Cara Osborne co-founded Baby & Company in 2014, a natural birthing center staffed with more than a dozen Certified Nurse Midwives (CNMs), in addition to other nurses and one supervising physician.
"North Carolina is ranked 44th in infant mortality, so this was a public health concern for me," Osborne says in an exclusive interview with the ABC11 I-Team. "If one in three women have a cesarean section - that's major abdominal surgery. We can reduce that through promoting natural births through midwifery."
According to data compiled by the North Carolina Department of Health and Human Services, the number of babies born through midwifery in North Carolina jumped 48% in three years - from 624 in 2015 to 1,193 in 2017. Among those babies born, 330 were delivered at Baby + Company in Cary, the most among all birthing centers in the state.
Baby + Company, however, is the same facility embroiled in controversy after three infant deaths over seven months.
"I don't think they're in any way correlated or there was some underlying or systematic failure," Osborne says of the cases, including one that happened in 2018. "Every time a baby is born, there's a risk of all kinds of things that can happen. In these cases, these things happened in a shorter amount of time period than would've been expected. None of them were outside of the realm of possibility regardless of whether you're in a birth center or hospital."
In all of NC, there are only seven birthing centers. All of them have an accreditation but they don't have any state licensing. That's because there's no such thing.
In a letter obtained by the ABC11 I-Team, Deputy Secretary for Health Services Mark T. Burton acknowledges the lack of legal authority to demand access to Baby + Co., but nonetheless offered "a transparent process that will answer many of the outstanding questions raised by these recent deaths" and "provide the public with the assurance that quality and safety are at its highest levels."
Osborne and her colleagues granted that access to a team of state investigators, which this week released a scathing report on Baby + Co.'s practices and protocols.
Specifically, officials derided Baby + Co for its lack of communication with its medical supervisory staff, including the supervising physician who apparently never learned of the infant deaths until days after each occurred.
The immediate response from Baby + Co. was defensive to say the least, with a statement saying in part "While we thank DHHS for conducting their review of our Cary Center, lack of familiarity with birth centers was evident in their report, resulting in significantly flawed findings."
Osborne echoed those sentiments to the I-Team.
"In this case, unfortunately, we didn't have standards to comply with," Osborne responds, again noting the lack of state regulations on birthing centers. "So when (state officials) use words like severe concern, it's because they didn't have an objective way to talk about what were doing and not doing."
Baby + Company resumed births at the end of May after a voluntary "diversion," as Osborne calls it, and she also claimed that the center did not lose patients as a result of the ordeal.
Moving forward, Osborne says she hopes to work with state lawmakers on setting up a regulatory process for birthing enters.
Sen. Ralph Hise (R-Madison) is sponsoring a bill that would establish such a license. Rep. Greg Murphy (R-Greenville, also told ABC11's partners at the News & Observer "There's a lot of energy in trying to find out what is going on at these birth centers and how can we bring them up to a national standard."
Lawmakers, however, are not likely to take up the issue until next year's legislative session.