Birth center: An option for pregnancy care

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Birth center: An option for pregnancy care

During pregnancy, you have many decisions to make — often beginning with the selection of a health care provider or facility. If you wonder whether a birth center might be right for you, here's what you need to know.

What is a birth center?

A birth center is a facility that provides care for women throughout pregnancy, including labor and delivery. A birth center typically has a relaxed, homelike atmosphere. A birth center can be free-standing or located within a hospital complex.

If you choose to use a birth center, during your prenatal care you'll become familiar with the setting where you'll give birth and, in most cases, the health care providers who'll handle your labor and delivery.

What services does a birth center offer?

Birth centers offer standard prenatal care, including prenatal tests, as well as care during and after labor and delivery.

Birth centers not located within a hospital complex are typically staffed by midwives, rather than doctors. If you experience complications during pregnancy or labor that require medical or surgical intervention, the birth center's providers will consult a doctor — typically a specialist at a collaborating hospital. During your prenatal care, the birth center's providers will review a list of conditions that would require treatment by a doctor. They'll also review challenges that can occur during childbirth and how the birth center — in comparison with a hospital — would handle them. You may be asked to sign a consent form stating that you understand the risks and benefits of giving birth in a birth center.

Are there certain situations when using a birth center isn't recommended?

Birth centers not located within a hospital complex aren't for every pregnant woman. You'll be carefully screened before enrolling at a free-standing birth center and during prenatal visits for possible health problems that may cause pregnancy complications. You may not be able to receive care and deliver your baby at a free-standing birth center if you:

  • Have diabetes, chronic hypertension, a seizure disorder or any chronic medical condition
  • Previously had a C-section
  • Are obese
  • Use tobacco or illegal drugs
  • Develop a pregnancy complication, such as preeclampsia, preterm labor or significant anemia
  • Are pregnant with multiples or your baby doesn't settle into a position that allows for a headfirst delivery

What happens during labor and delivery at a birth center?

During labor at a birth center, you may be able to wear your own clothes, take a shower or bath, and eat, drink and move around freely. You may also be able to control who's in the room and your labor position. Your baby's heart rate will be intermittently — rather than continuously — monitored. Some birth centers, particularly those located within a hospital complex, offer narcotics for pain relief during labor. Epidurals, however, typically aren't offered in free-standing birth centers because of the need for intravenous infusions, a urinary catheter and continuous electronic fetal monitoring.

After delivery at a birth center, you'll be close to your baby. The newborn exam may be done on your bed and used as an opportunity to discuss your baby's health and behavior. You'll also be given information on how to care for a newborn. Follow-up care from a birth center may include phone calls and home visits, lactation support and an office visit within two weeks of delivery.

How do I choose a birth center?

If you're interested in using a birth center — whether it's the free-standing type or a birth center located within a hospital complex — look for a facility that's accredited by the Commission for the Accreditation of Birth Centers or the Accreditation Association for Ambulatory Health Care. Also, check with your insurance provider for coverage details.

Before you begin care at a birth center, attend an orientation and take a tour of the facility. Make sure you're comfortable with the environment, the staff members and the facility policies. Ask about the consulting doctor, the credentials of the care providers and, for free-standing birth centers, the backup hospital and how often women are transferred to the hospital during labor. What you find out can help you make an informed decision about where you give birth.

What else do I need to know about birth centers?

Pregnancy is a normal part of life. Typically, healthy mothers and babies don't require special medical attention. Choosing a free-standing facility that doesn't provide emergency services carries a small risk, however, since serious or life-threatening problems are possible during pregnancy or labor and delivery. In those cases, the need to transfer a mother and baby from a birth center to a hospital can delay care.

Last Updated: 2010-10-12
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