Birth centers are a great place to have your baby. Their focus is on giving you a natural, family centered experience.
A birth center provides a higher level of backup and access to medical intervention than a home birth does. The centers are usually freestanding, though some are attached to hospitals. They’re usually staffed by midwives; often Certified Nurse Midwives and/or Certified Professional Midwives.
Your prenatal care may be at the birth center, or it may be at your care provider’s office.
Some birth center midwives also do home births. If that is the case at you can go to the birth center for prenatal appointments and have your baby at home.
Healthy and Low-Risk
You’re assessed for risk before you have a birth center birth, similar to the assessment given for a home birth.
Focus on taking care of yourself: good prenatal diet, moderate exercise, and getting enough rest helps you to stay low risk. If you develop pre-eclampsia, gestational diabetes, or other pregnancy complications, you could be “risked out” and referred to the hospital for birthing.
Some birth centers transfer you to hospital care if your baby is breech or if you’re carrying twins; find out your center’s policy.
Your Prenatal Care
You’ll probably see a midwife for prenatal care – appointments are around an hour long.
You may do your own urine and weight checks when you first arrive at your appointments, and some midwives have you fill in your own chart. Other midwives get your numbers themselves. All of this gets you familiar with what’s going on with your body. Bloodwork, if needed, can often be done at the birth center.
You get to know your midwife (or midwives) and the nurses and OB (if any) on staff. You also become very familiar with the building itself. You get to check out the labor rooms and spend time in the “family-style” room or kitchen.
Birth centers have a warm atmosphere and you can chat with other parents at your prenatals. You might meet parents coming back in for their postpartum checks. This can be a great opportunity to talk to them about their experiences.
Most birth centers have an extensive lending library of books and videos – a great thing! Many offer childbirth education classes as well. These can be a great way to meet other parents due around the same time as you who are also planning natural births.
Why Consider a Birth Center for Your Birth?
A birth center offers a homelike environment to birth in. You’re not barred by hospital rules and procedures. Your birthing room is set up like a normal room instead of a hospital room. You can wear your own clothing!
You’re able to walk around as you want to, changing positions at will. You can eat and drink if you wish to. Your birth center may have a jacuzzi tub or shower that you can labor and birth in.
You can have anybody you want there with you. You might want your older children at the birth and most birth centers will welcome them.
There might be a “family room” for your older children to play in if they don’t want to be in the labor room with you. The bed is big enough for your husband to curl up with you.
Your family also has access to the kitchen to cook food for themselves or for you. You can enjoy anything you want and aren’t limited to institutional foods.
You’ll probably be able to check out sooner, too – 12 to 24 hours after birth is the general rule.
A Few More Intervention Options
A birth center offers a few more options than a home birth. It probably has an IV available, and light pain relief medications.
A birth center may also have a warmer for your baby. There may be a special newborn transport unit set up in case your baby needs to transfer to the hospital.
You’re cared for by your midwife (or OB) and a registered nurse. They stay with you throughout your labor and your baby’s birth. This continuity of care is very reassuring during your labor and birth.
Your baby is monitored by Doppler (a small ultrasound device that picks up your baby’s heartbeat). Infant resuscitation equipment is available in case your baby needs it, just like a home birth midwife would carry or would be available at the hospital.
Hospital backup is already arranged in case there’s a need for transfer. Your CNM may have privileges at the hospital, so she can go with you if you need to transfer.
Fewer Interventions, More Help
You can’t have an epidural or spinal anesthesia at a birth center. You also can’t have oxytocin (Pitocin) to augment your labor.
You do get plenty of support from the midwives and nurses caring for you. They can give you ideas for working with your body and baby while you’re giving birth.
If your labor is slow or stalled, your midwives can encourage you to move around and change positions. They can try many different techniques to get your labor going. They may also send you home if your labor doesn’t seem to be quite ready to start yet
Your baby is put on your chest unless he needs help getting started (and even then, it may be done right on your chest). All newborn procedures are delayed so you have time to bond with your baby.
The newborn check is done right in front of you after you’ve had plenty of time to get to know your new baby.
You can go home quickly. Your midwife may come and do a home visit for your baby after you go home. Some come several days. Your birth center will advise you about when you should take your baby in to see her pediatrician or your family doctor – usually within a week to a month after birth.
Your postpartum check is around 6 weeks after birth to make sure that everything is looking good.
Choosing Your Birth Center
Choose your birth center carefully. Interview your midwife, nurse midwife, or doctor as carefully as you would if you were considering a home birth midwife or a hospital provider. Ask plenty of questions about procedures and get referrals. Talk to other moms who have had births there.
Some birth centers have a higher transport rate and more “medical” mentality than others. Doing your research lets you pick a center with the type of care you want for yourself and your baby.
Make sure that you like the atmosphere and the way the building is set up. It should be clean and well-kept. See if it offers a kitchen, living room area, and a lending library.
Find out if your birth center is accredited and what the credentials of the care providers at the center are. Take these into consideration. Also consider the level of service and professionalism. Don’t exclude a center that you love the feel of and that has great reviews just because not all the care providers are certified nurse midwives. Direct-entry and Certified Professional Midwives offer excellent care. Ask for references from past clients.
Always ask about hospital backup and what makes the center decide to transfer your care, either before or during labor. Ask if your midwife will stay with you at the hospital if you have to be transferred during labor.
Ask about costs and find out if your insurance will help you cover the cost of the birth. Find out if any payment plans are allowed. Many accredited birth centers in the United States can be paid for with Medicaid benefits, and with Champus (Tricare).
If you’re looking for a great natural birth and a little more backup than a home birth provides, or if you have a partner who is nervous about a home birth, a birth center is a great choice.
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Photo by Victoria Winters