Birthing Centers: The Happy Medium?

Birthing Centers The Happy Medium?

We’ve written about home birth a couple of times now (here and here). Many women want to have more control over their birth experience, and for them, a hospital birth is too clinical and too “medicalized.” But they may not want to give birth at home either. What to do?

Luckily, there is a happy medium: a birthing center. A birthing center (sometimes called a birth center) is a facility that gives you many of the comforts of home, more control over how you want to give birth, and can provide most of the medical support of a hospital. Rather than looking at labor and delivery as a medical event, a birthing center views childbirth as a normal family-centered process. Unlike hospitals, which may make you follow strict protocols and schedules, a birth center is usually more likely to help you follow your birth plan.

A birthing center is a low-tech, or more accurately, lower-tech alternative to a hospital. It can allow you to give birth in a facility that offers greater privacy than a labor and delivery ward in a hospital. Birthing centers allow you to walk around during your labor, wear your own comfy clothes, and even take baths or showers. The décor is softer and homier. A room in a birthing center might have a double bed, a rocking chair in the corner, kitchen facilities, or allow lighted candles and incense. Some centers offer water births. Your baby usually stays with you in the room in a birthing center.

At the same time, a birthing center is staffed by midwives (either licensed midwives or certified nurse-midwives) and/or obstetricians. Although procedures such as use of intravenous lines, epidurals, induction of labor, or continuous fetal monitoring are not routinely done, some centers have them available if they are needed. All have access to emergency equipment and a staff that is trained and prepared for emergencies.

Many hospitals in urban and suburban areas now offer a birthing center within their walls. However, there is some variability in just how “home-like” a birthing center in a hospital is. Some hospitals just renamed their labor and delivery units and that was the only change. But other hospitals offer a full range of choices and services in their birth centers and also have a regular labor and delivery unit.

There are also freestanding birthing centers that are often owned and operated by midwives. These are not attached to a hospital, but this means that if anything goes wrong either you or your baby or both may need to be transported to a hospital.

One downside to a birthing center is that they have a limited capacity. They can only handle a few births at a time. You may need to make a reservation very early in your pregnancy, but this will be part of your prenatal visits with the obstetrician or midwife you are using.

Another downside is that birthing centers tend to be in urban areas or suburbs and may be few and far between in other areas of the country. You may not live close enough to one to make delivering there feasible.

A birthing center may be a good choice for you if you are in overall good health. It might not be right for you if you have any underlying issues such as diabetes or high blood pressure or are having a breech birth or multiple birth.

If you are considering a birthing center for your labor and delivery, do your homework and do it early; in the first trimester, if at all possible. Take a tour of the facility to get a feel for it. Ask any friends who have given birth there about their experience. You can find a birthing center either though the Commission for the Accreditation of Birth Centers or the American Association of Birth Centers. Check the credentials and licensing of your midwife if you are using one. If the birth center is freestanding, make sure that the midwife or obstetrician you use has admitting privileges at your local hospital.

Don’t forget to check whether the birthing center and your healthcare provider accept your insurance. Giving birth in an out-of-network facility or provider may mean that you have to foot the whole bill.

Share your stories with us in the Comments section below or on Facebook.  Have you considered going to a birth center before?

Valerie DeBenedette
Valerie DeBenedette is an experienced health and medical writer who lives about an hour north of New York City with a dog that is smaller than her cat. Her work has appeared in magazines, newspapers, newsletters, and on websites. She is a member of the National Association of Science Writers.

Leave a Reply