th, at 6:00 pm CST.  and discussed common data gathering techniques including holding focus groups, public listening sessions, and windshield/walking surveys. We provided recommendations on how to find online data regarding population make up, insurance demographics, and maternity care options. All are essential to learning as much as you can about the political, geographic and economic climate in your target community for a successful, sustainable practice.

Watch the Webinar Now

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• Midwifery Care

The Nest midwives offer complete prenatal, labor & delivery, postpartum and newborn care, with the option for birth center or home birth. We also offer well woman, gynecological and reproductive health care services with our certified nurse midwife.

We believe that pregnancy and birth are normal life processes, to be treated with honor and respect.

• Vitalistic Whole Health Care

The Nest wellness branch is a multi-disciplinary team of providers, working collaboratively to care for your mental, physical and spiritual health. 

We practice from a vitalist philosophy of medicine, following the wisdom and innate healing ability of your being to uncover the root of any suffering, illness, or disease, and transform it with love – bringing you back to your true, whole self.  

• Whole Health Compendium

The Compendium is an ever-growing  resource repository for living a natural, intentional life.  

We share with you our collective wisdom, knowledge, and experience, from the very practical to the sublime: recipes; herbalism; holistic first aid; traditional  matriarchal practices of healing and ritual; sacred pregnancy, childbearing & parenting stories and skills; and everything in between.

Link coming soon!

• Curated Supplements

Our providers have done the research to select high quality supplements and herbs so you know you’re getting effective therapeutic supplements.

Our inventory includes bundles – preconception and prenatal package, liver package, immunity package, postpartum anxiety/depression package – as well as individual products for digestion, pediatrics, and more!

Purchase with your provider at your next visit or contact us for office hours.

ViviAnne Fischer

Licensed midwife.

ViviAnne brings the deep wisdom of experience to her care for women through prenatal, labor & delivery, and postpartum care.  She integrates the art of traditional midwifery and current knowledge.  ViviAnne enjoys the relationships she develops with families and often creates lasting friendships.  Women appreciate her compassionate, calm and patient nature.

Midwifery care is available at our Pullman, Moscow, and Lewiston offices!

Tina Gearhart

Certified nurse midwife.

As a certified nurse midwife, CNM, Tina is able to provide women’s health midwifery care from adolescence through menopause! She can provide care for Well Woman exams, labs, family planning, and gynecological concerns.  Tina’s straightforward and deeply caring manner really helps women feel informed and empowered in their healthcare. M idwifery care is billable to insurance, Medicaid, or self-pay and is available at our Pullman, Moscow, and Lewiston offices!  Book with any midwife for prenatal care, or book with Tina specifically for Well Woman care.

Naturopathic Doctor, Licensed Midwife

The Medicine Woman of The Nest, Dr. KO guides healing with a sense of patience, ease, and trust.  As a midwife and doula, Dr. KO brings a tender reverence for the sacred transition of birthing.  With a foundation of evidence-based care, she empowers the mother to trust her own body and intuition.  Book with any midwife for prenatal care and Dr. KO will be on your team – the three midwives rotate each week.

Dr. KO is currently not accepting new naturopathic clients; but you are welcome to call us at email [email protected] to discuss options and be added to a wait list for intensive spiritual counseling.

Click below to work with Dr. KO in her weekly group offering, Meditation Circle at The Nest in Moscow Wednesdays at 6pm.

Deborah Webster

Acupuncturist, chinese medicine practitioner.

Deborah believes the body cannot thrive if out of balance and seeks to help her patients feel better through natural means such as diet, and movement, and encouraging their natural healing process with acupuncture. Acupuncture is an amazing, gentle tool that can be used to remind the body that the path to healing is inside all of us. She works with pediatric patients, couples who are preparing for parenthood, and those experiencing pain and discomfort in their bodies. Our bodies reflect what is happening within us and by treating the whole self, our best lives can be appropriately reflected.

Deborah can book at our Pullman or Lewiston offices!

Megan Hewes

Office manager, embodiment instructor.

As the Office Manager, Megan values kindness, efficiency, and beauty.  She is our point person for scheduling, billing, and special projects; and she loves connecting with each client who comes to The Nest.

In Embodiment fitness classes, Megan creates a non-judgmental environment that encourages you to respect and understand your own body while challenging its cardiovascular system, strength, and flexibility.  Above all, expect exercises that feel good and music that makes you want to move!

Jess Mallery

Student midwife, birth assistant.

Jess brings a steadying and supportive presence to births at home and the birth center. As the student midwife at The Nest, she attends office visits and births as an important part of earning her degree from the Midwives College of Utah. Her contributions to maternity care and delivery reflect her deep honor for the experiences of pregnancy, birth, and womanhood.

Jessica Smith

Lactation consultant, nurse.

As your lactation specialist my goal is to compassionately support you through your parenthood experience.  I apply a holistic approach to my practice, combining ancient wisdom with evidenced based science to give you a full range of information. My goal is to create a safe space for you to feel connected, honored, and supported in the decisions that give you peace and joy. This is a very challenging, vulnerable, and intimate time in life and having someone to guide you through your journey can be immeasurable. I feel humbled and honored to work beside parents in this transformational time.

Pullman, WA

425 S. Grand Ave Pullman, WA 99163

Between the Coldwell Banker building and Old European Restaurant. Please parallel park on the south side of the building.

Lewiston, ID

523 1/2 Main St. #207 Lewiston, ID 83501

Next to and above Redingers Photography. Midwifery visits and Acupuncture offered at this location 

424 S Jefferson St. Moscow, ID 83843

We moved to a new Moscow office! Now located in the white house right behind the old Uma Center.

