Choosing a Birth Center for Labor

A laboring woman checks into a birth center
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A birth center is a relatively new concept for a place to give birth to your baby. It is a home-like setting that offers a place for low-risk women to give birth without the use of a lot of medical intervention, typically including the use of pain relieving medications. Instead, the birth center uses doctors, midwives, and doulas to help parents have a more natural birth. This is often considered a place to give birth between home and the hospital.

There are about two hundred birth centers in the United States. Birth center births are on the rise, but even when you add birth center births to home births, there is only slightly over one percent of births oucurring outside of the hospital.

A birth center is a very safe place for the majority of women to have their babies and there are many reasons that families choose birth center care from a doctor or midwife. The largest birth center study shows that eighty-four percent of mothers who intended to give birth at the birth center at the start of labor did so, with an overall vaginal birth rate of ninety-three percent. Be sure to talk to other families who have used birth centers. Many families talk about how happy they are with the care that not only the mom and partner get in labor but also the extended family. Some mothers choose to use a birth center to allow themselves the ability to go home fairly close after the birth, as many families go home within hours.

Questions to Ask About a Birth Center Birth

You need to ask your birth center some important questions, just as you would a hospital or home birth practitioner:

  • Will your insurance pay for the prenatal care from a birth center practitioner? The birth and postpartum care?
  • What types of support does the birth center offer during labor? Comfort measures?
  • Is water birth allowed? Encouraged? If not a water birth, can you use water in labor? What water is available? Tub? Shower? Jacuzzi?
  • Who provides care in the birth center? Are they all licensed? If so, by whom?
  • How many mothers transfer care to a hospital or obstetrician during pregnancy? What are the guidelines for transfer of care in pregnancy?
  • How many mothers transfer care to a hospital during labor or postpartum? What are the reasons for transfer to the hospital? Do they have a relationship with a doctor and/or hospital or will you be transferred without that in place? Will the practitioner stay with you in the hospital?
  • What is the cesarean rate for the birth center? The transfer rate? (Pregnancy vs. Labor.)
  • Is your birth center accredited by anyone? The Commission for the Accreditation of Birth Centers (CABC)? Is there a license given by your state?
  • How late in pregnancy can you change to the birth center? Is there a visit to review policies and the facility, such as an orientation?
  • Can you talk to others who have given birth there?
  • Are there classes available for pregnancy, birth, postpartum and baby care?
  • What does your gut say during a visit? Do you feel cared for? How long are prenatal visits? Do families seem happy? Is it clean and professional?

Transfer of Care

There are a certain number of mothers and/or babies who will need to transfer their care to the hospital. The vast majority of these in labor are not emergencies and are, instead, simply for pain medication or medication to help speed up labor, like Pitocin. In the Stapleton study, about two and a half percent of mothers or babies transferred after the birth for medical attention and only about one point nine percent transferred in an emergency situation before or after birth. Be sure to ask what the statistics are in your area and what the plans look like if transfer becomes necessary.

Sources:

MacDorman MF, Mathews TJ, Declercq E. Trends in out-of-hospital births in the United States, 1990–2012. NCHS data brief, no 144. Hyattsville, MD: National Center for Health Statistics. 2014.

Stapleton SR, Osborne C, Illuzzi J. Outcomes of Care in Birth Centers: Demonstration
of a Durable Model. J Midwifery Womens Health 2013;58:3–14 c 2013 by the American College of Nurse-Midwives.

 

Read more: Hiring a Midwife

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