Birthing centers have become popular for many women because they provide a trio of advantages: midwife care, less medical intervention, and convenience. Many birthing centers are actually in or nearby a hospital with a doctor on call, making them an attractive choice for women whose pregnancies are considered low risk. Other advantages include the freedom to choose how mobile you want to be during labor; which birthing positions you’d like to try, and which comfort and labor aids - such as massage, relaxation techniques, a warm shower or a birthing pool - you want to use.
WHAT TO EXPECT
If you are thinking of having your baby at a birthing center you can expect a more family-centered and affordable birth experience than you would have in a hospital. Typically, a birth center is an independent facility, though some are housed inside hospitals. You can go there for prenatal care throughout your pregnancy, as well as for labor and childbirth when the time comes. Certified nurse-midwives provide most of the care in birth centers, although a physician is on call in case of an emergency. Not surprisingly, it’s best to give birth at a birthing center only if you’re as certain as you can be that you’re at low risk for complications during childbirth.
THE ADVANTAGES
If you are a healthy woman at low risk for labor complications and want your health care provider to be a nurse-midwife, a birthing center may be the ideal choice for you, especially if you are commited to a more natural childbirth experience. Birthing centers offer a low-tech, personalized, and comfortable place for women to deliver their babies. There you can labor, deliver, and recover in the same room. And if a birth turns into a medical emergency, any accredited birth center will have a back-up arrangement with doctors at a nearby hospital.
Other advantages to laboring in a birthing center include comfortable, home like rooms, where you can labor in the company of your partner, a close friend, and even your children, and have access to comforts such as a birthing pool. You also have the freedom to move around and wear what you like, as well as choose the position you’d like to be in for labor and delivery. Birthing centers are dedicated to natural childbirth, without medical interventions such as drugs or episiotomies. However, they do have IV’s, oxygen, and infant resuscitation equipment. A handheld Doppler may also be used to monitor your baby’s heartbeat, instead of an electronic fetal monitor, and analgesic drugs, such as Demerol, are also available if you want them, but epidurals are not. Pitocin is not used during labor to stimulate contractions, but may be used to control postpartum bleeding. All treatments and exams for both you and your baby are done with your supervision and consent and with a full explanation of what is happening. Birthing centers have no routine procedures that require you to be separated from your child. They also make it a priority to provide breastfeeding education and support during the prenatal period, in the first hour after birth, and later in the postpartum period. And because women who deliver in birthing centers usually stay for a shorter time and use fewer interventions, it costs about one-third less on average to deliver in a birthing center than it does in a hospital.
THE DISADVANTAGES
For women whose pregnancies are complicated, birthing centers are not the best option because they are not designed or equipped to handle complications that may arise either during your pregnancy or when you are in labor. Roughly 12 percent of women who begin their labor in birthing centers are transferred to hospitals for non-emergency reasons, such as when labor is not progressing and Pitocin is needed. Another drawback is the lack of access to pain medications. For example, if you plan on having an epidural (or want the option), you’ll need to give birth in a hospital because an anesthesiologist is required to administer this form of pain relief.
Also, if you are transferred to your backup hospital, where your midwife mayor may not have admitting privileges, there is a good possibility that your baby will be delivered by a doctor you’ve never met before. And being moved from place to place while you are laboring can be upsetting in itself.