(509) 330-5539

[email protected]

Fax: (509) 795-0936

Mailing address: 425 S Grand Ave. Pullman, WA 99163

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My journey to midwifery started early.  I was born at home with a midwife and grew up surrounded by women who used herbs, homeopathy and food to heal the body.  I was always drawn to pregnancy and birth, however, I took a few detours along the way!  My boys were born in 2002, 2005, and 2006.  I earned my Masters Degree in Human Development shortly after the birth of my second son – with a focus on families and parenting.  In 2007, I became a birth doula while also teaching at WSU.  The calling to midwifery grew louder over time and I went back to school to earn my bachelors in midwifery and become a certified professional midwife in 2015. I love connecting with families and being a part of their journey.  I am passionate about doing what I can as a midwife to facilitate and hold space for normal physiological birth, with the goal always that women will feel they were well cared for, heard and honored.  I am also excited about advancing midwifery care in the U.S.!  I serve as a committee member on the Midwifery Advisory Council in Washington and the Idaho Midwifery Council in Idaho. 

I have been in health care my entire adult life.  I started as a certified nursing assistant working in a nursing home, became a phlebotomist, and an EMT (though, I never worked as an EMT) until I discovered my passion for nursing. I found out I was pregnant with my first daughter the same time I was accepted into nursing school. As a typical first-time mom, I was nervous, excited, and wanted to feel as though I could connect with my OB. After 3 visits of having to explain to him I was there because I was pregnant, I had lost all confidence that he’d be of any use once in labor.  A friend had suggested a CNM (certified nurse midwife), and this was life-changing.  She deserves all the credit for where I am today.  

I attended nursing school at the Colorado Mesa University in Grand Junction, Colorado and graduated with a Bachelor’s of Science in Nursing, in 2002. I started nursing school with a 3 month old, and my second daughter was 3 month old when I graduated… something I don’t necessarily recommend attempting.  While working as a medical/surgical nurse, I attended graduate school at the University of Colorado in Denver and graduated in 2006 with a Master’s in Science specializing in nurse midwifery (Nurse Practitioner, Nurse Midwife).  I would spend the majority of my career in Colorado working in the hospital and clinic setting, until crossing over to the home birth and birth center world. I finished 2021 by becoming an IBCLC (International Board Certified Lactation Consultant). 

I am passionate about women’s health, pregnancy, and birth. I believe in empowering teens to learn and trust their bodies, guiding women and their partners through their low-risk pregnancies and birth, and guiding women through and beyond menopause.  I treat women as a whole – mind-body-spirit – and believe optimal health can be achieved when all three are aligned. As a Certified Nurse Midwife (CNM), I am able to evaluate, diagnose, prescribe medications if needed, and support women throughout the life span. I provide evidenced-based education, resources and recommendations to allow for individuals to make informed decisions about their health in a non-judgemental manner. Types of visits include preconception counseling, birth control (IUDs, Nexplanon, Natural Family Planning, etc.), gynecological visits, annual physical exams, and blood work if needed, and of course prenatal and postpartum visits. As an IBCLC, I support the breastfeeding mama throughout the entire breastfeeding journey. I am also able to evaluate tongue/lip ties and revise them, if and when appropriate.  

I was born in Moscow a few years ago, and grew up on the Palouse. My husband and I live on a lovely farm outside of Palouse that has been passed down by my great-great grandparents who settled here 1913.  I have two grown daughters (22 & 19), one of which is a pharmacy tech, and the other is currently attending WSU – Go Cougs! I am also lucky enough to have two bonus boys (12 & 10); along with the true rulers of the farm, a 7yr old white golden retriever and a 6yr old German Shepard. We are looking forward to bringing more animals back to the farm in the near future.  I love lifestyle photography and more recently have delved into birth photography.  I enjoy running, reading and audible books, gardening, and might be a bit of a wine enthusiast; mostly though, I just enjoy being at home with my husband.

I was born and raised in a suburb of Minneapolis, Minnesota. I graduated from Bastyr University as a doctor of naturopathic medicine. I am also in the final stages of completing a Masters of Science in Midwifery from Bastyr. I was brought to midwifery and naturopathic medicine through the desire for a life dedicated to the pursuit of the overwhelming joy of loving service. I have been volunteering with several organizations to serve underprivileged children in various countries since the age of 16.

I attended Stanford University and graduated with a degree in neurological psychology and a minor in human biology. As I gained more focus on healthcare throughout my undergraduate career, I geared my service work towards sexual and women’s health. After graduation, my entrepreneurial spirit and search for a more holistic system of medicine brought me to a career in naturopathic medicine, and training as a craniosacral and visceral manipulation practitioner and massage therapist. I am very dedicated to the power of holistic healthcare, and I believe firmly in the ability of each individual to manifest their own health. I have begun my clinical education at Bastyr; while my skills continue to evolve, the clinical style I always attempt to embody is illustrated by the phrase, ‘listening in love.’

I came to midwifery through a desire to support health from conception. I ascribe to the belief that a child’s time in the womb and experience of birth are some of the most formative health experiences, and these experiences will continue to impact the health of the individual throughout the entirety of their life.  In addition, I am drawn to the empowerment of women that pervades the field of midwifery, returning to women their dignity and power, and supporting the reclamation of birth by the women who are giving it.

I truly believe that giving birth is one of the most important events that will occur in the life of a woman; I cannot adequately express how excited, honored and grateful I am to have the opportunity to partner with women in this experience.

The foundation of my life, belief, and medical practice is this:

All illness would be eradicated if we could all remember the one essential truth-

Everything is love.

Deborah Webster is a licensed acupuncturist who graduated with her Master of Science in Acupuncture and Oriental Medicine from South Baylo University and holds a bachelor’s degree in Kinesiology with an emphasis in Exercise Science. She loves to help her patients move and feel their best without pain or discomfort. Deborah has experience in treating a wide range of disorders and patient issues which has given her the tools to understand that each person is unique and will have their own healing journey. Our bodies reflect what is happening within us and by treating the whole self, our best lives can be appropriately reflected. This is true for her wellness, fertility, pregnancy, and postpartum patients who are preparing their bodies for the next stage in life. For patients with chronic or acute pain syndromes, Deborah loves the moment when they tell her they are pain-free and they are able to come up with a plan to keep them moving and living their best life. For her pediatric patients, she seeks to help them feel comfortable and safe as they are growing. Acupuncture helps the body by increasing circulation, stimulating the immune system, and improving the body’s pain response. It is both gentle and effective at helping to bring the body back to balance.

