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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.

A Community Needs Assessment requires input from many individuals and groups in the community.
By performing a thorough Community Needs Assessment, you can ensure that you are filling the needs of individuals and groups in your community.

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.

A Community Needs Assessment helps provide clarity on the demand and support in your community for a birth center.
In the course of performing your Community Needs Assessment, you may find that there is a much higher demand for your services than you anticipate.

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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