How are Birth Centers Different?

From the American Association of Birth Centers FAQ’s:

A Birth Center Provider Explains

by Marion McCartney, CNM – Washington, DC

Birth centers were designed for healthy, low risk mothers and healthy babies. It’s a very relaxed atmosphere in a birth center. It feels more like a nice country inn, or somebody’s really well kept home, than a hospital. It looks like a house with wallpaper, bathrooms with showers, and Jacuzzis for women to relax in labor. There are kitchens where people can bring their own food and cook in the birth center. In fact, that’s how you often know a baby is coming – you can smell some good food being cooked in the birth center kitchen.

There is also a lot of privacy at the birth center because of its low volume. We don’t have 15 or 20 women giving birth at the same time. One, or maybe two, women will be in the birth center at the same time. And, because it’s the place where mothers have come for all their prenatal care, they are very familiar with it. They know the staff who work there. They know the birth rooms since they have looked at them several times and shown them to their parents, friends and their other children.

Through the educational program that goes on throughout the pregnancy, parents know what to expect once the mother goes into labor. A mother knows that she can wear her own clothes and that she can eat and drink in labor. She will be encouraged to get out of bed and walk around. She is able to choose her support people – whether it’s her own mother, her sister or friend. The father of the baby is almost always there, unless there is some special reason for him not be. It’s up to the mother to decide how she wants this to go. This is her labor and whatever makes her feel good is what the staff wants to do for her. The mother can labor in any position that is comfortable for her. She can push on her hands and knees. She can squat, lay on her side or sit in the bed–anything that makes it easier for her to get the baby out. We know that babies come out better when the mother is relaxed, so we try to provide an atmosphere where she feels confident and comfortable so that she will use her body well.

Birth centers promote breastfeeding. In fact, because we know that a baby is alert and will nurse well in the first hour after birth, breastfeeding is encouraged immediately. In this way, breastfeeding and the education and support of the mother in the breastfeeding process is established early on.

There are no routines in a birth center. There is no routine prep or enema or IV. We do not do the continuous electronic fetal monitoring that keeps a mother tethered to a machine. The baby’s heartbeat is monitored, but it is monitored intermittently with a handheld doppler. Also, birth center care reflects a difference in philosophy about episiotomies. We don’t cut routine episiotomies. Instead, we use warm compresses to ease the passage of the baby so the mother won’t tear. The episiotomy rate in birth centers is about 12 percent while it is well over 90 percent in most hospitals.

The most important difference you will find in birth centers, (and a common reason that many people choose a birth center) is that there is no separation of mother and baby. Anything that is done for the baby – treatment or exam – is always done in front of the parents so that they may learn about their baby. The same staff takes care of the mother and baby together. The nurse-midwife, the nurse or the physician in the birth center care for them as a unit.

Now, what about problems? We know that people are going to have problems, so there are systems set up to deal with transfers to the hospital. We know that we are going to transfer about 12 percent of the women in labor and that the vast majority of these transfers are not emergencies. Only about two percent of women go to the hospital as emergency transports.

The birth center is part of the medical care system and linked to the acute care level of hospitals which insures that, if the mother or the baby develops a problem, we can get them the level of care that they need.

A Parent Explains

by Amy Smith – Delaware

We chose to have our baby at the Birth Center because I wanted to give birth in a situation where my opinion would always be respected. My husband and I consider childbirth a natural process, not a medical procedure and wanted if possible to avoid any involvement with doctors and hospitals. I wanted to be cared for by people who shared this perspective.

At the Birth Center we developed a close, trusting relationship with a small number of midwives and nurses. Dealing with very few people gave us confidence that our wishes for our son’s birth would be honored and that when the time came we would be with people we knew and who knew us and what was important to us. We were also confident that if there were a problem, our baby and I would be in good hands – in hands that we trusted.

The nurses at the Birth Center taught two excellent series of classes which helped us get to know them better as well as familiarizing us with what we could expect through the pregnancy and during childbirth. The classes were informative, helpful and very reassuring.

The classes were small so all of our questions were addressed. In addition we were together with the same small group of people throughout our pregnancy. The resulting camaraderie allowed us to support each other both before and after our babies’ births. Ours was a class with everything: a breech baby, gestational diabetes, long labor, short labor, you name it. It was exciting to hear about everybody’s birth experience. We still get together every couple months to see how everyone is doing.

On the day our son was born, my parents were with my husband, David, and me at the Birth Center. My mother and David helped me through labor and delivery. Our midwife and our nurse were wonderful. David was terrific. Giving birth was thrilling and everything went well. Graham was gorgeous from the start. Mom was so happy to be there. I couldn’t have dreamed of a finer present for her. I loved seeing Daddy holding his grandson just a few minutes after he was born. Being able to be together as a family right away felt normal, simply the way it should be.

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