I have been the Office Manager of The Nest since October 2018 and am so grateful to be a part of this holistic practice.  My experience here has been both as staff and patient, as I delivered both of my babies at home with The Nest!  Before coming to The Nest I worked in fitness since 2010, with a Bachelors of Science in Kinesiology from WSU and certifications as a fitness instructor and personal trainer.  I am thrilled to merge my background in exercise with the vitalistic approach of The Nest to offer classes that not only challenge cardio, strength, mobility, and balance, but incorporate a meditative quality of movement and closeness with our emotions.

Embodiment fitness classes:

Tuesdays & Thursdays 9:30am

All ages and bodies are welcome in this mindful movement practice that promotes vitality, strength, mobility, and balance. Music-led exercises blend yoga, qigong, dance, weightlifting, and calisthenics with plenty of options to honor and adapt to your body as it is right now, including senior, prenatal, and postpartum bodies. Try out your first class for free!

Then $15/class   or 8 for $12/class

Location: Pullman Parks & Rec Center, Room 213

190 SE Crestview St. Pullman, WA 99163

Student Midwife, DONA Birth Doula

When I was 11 years old, I attended the birth of my little sister. This experience laid the foundation for a lifelong fascination with all things pertaining to childbearing and women’s health. I received excellent midwifery care during my own pregnancies, which inspired me to become a midwife myself. I am currently in midwifery school and have been honored to learn from several local midwives, including the amazing midwives at The Nest. I’ve attended nearly 100 births and am grateful for each of these experiences.

I also work independently as a doula (find me at palousedoulacollective.org).  My goal is to provide support that is suited to the needs of each woman and her family. Creating such support requires time, attentiveness, and honor for the unique needs of each client. Because of this, I place high value on prenatal visits in which we get to know each other, explore individual goals, preferences, concerns, and questions. I do my utmost to ensure my clients have access to evidence-based information, are honored in their decisions, and feel prepared to welcome their baby. I support labor and delivery through in-person emotional and physical care. And in the early postpartum days, I remain available to offer a listening ear, gentle advice if it is desired, and connection to additional community resources. It is my joy and privilege to support this sacred and ordinary process.

When I’m not busy with birth work, I enjoy cooking, making things with yarn and fabric, and exploring with my family. My husband and I live in Latah County, Idaho, and have five children.

Nurse, Lactation Consultant

Hi there, I’m Jessica Smith. I offer lactation consultation at The Nest for the greater Palouse community, whether you are a Nest midwifery patient or not.  I’m a nurse, IBCLC (International Board Certified Lactation Consultant), Certified Birth and Postpartum Doula (find me at palousedoulacollective.org), and Certified Breastfeeding Educator. I’m also a rural, homeschool momma of four littles living on our regenerative farm with ALL the animals in Palouse, WA.

My interest in wellness, birth, babies and maternal health started from a young age. During high school and college I taught swim lessons and worked at a long term care facility as well as a special needs home. Upon graduation I worked as a school nurse, pediatric home-care nurse, and a minor-care/ready-care nurse. But, soon my passion for the healthcare, or rather dis-ease care system began to wane. I was constantly trying to get my patients outdoors to experience the world and nature around them. I wanted to help them live healthy, balanced lifestyles. My passion for getting back to nature and our roots continues throughout my own life and blends into my work. This is why I take a “holistic” approach.

When my own journey with motherhood began, I was awakened to the fact that in our culture there is a disconnect between birth and postpartum. Like many, I prepared for the birth but never really gave much thought to postpartum. While planning for birth is important, planning for the postpartum period is even more important. I found myself struggling with lack of resources and unable to ask for help. I struggled with breastfeeding, low supply, and ended up supplementing. Through help of doctors and lactation consultants we ended up saving my breastfeeding experience for two years and then was able to successfully tandem nurse when baby #2 arrived! I experienced birth trauma and postpartum anxiety & depression. I struggled to find balance and healing again after each baby. I came across Julia Jones Newborn Mother’s Collective, Ayurveda Postpartum care and found the missing link in my postpartum experience. Through the wisdom of ancient traditions and scientific role of Oxytocin, I learned what we have missed in our culture. While there’s much from ancient traditions and culture, we can’t apply to our modern lifestyle there are two culturally universal things we can do, help and support the new mother and offer nutrient dense, warm prepared meals.

Through my pediatric nursing experience, I cared for many previous NICU babies with unique challenges, in which I saw a vast difference in the ones who were fed breastmilk. This led me to dive deeper into the lactation world and fueled my love for working with families through difficult times. I furthered my education and became certified as a breastfeeding educator and birth doula.  Birth work has caused me to look deeper at my own healing so I can show up for clients with positive energy. As your lactation consultant my goal is to support you through your experience. I love working and troubleshooting through challenges with clients to apply what feels right for you and your needs. I want to guide you where necessary with an open mind well as empower you and promote healthy lifestyle.

The best to you, Jessica

Special Trainings:

• Midwife Assistant Training | 2009
• Lewis-Clark State College, Nursing Graduate | 2011
• Postpartum Doula Training, Newborn Mother’s Collective | 2015
• Certified Birth Doula | 2015
• Certified Lactation Educator, Evergreen Perinatal Education | 2016
• Intuitive Birth for Birth-Workers | 2019
• Perinatal Mood and Anxiety Workshop, Perinatal Support Washington | 2020
• University of San Diego Extension, Lactation Consultant Didactic and Internship | 2021
• Steamy Chick, Peri-Steam Facilitator | 2021
• Tongue Tie, A Comprehensive Approach to Assessment and Care, Melissa Cole, MS, IBCLC | 2022
• International Board Certified Lactation Consultant | 2022

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How to Enhance Profitability at Your Birth Center

By alex ryzhkov, get full bundle.

