What is a birth center?
What exactly is a freestanding birth center?
A freestanding birth center is a facility that is NOT part of a hospital. Depending on each states rules and regulations a birth center may be licensed and/or accredited. In Minnesota birth centers are required to be nationally accredited by the Commission for the Accreditation of Birth Centers (CABC) and licensed by the Minnesota Department of Health. While many hospitals use the term "birth center" or "family birth center" to describe their labor and delivery, there are no accredited birth centers in this state that are connected to or within a hospital. This is a helpful distinction to understand when making decisions regarding your chosen birth location and what services you are hoping to receive.
Because Minnesota requires accreditation of freestanding birth centers as a prerequisite to licensing, Minnesota families can feel confident that any freestanding birth center meets rigorous standards. The CABC conducts multi-day site visits on an ongoing basis to review each birth center's policies, procedures, equipment, facility, staffing, charting, and patient care.
Each licensed birth center is designed to feel inviting, comfortable, and home-like. We strive to be a "maxi-home" vs. a "mini-hospital" and the care we provide centers around the family experience of pregnancy, birth, and postpartum.
What is the care like in a birth center?
While each birth center will have their own staffing model and individual policies, there are some general things families can expect. Freestanding birth centers provide the midwifery model of care. The midwifery model of care is founded on informed consent and shared decision making, which means we want for families to learn and grow and ask questions! We encourage families to educate themselves on a variety of topics and make choices that fit their needs. Birth centers are the perfect fit for people experiencing low-risk, normal pregnancies who desire autonomy.
Most birth centers have a fairly small staff to encourage continuity of care. This encourages families to get to know their care provider(s) and for the provider(s) to know and understand the families they are serving. These providers provide families with all their prenatal care visits, care throughout the labor and birth of the baby, immediate newborn and postpartum care, and continued postpartum visits for the first 6 weeks following the birth. Visits are purposefully scheduled to have a relaxed pace with plenty of time for questions and/or small talk. While the care has a very personal touch, all the routine labs and/or ultrasounds can also be ordered to monitor your pregnancy and a midwife is always assessing the health and wellness of each client to be sure they are receiving the care that is most appropriate for them. While your provider is prepared to respond to any problems that may arise, the model of care supports treating each pregnancy/birth/postpartum/newborn as NORMAL unless proven otherwise, so interventions are introduced only as needed.
What options are available in a birth center?
Freestanding birth centers are set-up to provide amazing experiences of natural birth. You will find encouragement to eat and drink to nourish yourself during labor. You will find encouragement to move and choose the labor and birth positions that are right for you. While birth centers do not offer epidural pain medication, we do offer many natural things to help clients in labor such as water labor/waterbirth, aromatherapy, position changes, relaxed lighting, personal support, and many birth centers may also offer nitrous oxide (laughing gas). You get to choose your support team and many clients will choose to work with a doula to provide emotional support and additional comfort. Monitoring of labor is done in the least intrusive ways available so that clients have freedom of movement without being tethered to machines.
It is routine in birth centers to delay clamping and cutting of the cord and to prioritize skin-to-skin with the newborn after birth. Newborn care and examinations are done under your watchful gaze and with your consent. Routine screenings are available and are discussed with families so that each family can make the choices that are right for them.
After a few hours of postpartum/newborn monitoring families are able to discharge to home! Birth centers will make arrangements for follow-up care.
While all birth centers offer maternity care spanning from prenatal all the way through the postpartum time, some may offer additional care options. These things may include lactation support/lactation consultants, on-site pediatric providers, ongoing family practice care, preventative health visits outside of childbearing year, etc. Some may have complimentary health providers as well.
What services/options are NOT available in a birth center?
Freestanding birth centers are not hospitals nor are they trying to be. There are many obstetric procedures that are not done in birth centers. Some of these procedures would include: the use of epidural pain medication, narcotic pain medication, the use of a vacuum or forceps to assist with delivery, surgeries, c-section births, continuous fetal monitoring (we utilize intermittent fetal monitoring), and high risk delivery. Freestanding birth centers are prepared to provide immediate newborn care which includes resuscitation, but newborns who require more intensive support following birth would be transported to a hospital nursery or NICU for continued care.
Much like smaller hospitals may need to transport individuals to a larger hospital with a higher level of care, freestanding birth centers have plans in place to consult/transfer/or transport individuals to higher levels of care within the hospital systems when those situations arise.
Who can benefit from the care offered in a birth center?
Anyone who is experiencing a health pregnancy who desires this kind of care! The vast majority of pregnancies remain low-risk and it is safe to anticipate a normal birth without interventions and these are the exact pregnancies that can receive the most benefit from utilizing a freestanding birth center.
Some people may have certain health conditions that require obstetric care to maintain safety and birth centers are aware and respectful of that distinction. Careful screening of health and routine prenatal visits help a birth center provider to identify those individuals who would be best served in another setting. Some examples of pre-existing health conditions that would risk an individual out from a birth center would be: heart disease, kidney disease, liver disease, hypertension, current/active substance abuse or dependency, diabetes, or blood/clotting disorders. There may also be certain issues that come up during pregnancy that indicate the birthing person or the newborn would be best served in a hospital setting. In those cases, a transfer of care or transport to the hospital would be initiated. Some of these conditions could include: pregnancy of more than 1 baby, issues with fetal growth or the placenta, pregnancy induced hypertension or pre-eclampsia, preterm labor, a baby presenting in a breech position at full term, or a discovered genetic condition.
Who should choose a birth center for care?
First of all, only people who are interested in utilizing a birth center should choose one! If an individual would prefer to utilize a hospital, they should do so and feel good about making the choice that is right for them! We are not here to say that our care is the best option, just that it is one of the options. The option each family chooses will be based on many factors such as health, family life, living conditions, provider preferences, location preferences, transportation, fears, hopes, dreams, and.... yes, insurance coverage/finances. How you assign value to each category is going to be completely individualized and the choice you make should be what is right for you.