The Spark

the Voice of
The Communist League of Revolutionary Workers–Internationalist

“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx

Who Dares to Put C-Sections on an Outpatient Basis?

Jul 1, 2024

This spring, Florida passed a law to allow doctors to perform caesarean sections outside hospitals, in outpatient facilities called “advanced birthing centers.” Advanced birthing centers were promoted as a way to expand access to maternity care in the state, where many hospitals have closed their labor and delivery departments. As of April, only two of Florida’s 21 rural hospitals were still providing labor and delivery services.

Florida lawmakers say they’re hoping to bridge the care gap for pregnant women living in rural parts of the state by passing this bill. But they are leaving out what is more than a small detail: It was private equity firms that lobbied hard to pass the new law. Women’s Care Enterprises, a private equity-owned doctor’s group with multiple practice locations in Florida, supported this C-section bill. And the bill’s sponsor was Senator Gayle Harrell, who once managed her husband’s OB-GYN practice!

In recent years, private equity firms have been invading virtually every nook and cranny of the health care system. With their ownership of these “birthing centers,” they have entered women’s health: between 2010 and 2019, private equity firms acquired 24 women’s health groups, covering 605 offices and more than 2,000 clinicians. According to the department chair of Obstetrics and Gynecology at the University of South Florida, Dr. Judette Louis, “I think we also can’t ignore the fact that the people promoting it and who think it’s a good idea are private equity-based companies. It’s Women’s Health Care Enterprises, and they are big money in the state of Florida, so you always have to be cautious about whether there is financial gain to be had by allowing a birth center to also do C-sections.”

Rightfully so, medical experts in the fields of obstetrics and gynecology and maternal fetal medicine have raised a red flag that this new law is a threat to the safety of women and newborns. C-sections are major abdominal surgeries where you have two patients—the baby and the mother, and there is no such thing as a low-risk patient, or a low risk C-section. C-section complications like bleeding and damage to surrounding tissue “require immediate attention and assistance from other hospital teams and resources like an intensive care unit, ventilators and additional surgical assistance,” according to one maternal fetal medicine doctor. And Dr. Louis stated: “One of the biggest predictors of maternal morbidity and mortality is caesarean delivery, so by virtue, the procedure itself really amps up the risk to the mothers. The fact that we now would be doing it outside of a hospital setting, where you can have the backup that you need should things go awry, is very concerning to me.”