Exploring the financial viability of birth centers unveils a complex landscape of profit margins, operational costs, and revenue streams. As these facilities strive to offer a personalized and intimate birthing experience, potential investors and healthcare professionals often ponder several critical questions. How do birth centers sustain their business models while ensuring high-quality care? What are the main financial challenges they face in comparison to traditional hospitals? This introduction delves into the seven pivotal questions regarding the profitability of birth centers, providing insights into their economic dynamics and strategic financial planning essential for their success.

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• What Are The Costs To Consider When Establishing A Birth Center?
• Determining Birth Center Business Worth?
• Comprehensive Guide: Crafting a Business Plan for a Birth Center
• Evaluating Birth Center profitability
• Identifying key revenue sources for Birth Centers
• Time frame for Birth Center profitability
• Calculating ROI for Birth Centers
• Assessing financial risks in Birth Center operations
• Strategies for revenue diversification in Birth Centers
• Impact of competition on Birth Center profitability

Is a Birth Center a profitable business venture?

Investigating the birth center profitability inherently involves understanding various economic and sector-specific factors that influence earnings and sustainability. Birth centers, as part of the broader maternity center business, offer a distinctive approach to childbirth, focusing on a more natural, less medicalized experience. The profitability of such an endeavor hinges on various key elements including market demand, operational efficiency, and effective financial management.

The concept of birth center business is not just a healthcare service but also a deeply personal choice for parents-to-be. With an increasing number of families looking for personalized, respectful, and natural birthing experiences, the demand for birth centers has seen a notable rise. According to recent studies, the number of birth centers in the United States has increased by over 25% from 2020 to 2022, reflecting growing consumer preference for these facilities.

However, turning these facilities into profitable ventures requires careful consideration of birth center revenue streams and birth center ROI (Return on Investment). Revenue for birth centers can come from various sources:

• Direct payments from clients for prenatal, birth, and postpartum services.
• Insurance reimbursements, depending on the network and agreements with insurance providers.
• Auxiliary services such as childbirth education classes, lactation consulting, and postnatal yoga.

Among the primary financial risks of operating a birth center are the upfront costs associated with setting up a facility that meets both health regulations and creates a welcoming, home-like environment. Furthermore, ongoing expenses such as staffing, insurance, and supplies must be meticulously managed to avoid financial strain.

Tips to Enhance Birth Center Profitability

• Expand service offerings to include comprehensive prenatal and postpartum programs, thus increasing client retention and satisfaction.
• Develop partnerships with local healthcare providers to receive referrals and enhance the care continuum.
• Utilize digital marketing strategies to improve visibility and attract a larger clientele base in the competitive birth center market competition .

According to industry benchmarks, the average return on investment for birth centers can vary widely, but many centers reach a break-even point within the first 3 to 5 years of operation. This profitability timeline for birth centers depends heavily on local market conditions, the efficiency of operations, and the ability to diversify and optimize income sources.

In the realm of strategies to enhance birth center profitability , understanding and adapting to local market needs is crucial. For instance, in areas with high demand for natural birthing options, centers can capitalize on this by offering unique, personalized experiences that differentiate them from traditional hospital births. Additionally, integrating technology for better service delivery and client engagement can also play a significant role in enhancing birth center financial risks management.

Ultimately, the success and profitability of a birth center are contingent upon delivering high-quality care, maintaining operational excellence, and continually adapting business strategies to meet the evolving needs and preferences of families. With a focused approach towards maximizing income sources for birth centers and effective management of overhead, birth centers can indeed prove to be a profitable business venture in the burgeoning field of alternative maternity care.

What are the key revenue streams for a Birth Center business?

The financial viability of a Birth Center hinges on identifying and leveraging multiple revenue streams effectively. As the healthcare sector continues to evolve, particularly in the maternity care segment, understanding these sources of income is crucial for the sustainability and growth of a birth center business.

Primarily, births centers operate on a fee-for-service model. This foundational revenue stream involves clients paying out-of-pocket for the prenatal, delivery, and postnatal services they receive. Unlike traditional hospital settings, birth centers provide a more personalized, intimate experience which can often justify a premium pricing strategy. According to industry benchmarks, the average cost for a delivery at a birth center can range significantly depending on location and services provided, but typically it lies between $3,000 and $5,000.

Beyond the direct fees for services, other significant sources of revenue include:

• Workshops and Education Classes: Many birth centers offer classes on childbirth preparation, newborn care, breastfeeding, and maternal yoga, amongst others. These classes not only provide additional income but also help in establishing a stronger bond with clients which can lead to higher client retention and word-of-mouth referrals.
• Add-on Services: Upselling services such as water birthing, acupuncture, or massage therapies during the prenatal or postnatal period can significantly enhance revenue. Offering these specialized services allows the facility to cater to a broader client base seeking a holistic birthing experience.
• Partnering with Healthcare Professionals: Collaborating with obstetricians, pediatricians, and other specialists to provide comprehensive care options can open additional revenue streams through referrals and shared service agreements.

Moreover, birth centers can diversify their revenue by participating in health insurance networks. While navigating insurance agreements can be complex, inclusion in such networks could allow a broader demographic of clients who might prefer the birth center experience but rely on insurance coverage.

Strategies to Enhance Birth Center Profitability

• Optimize Resource Utilization: Efficiently manage staffing and inventory to reduce overhead costs while maintaining high-quality service delivery. Scheduling and resource allocation technologies can streamline operations.
• Expand Community Outreach: Engaging with the local community through open days and participation in local health fairs increases visibility and attracts new clients.
• Focus on Quality and Safety: High standards of care and safety improve client satisfaction and can lead to reduced liability and increased referrals.

As per a recent industry report from 2022, birth centers that focus on a diverse service offering and strong community engagement report higher satisfaction ratings and, consequently, a more robust return on investment for birth centers . The report also highlighted that successful birth centers typically see a break-even point within the first three years of operation, which is a crucial benchmark for potential investors and stakeholders considering the financial risks of operating a birth center .

In conclusion, the revenue model of a birth center is multifaceted. While the core income often comes from the direct payment for childbirth and associated services, effectively managing and expanding ancillary services and harnessing the power of community engagement play pivotal roles in driving the birth center profitability .

How long does it typically take for a Birth Center to become profitable?

