A birth center is an option for a mother who wants a more intimate, natural labor experience than in a hospital, but with more assistance than at home. At a birth center, a healthy woman with no pre-existing medical conditions can expect a delivery without the medical interventions common at a hospital. There are no routine intravenous (IV) drips, electronic fetal monitoring, inductions, epidurals or cesarean sections at a birth center. Even though the baby is not delivered by an obstetrician, a birth center is staffed by an attentive group of qualified midwives and nurses.
One of the benefits of a birth center is that it may be the low-tech, quiet and intimate labor experience that a mother is looking for. You won’t be strapped to an uncomfortable bed, belted into a fetal monitoring device or hooked up to an IV. A midwife checks on the baby’s heartbeat periodically with a hand held Doppler. There are no constrictive policies that require the baby to leave your side for routine exams, and he or she will room with you. You can choose the position in which you’d like to labor, and you can eat and drink when you want.
The midwives and nurses at a birth center are trained to offer you support in your decision to have a drug free birth. Although some analgesic drugs may be available, any that require an anesthesiologist aren’t. The rooms are comfortable, decorated to look like a country inn or a homey bedroom. There is a bed big enough for your partner to sleep with you and the baby, as well as kitchens, family rooms and on occasion, large whirlpool tubs.
Birth centers offer an all-inclusive care package for your pregnancy, labor, delivery and postnatal care. Many offer prenatal, childbirth and breastfeeding education classes to their clients. After the birth, many birth centers will schedule a postnatal visit to your home. The decision to use a birth center typically results in a shorter stay, approximately 12-24 hours, and fewer interventions. This explains why the average birth center delivery costs about one-third of a hospital delivery.
If a problem arises with the delivery, the birth center should have a back up plan in place that designates which hospital the woman will be transferred to. A good birth center will have oxygen, IV, medication and infant resuscitation equipment on hand so that they can provide emergency medical treatment until an ambulance arrives to transport you to a hospital. Approximately one in eight women who begin their labor in a birth center require transfer to a hospital for medical intervention or assistance with their delivery. You are a good candidate for a birth center delivery if you do not have high blood pressure or diabetes and have never had a previous cesarean or uterine surgery. It is safer to give birth at a hospital if you are carrying multiple babies, go into labor prematurely or develop preeclampsia, or if the baby is in a bad position for delivery, such as the breech position.
Once you’ve made the choice to deliver at a birth center, check with the National Association of Childbearing Centers for recommendations. The birth center you choose should be accredited by the Commission for the Accreditation of Birth Centers. Ask a potential birth center about their back up plan for complications during delivery.
One important detail to ask about is whether your midwife has privileges at the back up hospital so that she can continue to assist your delivery if you are transferred. You should also meet your backup physician to assess if he or she is a good fit with your personality. One of the most important questions to ask before you decide to deliver at a birth center is whether your health insurance plan will cover a birth center delivery.