Months after passing a near-total ban on abortion, West Virginia lawmakers are advancing a bill that would eliminate some of the red tape involved with opening birthing centers in the state.

The state House of Delegates passed a bill Tuesday that would remove birthing centers from the state’s certificate of need process, which requires health care providers to obtain government approval before adding or expanding services.

“We just told thousands of women throughout this state that they were going to have to give birth,” Republican Del. Kathy Crouse said, adding that many pregnant people currently have to travel hours for care, especially in rural areas.

“We need to give women choices, and we need to have more access available,” she said.

Republican Del. Todd Longanacre also mentioned the body’s vote to ban abortion while speaking in support of the proposal.

“Everybody said, ‘Hey, if we’re going to do this, let’s then have some bills to actually help the women carry the baby and help the women — give them the support they need,’” he said. Longanacre said making it easier for birth centers to open in the state is a step in that direction.

Birthing centers are health care facilities for childbirth that operate outside of hospitals and are typically staffed by nurse midwives. Many also have obstetricians on staff.

There is currently only one birthing center in West Virginia — the FamilyCare OB/GYN & Birth Center in Charleston. Although nurse midwives can deliver in hospitals, many don’t attempt to open birthing centers because the process is so prohibitive, Republican Del. Heather Tully said. Tully is vice chair of the House Health and Human Resources Committee.

“What we’re doing is allowing competition to flourish and really allowing options for patients,” Tully said, speaking on the bill.

The bill now advancing to the state Senate would remove the requirement that a birthing center obtain a certificate of need before starting operations. However, birth centers would still need to obtain a license from the state Office of Health Facilities Licensure and Certification before starting operations.

Since 1977, most West Virginia health care providers that want to open or expand facilities must obtain a “certificate of need.” The process is overseen by the state’s Health Care Authority. To acquire a certificate of need, facilities must prove their community needs the proposed service.

The purpose is to regulate the health care market to discourage unnecessary duplication of services. However, some lawmakers and advocates have asserted in recent years that the process — which can cost providers tens of thousands of dollars — actually creates more barriers to care. They claim it protects existing providers from competition more than it protects patients.

A bill that would have repealed certificate of need requirements failed last year in the House Health and Human Resources Committee after hours of discussion and debate. Lawmakers also balked on proposals to repeal the requirement in specific health care settings, like birthing centers.

Republican Del. Chris Pritt said as a conservative, he supports policies that cut “needless regulation.”

“There’s something very fundamental about who we are as Republicans, that we want to cut regulations, especially regulations that are totally unnecessary,” he said. “The government doesn’t have any business in regulating where somebody wants to set up a birthing center.”

In 2018, a five-year study conducted by the federal government comparing birth centers with other forms of maternal birth care for women on Medicaid revealed a dramatic reduction of preterm, low-weight and cesarean births for patients at birth centers.

Home births and other out-of-hospital births have been rising since around 2004, when they numbered close to 36,000, other data shows. The increase coincided with a rise in non-hospital birthing centers.

Among almost 4 million births in 2021, nearly 52,000 occurred at home, a 2022 Centers for Disease Control and Prevention report showed. That’s up about 12% from 2020, following a 22% rise from 2019 to 2020.

The American College of Obstetricians and Gynecologists notes that while home births typically involve fewer medical procedures than hospital births, they’re riskier. It advises against home births for certain situations, including multiple births and among women who previously delivered via cesarean section.

Hospitals and accredited birth centers are the safest places to give birth, said Dr. Jeffrey Ecker, a former chair of the group’s committee on obstetric practice and chief of obstetrics and gynecology at Massachusetts General Hospital. Although serious complications associated with labor and delivery are rare, they can be catastrophic.