The timeline for a Birth Center to reach profitability can vary widely depending on numerous factors, including initial investments, operational efficiency, and market conditions. Typically, industry benchmarks suggest that a Birth Center can begin to see profitability within 2 to 4 years after opening. This window allows for the substantial upfront costs associated with launching a birth center business, such as facility leasing or purchasing, equipment acquisition, and staffing.

Understanding the birth center revenue streams is crucial in predicting the timeline to profitability. These centers generally rely on payments received directly from clients or through insurance providers. The fee-for-service model, where clients pay for prenatal, birth, and postpartum care, allows for straightforward revenue calculations, but also introduces variability based on the number of clients served and the types of services offered.

• Diversifying revenue : Adding ancillary services such as childbirth preparation classes, lactation consulting, and postpartum support can help stabilize income streams.
• Optimizing operational efficiency : Streamlining administrative processes and utilizing technology for scheduling and records can reduce overhead costs and improve client satisfaction.
• Effective marketing strategies : Focused marketing efforts on the unique benefits of midwife-led care and the intimate, home-like setting can attract more clients.

Market competition within the maternity center business also significantly influences profitability timelines. A Birth Center operating in a community with high demand for personalized, holistic birthing experiences may find quicker financial success than one in an area with intense competition from hospitals or other birthing facilities. As such, a strategic analysis of birth center market competition is indispensable.

Another critical factor is the birth center ROI (Return on Investment) . This indicator helps potential investors and owners understand when their initial investments will likely be recouped. According to recent analyses, the ROI for birth centers can be positively impacted by maintaining high standards of care, which boosts client retention and referrals—key components for ongoing financial sustainability.

Nevertheless, potential financial risks of operating a Birth Center should not be overlooked. These include regulatory changes, insurance policy shifts, and potential legal challenges which can influence profitability. It's essential to establish a robust risk management strategy to address these issues proactively.

In conclusion, while the "profitability timeline for birth centers" generally ranges from 2 to 4 years, achieving and maintaining profitability requires a balanced approach focusing on efficient operations, market understanding, strategic revenue diversification, and effective risk management.

What is the typical return on investment (ROI) for a Birth Center business?

Understanding the typical return on investment (ROI) for a Birth Center business requires comprehensive analysis of various financial metrics and market dynamics inherent to the healthcare and wellness industry, specifically within the niche of maternal and child health. Birth centers provide an alternative to traditional hospital births, advocating a more personalized, tranquil birthing experience. This business model, focusing on a fee-for-service system where clients pay for prenatal, birth, and postpartum care, involves substantial initial investment along with continuous operational costs. The profitability of birth centers, therefore, hinges on several critical factors.

When examining birth center ROI , it's important to consider initial setup costs, which typically include physical space acquisition or leasing, medical equipment, licensing and insurances, and staff hiring. According to industry studies and market research from 2022, the start-up costs can range significantly depending on location and size but generally fall between $250,000 to $500,000. Operational costs, primarily comprising staff salaries, utilities, and ongoing medical supplies, also need to be factored into the financial planning of a birth center.

The revenue for a birth center is principally generated from the fees charged for maternity care services offered. These encompass prenatal visits, the birth itself, and postpartum care. Additional income sources for birth centers include offering classes such as childbirth education, lactation consulting, and even incorporating holistic services like yoga or massage tailored toward pregnant women. In 2022, average charges for a birth at a birth center were reported to be around $3,000 to $4,000 per birth, though this can vary significantly based on geographical location and service complexity.

The profitability timeline for birth centers typically stretches over a few years. Most birth centers reach a break-even point within 3 to 5 years, subject to effective management and local market conditions. This timeline is crucial for investors and entrepreneurs to consider, as it impacts the liquidity and risk factors involved.

Diversifying revenue in birth centers is a strategic approach to enhancing overall profitability. By not solely depending on direct birthing services, centers can stabilize income streams and mitigate financial risks of operating a birth center . Engagement with insurance networks, although complex, can also substantially boost revenue by broadening the client base to those who prefer or require insurance cover.

Tips to Optimize the ROI of a Birth Center

• Streamline operations by adopting efficient scheduling software and administrative systems to reduce overhead costs and improve client satisfaction.
• Expand service offerings to include postpartum home visits, which can enhance client retention and attract new customers looking for comprehensive care packages.
• Engage in community outreach and partnerships with local healthcare providers to enhance referral networks and increase market visibility.

When assessing the return on investment for birth centers , it's also vital to consider the birth center market competition , which has been intensifying as the preference for personalized and non-invasive birthing experiences grows. Successful birth centers often focus on exceptional service quality, client education, and maintaining high safety standards, which significantly contribute to their market differentiation and profitability.

In conclusion, while the ROI for a birth center can be quite variable, informed financial planning, strategic service diversification, and robust operations management can vastly improve the financial outcomes. Prospective birth center operators should undertake thorough market analysis and continuous assessment of both internal operations and external market conditions to ensure sustainable profitability and service excellence.

What are the most significant financial risks when operating a Birth Center?

Operating a Birth Center involves distinct financial risks which are imperative to understand for anyone looking to enter or sustain their position in this niche market. These risks can broadly impact the birth center profitability and long-term viability of such ventures.

The primary financial risk comes from the substantial initial capital requirement. Establishing a Birth Center demands significant investment in terms of both infrastructure and personnel. This includes costs related to acquiring a suitable property, retrofitting it to meet medical and comfort standards, purchasing necessary medical equipment, and hiring qualified staff such as certified midwives and doulas. As per a 2022 report, the up-front costs for starting a small to medium-sized birth center can range between $500,000 to $1 million, depending on location and scale.

Another major financial risk is the volatility of market demand . Birth Centers predominantly operate on a fee-for-service model, making their revenue streams heavily dependent on the number of clients they serve. Fluctuations in birth rates, changes in public health policies, or shifts in patient preferences towards hospital births can significantly affect their client intake. For instance, a sudden decline in local birth rates in 2023 could lead to underutilization of facilities, directly impacting the birth center revenue streams .

