Birth Center

At a time when women are encouraged to embrace the birth process that is right for them, more and more hospitals, obstetricians, and midwives are providing women with the option of a birthing center. For women who are having a low risk pregnancy and want a more natural birth experience, a birthing center might be just the right fit. It is always best to research the birthing centers in your area to find the one that suits you best. Perhaps you have been contemplating the pros and cons of home birth, or you and your partner are trying to compromise on a birth location; you may want to consider a birthing center.

What can you expect from a birthing center?

  • Relaxed and warm setting
  • You can return home shortly after the birth if you wish
  • Health care providers include nurse-midwives, direct-entry midwives, or nurses working with an obstetrician
  • May be free-standing, on hospital grounds or inside a hospital building

Birthing centers can vary significantly, so you will want to investigate carefully their philosophy of care; review mission statements, objectives and interview personnel to find the one that fits your birth plan.

A true birth center holds to the following:

  • No Induction
  • No augmentation of labor with Pitocin (oxytocin)
  • No electronic fetal monitoring except Doppler ultrasound
  • No drugs for pain relief except local analgesia to suture tears in the perineum
  • Very few episiotomies
  • No operative deliveries
  • In many birth centers, the only equipment is oxygen and catheters to clear a baby’s airways, if necessary.

If the birth center is connected to a hospital, medical intervention can be a routine part of their care. If you are choosing a birth center connected to a hospital, ask if it has it’s own staff or is staffed by hospital personnel. You may also want to know in which situations the birthing center would obtain the assistance of hospital personnel and how often this occurs.

A birth center might not be the right fit for you if:

  • You are expecting twins
  • You are diabetic
  • You have preeclampsia (pregnancy induced high blood pressure)

Questions to Ask a Birthing Center:

  • What is the transfer rate of women from the center to the hospital (a rate of 7-12% is reasonable)
  • In what situations would you induce labor with Pitocin (oxytocin) or breaking of the amniotic sac (amniotomy)?
  • Is electronic fetal monitoring used? If so, in what situations and in what form: Doppler ultrasound, scalp clips or abdominal belts?
  • Is intravenous glucose given? If so, in what situations and can it be refused?
  • Are analgesic drugs used?
  • Do you offer epidural anesthesia?
  • Is there a time limit on the second stage of labor?
  • What percentage of women have episiotomies? (Less than 10% is normal)
  • Do you ever provide assisted deliveries with forceps or suction? In what situations?
  • Can I walk around during labor?
  • Can I give birth on the floor if I wish?
  • Can I give birth standing up?
  • How do you help a woman who is having back labor?
  • Can I take a bath or shower during labor?
  • Can my other children be present?
  • Can I eat and drink during labor?
  • Will there be a midwife with me throughout the first stage?
  • Is there a birth pool?

Experience and history demonstrate that a woman’s body is made for birthing. For some women it is important that labor not be viewed as a medical condition, but as the culmination of the most beautiful, natural 9-month process. Birthing centers are committed to prenatal care and education to empower women to direct their personal birth experiences.

Last Updated: 09/2008

Compiled using information from the following sources:

American Association of Birth Centers, http://www.birthcenters.org/

Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 1.

American Pregnancy Association, http://www.americanpregnancy.org

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