Insurance and reimbursement issues also pose a substantial risk. Many insurance plans have stringent criteria for covering births in non-hospital settings, which can limit client bases to only those who can afford out-of-pocket expenses or those whose insurance plans cover such services. This uncertainty in insurance reimbursements can make projecting birth center ROI challenging and affect overall financial stability.

Competitive pressure from traditional hospitals and other birthing facilities also constitutes a significant risk. Hospitals often have better financial backing and can provide a broader range of emergency services, which might be appealing to risk-averse clients. Birth center market competition from well-established hospitals with obstetric departments can lead to a significant reduction in market share for standalone birth centers.

Regulatory risks cannot be overlooked as they directly influence operational norms and cost structures. Birth Centers must comply with both state and federal regulations, which may involve costly licensing fees, regular inspections, and mandatory staff certifications. Non-compliance can result in fines or even closure, impacting both revenue and reputational standing.

Tips to Mitigate Financial Risks for a Birth Center

• Diversify revenue sources : In addition to core services, offer complementary services such as prenatal yoga classes, educational workshops for expectant parents, and postpartum support groups, which can help stabilize income.
• Engage in community outreach : Increase visibility and client trust through active engagement in community events, which can drive word-of-mouth referrals and strengthen client base stability.
• Optimize insurance partnerships : Work closely with insurance companies to become a part of more insurance networks, potentially increasing the number of clients who can access services through insurance coverage.

The challenges of maintaining profitability in a Birth Center are therefore intertwined with managing these inherent financial risks. By understanding and strategically addressing these risks, operators can not only safeguard but potentially enhance their birth center profitability . This requires a keen eye on shifts in market dynamics, proactive financial management, and continuous adaptation to the complex healthcare landscape.

What strategies can a Birth Center employ to diversify revenue streams and enhance profitability?

In the ever-evolving landscape of healthcare, the sustainability of a birth center business hinges on its ability to adapt and innovate in terms of revenue generation. The traditional fee-for-service model, where clients pay for prenatal, birth, and postpartum care, provides a solid foundation; however, diversification of income sources can significantly boost birth center profitability .

Firstly, broadening the scope of services is an essential strategy for any birth center looking to enhance revenue streams. Beyond basic midwifery and doula services, successful birth centers are increasingly incorporating additional wellness services that appeal to expectant mothers. These might include prenatal yoga classes, massage therapy, lactation consulting, and nutritional counseling. For instance, a 2022 study indicated that centers offering a spectrum of wellness services saw a 20% increase in client retention and a corresponding boost in profitability.

Key Tips for Expanding Birth Center Services:

• Partner with professionals: Collaborate with yoga instructors and massage therapists to offer classes and services on-site.
• Offer specialized workshops: Conducting educational sessions on topics such as childbirth preparation or newborn care can attract a broader clientele.
• Implement a membership model: Create membership packages that include a variety of services at a discounted rate, encouraging ongoing engagement.

Another effective method to diversify revenue is through the implementation of ancillary product sales. Selling maternity and baby products such as prenatal vitamins, nursing bras, and organic baby clothing can leverage the trust clients place in their care providers while simultaneously increasing revenue. Reporting from a 2023 industry analysis showed that birth centers with retail operations reported a 15-25% increase in annual revenue.

Technological integration also plays a crucial role in the modern birth center business . By offering telehealth services, birth centers can not only expand their market reach to include remote clients but also supplement their main income. Telehealth offerings can range from virtual consultations and birth planning sessions to online postpartum support groups, tapping into the growing demand for digital health solutions.

Leveraging the birth center's community presence can further enhance its financial viability. Initiating or strengthening partnerships with local hospitals can steer overflow patients who prefer a natural birthing experience to the birth center, thus boosting client numbers and, inherently, revenue. Furthermore, hosting community events and educational seminars can elevate the center's profile and attract a wider audience.

Lastly, exploring alternative financing models like subscription or bundled payment arrangements can address the financial risks of operating a birth center . These models provide predictable income streams and can make care more affordable and accessible, potentially increasing the client base. For example, as revealed by recent data, centers adopting bundled payments saw a reduction in administrative costs by up to 30%.

In conclusion, while the path to enhancing birth center profitability involves navigating through a complex landscape of birth center market competition and financial risks , a strategic approach in diversifying services, incorporating retail and technological solutions, and engaging the community can substantially uplift the ROI for birth centers .

How does market competition affect the profitability of a Birth Center?

Understanding the dynamics of market competition is crucial for assessing the viability and long-term success of a Birth Center. The competitive landscape can significantly influence several factors that determine a Birth Center's profitability such as pricing, client volume, and service quality. As we delve into this relationship, we will explore how these factors interplay and impact financial success.

In recent years, there has been a notable shift in the preference for personalized and non-invasive birthing experiences, which has led to increased demand for services offered by Birth Centers. Birth Center profitability depends heavily on how well it can capitalize on this trend relative to its competitors. According to the American Association of Birth Centers, the number of operational birth centers increased by approximately 80% between 2010 and 2020, reflecting a growing market yet also indicating heightened competition.

Competition in the birth center market typically comes from three main categories: traditional hospitals, other birth centers, and at-home birth services provided by midwives or doulas. Each type of competitor comes with its own set of strengths and challenges for a birth center. For example, while hospitals often offer more extensive medical facilities and can handle higher-risk pregnancies, Birth Centers are preferred for their home-like environment and personalized care, especially for low-risk pregnancies.

One of the primary areas where market competition influences birth center financial risks and profitability is through pricing strategies. Birth Centers need to competitively price their services to attract expectant mothers who are looking for a cost-effective yet comfortable alternative to hospital births. However, setting prices too low can squeeze profit margins, while too high might alienate a significant portion of potential clients.

Tips to Outmaneuver Market Competition and Enhance Profitability:

• Offering unique value-added services such as prenatal yoga, breastfeeding classes, and postpartum support groups can distinguish a Birth Center from its competitors.
• Implementing efficient operational practices to reduce overhead costs, thereby allowing more competitive pricing while maintaining healthy margins.
• Building strong community relationships and partnerships with healthcare providers can enhance referrals and increase the client base.

Another critical aspect influenced by competition is the capacity to innovate and maintain high service quality. In the face of increasing birth center market competition , centers must continuously invest in skilled staff, advanced training, and facility improvements to meet clients' expectations and enhance childbirth center revenue .

Market saturation is another factor to consider. As more Birth Centers enter the market, especially in urban areas, the competition for a share of the market intensifies. This can lead to a scenario where only the most well-managed and distinctively branded centers thrive. A study of market trends from 2022 highlights that centers which strategically located themselves in under-served suburban or rural areas tended to perform better in terms of return on investment for birth centers .

Understanding and adapting to the competitive dynamics of the Birth Center industry are essential for ensuring successful operations and optimal birth center ROI . By analyzing competitors and correctly positioning their services, Birth Centers can not only survive but also thrive in this evolving healthcare landscape.

Ultimately, each Birth Center must evaluate its competitive environment and determine the best strategies to ensure its profitability and sustainability. While competition poses challenges, it also pushes Birth Centers to elevate their level of care, innovate in service delivery, and enhance overall client satisfaction, which are all crucial factors for long-term success.

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Ukraine war latest: Zelenskyy sacks air force chief; girl among six killed in Russian bomb attack that hit Kharkiv playground

Ukrainian President Volodymyr Zelenskiy has dismissed the country's air force commander Mykola Oleshchuk after claims an F-16 pilot was killed by friendly fire. Six people have died, including a 14-year-old girl on a playground, in a Russian guided bomb attack on Kharkiv, officials say.

Friday 30 August 2024 21:50, UK

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• Zelenskyy sacks Ukraine's air force commander
• Decision comes after MP claimed F-16 pilot was killed by friendly fire
• Girl among six killed with dozens injured in strike on Kharkiv
• Russia accused of war crimes over guided bomb attack that hit playground
• Women killed in strike on Sumy region that hit baby food packaging factory
• Putin to visit International Criminal Court member Mongolia
• Analysis: Why Putin's arrest in Mongolia is unlikely
• Battlefield situation: Latest frontlines in maps
• Watch: Who are Ukraine's secret resistance?
• Your questions answered: Strategic consequences for Ukraine if Pokrovsk falls
• Reporting by Bhvishya Patel , and earlier by  Mark Wyatt

We'll be back with more updates and analysis soon, but before we go, here's a recap of the key developments that took place today:

• Volodymyr Zelenskyy has sacked Ukraine's air force commander, days after a pilot died when an F-16 jet crashed
• Six people have died and at least 55 others hurt following a Russian guided bomb attack on the city of Kharkiv;
• Two women died and 11 people were injured by an attack which struck a factory in Sumy that manufactures packaging for baby food, juices and household products;
• The Kremlin announced that Vladimir Putin plans to visit Mongolia - a member of the International Criminal Court which has an issued an arrest warrant for him;
• The Ukrainian pilot killed when his F-16 fighter jet crashed on Monday was shot down by Ukraine's own anti-aircraft missile system, an MP has claimed;
• Mr Zelenskyy said today's attack on Kharkiv could have been avoided if Ukraine had permission to strike Russian military targets with Western weapons;
• The EU rebuffed a request from Kyiv for the bloc to train Ukrainian soldiers inside the war-torn country.

Ukrainian President Volodymyr Zelenskyy has dismissed the country's air force commander Mykola Oleshchuk.

The sacking was announced on Friday in a presidential decree. 

There was no immediate explanation from Mr Zelenskyy for his decision but it comes days after a Ukrainian pilot was killed when his F-16 jet crashed on Monday.

Lieutenant Colonel Oleksiy Mes was killed while defending Ukraine's skies in a Western-donated warplane.

Ukrainian MP Mariana Bezuhla has claimed the jet was shot down by the country's own anti-aircraft missile system.

In response to Ms Bezuhla before his sacking, Lieutenant General Oleshchuk said her comments were a "tool to discredit the top military leadership".

"Mariana, the time will come when you will apologise to the entire army for what you have done, I hope in court!", he added.

Six people are now known to have died following the Russian guided bomb attack on Kharkiv, local authorities have said.

Kharkiv mayor Ihor Terekhov said one child was killed in a playground and three people were killed in a 12-storey apartment block that caught fire as a result of the strike.

The Ukrainian authorities did not give the circumstances in which the two other people died in the strikes, which hit four areas of the city. 

As well as those people who died, at least 55 others were injured, officials said. 

About 20 of the injured were in severe condition, according to regional governor Oleh Syniehubov.

Top Ukrainian officials have begun a visit to Washington, the Ukrainian presidential office has said. 

The delegation includes economy minister Yulia Svyrydenko and defence minister Rustem Umerov.

"We are working in Washington... We are grateful to our partners for their support," the president's chief of staff Andriy Yermak said on Telegram .

The visit comes amid Volodymyr Zelenskyy's renewed a call on Western allies to allow Ukraine to use long-range Western weapons to attack Russian military air bases.

Kyiv says that the most effective way to counter Russian strikes is to target Russian planes, not the bombs themselves.

The US ambassador to Ukraine has called on Russia to be "held accountable for these war crimes" in Kharkiv. 

In a statement on X, Bridget A Brink said "Russia struck an apartment building in Kharkiv with a guided aerial bomb, killing several and injuring many, including children".

Kharkiv has been the focus of heavy Russian bombing throughout the war, although there had been a drop in intensity in recent weeks, possibly related to a surprise invasion launched by Ukrainian forces into Russia's Kursk region.

Ukrainian authorities said today's attack involved five aerial guided bombs launched from planes in Russia's Belgorod region, also known as "glide bombs" which are fitted with a navigation system taking them to their targets.

The footage below shows the aftermath of the attack in Kharkiv.

The EU has rebuffed a request from Kyiv for the bloc to train Ukrainian soldiers inside the war-torn country, but will train them as close as possible to Ukrainian territory, EU foreign policy chief Josep Borrell has said. 

The EU has trained some 60,000 Ukrainian soldiers inside the economic union's borders since Russia's invasion of the country and will aim to train 15,000 more by the end of the year, Mr Borrell said.

Kyiv has asked the EU to consider some training inside Ukraine, arguing this would be faster, more cost-effective, and logistically easier than inside the EU.

But multiple EU countries are reluctant to deploy troops inside Ukraine, expressing concerns about their safety and questioning whether such a move would divert Ukrainian forces from their core mission, in order to protect trainers.

Mr Borrell told reporters: "Some member states were ready, others reluctant.

"Finally, we decided that the training will be as close as possible to Ukraine, but not in Ukrainian territory."

Ukraine has urged Mongolia to arrest Vladimir Putin on an International Criminal Court (ICC) warrant when he visits next week.

The court issued an arrest warrant in March of last year against Mr Putin, accusing him of the war crime of illegally deporting hundreds of children from Ukraine. 

The Kremlin has dismissed the accusation, saying it is politically motivated.

The warrant obliges the court's 124 member states, including Mongolia, to arrest Mr Putin and transfer him to The Hague for trial if he sets foot on their territory. 

Now, the Ukrainian foreign ministry has called on the ICC to arrest the Russian leader when he visits Mongolia on 3 September. 

"We call on the Mongolian authorities to comply with the mandatory international arrest warrant and transfer Putin to the International Criminal Court in the Hague," the ministry said on Telegram.

Asked earlier today whether Moscow was concerned that Mongolia was a member of the ICC, Kremlin spokesman Dmitry Peskov told reporters: "No, no worries about this. We have a great dialogue with our friends from Mongolia."

Asked whether there had been discussions with Mongolian authorities about the ICC warrant, Mr Peskov added: "Obviously the visit, all of the aspects of the visit have been thoroughly discussed."

Volodymyr Zelenskyy says he held a meeting with the top military commanders of Ukraine this afternoon.

The president said that three key issues were discussed, starting with the situation on the frontlines.

Kursk invasion

Ukraine's top commander says Kyiv's forces have advanced up to 2km in their invasion of Russia's Kursk region.

Oleksandr Syrskyi briefed Mr Zelenskyy via video link and said Ukrainian forces took control of 5sq km of Russian territory. 

Discussions were also had over the next set of reinforcements in the area, which Mr Zelenskyy said was "extremely important for strengthening our positions".

General Syrskyi also briefed the president on the ongoing fighting near Pokrovsk, which Ukraine is trying desperately to hold in the face of advancing Russian troops.

Preparing for new academic year

The meeting also covered how Ukraine will deal with the new academic year for schoolchildren, which starts next week.

Mr Zelenskyy heard reports from Prime Minister Denys Shmyhal, internal affairs minister Ihor Klymenko and education and science minister Oksen Lisovyi.

The president said discussions covered security issues, as well as the construction of bomb shelters.

Energy problems

The third key issue addressed was the current state of Ukraine's energy grid following a week of heavy Russian strikes.

Mr Zelenskyy heard analysis of energy issues, including the potential construction of protective structures around key energy infrastructure.

Images are emerging of the aftermath of today's attack on Kharkiv.

Russia denies deliberately targeting civilians, but thousands have been killed and wounded in its strikes during its invasion.

The scenes come as Volodymyr Zelenskyy renews a call on Western allies to allow long-range attacks on Russian military air bases after the attack.

The number of people killed in a Russian strike on Kharkiv has risen to five.

Meanwhile, 40 people have been injured after the Russian missile hit a residential building and playground, according to the regional governor Oleh Syniehubov.

Earlier, we reported that a 14-year-old girl was among the dead.

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Designing the Perfect Birth Center Floor Plan: Essential Tips and Considerations

• June 20, 2024

Designing a birth center floor plan requires careful planning to ensure functionality, comfort, and safety for both patients and staff. Here’s a comprehensive guide to creating an optimal birth center layout:

• Begin by assessing the space needed for various areas such as reception, waiting rooms, consultation rooms, birthing suites, postpartum rooms, and administrative offices.
• Consider future growth and scalability in your design plans.
• Design the floor plan around patient comfort and convenience. Ensure privacy while maintaining easy access to essential services.
• Incorporate natural light, soothing colors, and calming decor to create a peaceful environment conducive to childbirth.
• Clearly define functional zones to optimize workflow. Separate public areas from private patient care areas to enhance privacy and security.
• Allocate space for staff workstations, storage areas, medical equipment, and emergency supplies.
• Design spacious and well-equipped birthing suites with adjustable lighting, comfortable furnishings, and amenities like birthing tubs or showers.
• Ensure accessibility to medical equipment and technology while maintaining a homelike atmosphere.
• Include family-friendly spaces such as family waiting areas, lounges, and breastfeeding rooms to accommodate the needs of families and support persons.
• Facilitate bonding opportunities between parents and newborns with comfortable seating and infant care stations.
• Prioritize safety by incorporating features such as non-slip flooring, handrails, emergency call systems, and easy access to emergency exits.
• Ensure compliance with healthcare facility regulations and guidelines for infection control and patient safety.
• Opt for efficient layouts that minimize travel distances between patient rooms, treatment areas, and support services.
• Design corridors and doorways to accommodate wheelchair accessibility and stretcher movement.
• Design flexible spaces that can be easily adapted for different patient needs and care delivery models.
• Consider modular furniture and equipment arrangements that allow for future reconfiguration or expansion.
• Collaborate with architects, interior designers, and healthcare consultants experienced in birth center design.
• Seek input from midwives, nurses, and other healthcare professionals to ensure the floor plan meets clinical requirements and operational needs.
• Incorporate environmentally sustainable practices, such as energy-efficient lighting, water-saving fixtures, and eco-friendly building materials.
• Promote a healthy indoor environment with good air quality and natural ventilation options.

Designing the perfect birth center floor plan involves thoughtful consideration of patient care needs, operational efficiency, safety standards, and aesthetic appeal. By prioritizing these tips and considerations, midwives can create a welcoming and functional environment that supports positive birth experiences and enhances overall patient satisfaction.

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