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Are Birth Centers Safe?

by Amelia on October 29, 2007
category: Labor and Delivery

We got this email from a reader:

I had my second child without medication. Not by choice but because I didn’t make it to the hospital in time. It was painful but I liked that the recovery was so much easier. I am considering going natural when we get pregnant with our third child. I like the concept of childbirthing centers. Is natural childbirth safe in a childbirthing facility? What if something unpredictable happens during the birth? How are the midwifes prepared for emergencies?

Amelia responds:

Since I have only had unmedicated births, I don’t have anything to compare it to, but my friends that have had a natural birth after a medicated one have also said that the recovery time is easier and faster. I would love to hear your birth story!

Free standing birth centers are a great place to have a baby and yes they are safe. I would venture to say that natural childbirth is safer at a birth center than in a hospital. They are a great alternative for people who want a more home-like facility but don’t feel comfortable having a home birth. Some moms prefer a birth center experience after having a disappointing experience at a hospital or want a natural birth and don’t want to hassle with routine hospital procedures. Birth Centers are usually run by Certified Nurse Midwives (CNMs) which means that they have a nursing degree and have also completed a degree and training in midwifery at an accredited school. Birth centers typically have lower c-section rates, episiotomies, inductions, infections, and the list goes on. For example, the birth center I had Graham in has a 7.5% C-section rate, compared to a 30% national rate. Midwives are often better trained to help women cope with the pain of labor and are available to help support the woman throughout the labor. Birth centers also let women eat and drink throughout labor. Hydration and food for nourishment are important factors for allowing a woman’s body to flourish during labor. No matter where a woman chooses to give birth, the most important thing is to feel confident and comfortable with your birth provider and the birth facility.

A word about midwives:
Most midwives have a different perspective when it comes to birth. Midwives are trained to look at birth as a normal, natural event. Obstetricians are trained surgeons and are trained to scoping out problems. As a result OBs tend to do a lot more testing and intervention during pregnancy and birth and have a much higher c-section rate. Many midwives also spend more time with their patients and take time to answer questions.

In my own experience with midwives, I have left appointments feeling like they have taken the time to get to know ME as a whole person. The midwife group for my last pregnancy was amazing. I felt like they were looking out for me during and after the pregnancy. The midwife who caught Graham called me this past Monday, seven weeks after the birth, to check up on me and the baby. They knew that I had struggled with postpartum depression after my second birth and have been very proactive about making sure I have the support network I need.

To answer your question about emergencies, birth centers are often close to a hospital so that if a transfer is needed it is easy to get there in an emergency. Birth centers also screen their patients throughout the pregnancy to make sure they are low risk. Most births will proceed with little problem and usually when a problem develops it shows up over a period of time. A woman that falls into a high risk category (i.e. pre-eclampsia, diabetes requiring insulin) will be asked to birth in the hospital. Women who need to be induced with Pitocin will be asked to birth in the hospital as well. In my last birth, I had shoulder dystocia, which is where the baby’s shoulders get stuck under the pubic bone. Graham’s head was out and we had to get the rest of him out quickly. Our midwife was calm and instructed me how to help her get the baby out. It was a serious situation. After Graham came out he was floppy and needed oxygen. The midwife and nurse knew exactly what to do and did it well.

Midwives are required to be trained in infant and adult resuscitation. They also have local anesthesia available for any tissue repairs after the birth. They have medications available for things like postpartum hemorrhage and will transfer to the hospital should a need arise during or after the birth.

I would encourage you to find a birth center in your area and ask to take a tour. I would also encourage you to take an independent childbirth class or do some additional reading to help you prepare for your next birth.

Some great books are:

Creating Your Birth Plan: A Definitive Guide to a Safe and Empowering Birth by Marsden Wagner

Thinking Woman’s Guide to a Better Birth by Henci Goer

Natural Birth the Bradley Way by Susan McCutcheon

4 Responses to Are Birth Centers Safe?

  • Comment by Amanda
    October 29, 2007 @ 1:00 pm

    Great information, Amelia!

    Would I have to leave my current OB and go only to the Birth Center for checkups? Who would I go to for my annuals?

  • Gravatar
    Comment by amelia
    October 29, 2007 @ 5:18 pm

    One of the great things about seeing a midwife at a birth center is that they are also trained to do yearly exams.

    Midwives cover all prenatal and postnatal exams. It is up to you if you want to continue going to your OB for yearly exams. If you run into any other problems like mastitis you can also go see the CNM’s at the birth center. They can prescribe antibiotics if needed.

    I will continue to go to The Midwife Center of Pittsburgh for all my women’s health issues.

  • Comment by McKenna
    October 30, 2007 @ 6:16 pm

    I can’t deliver at a birthing center because my kids like to have unexpected things come along with deliveries, but I do think it’s a great option for people who it’s a good fit for. I especially like the fact that birthing centers are usually more open to video taping the delivery…something we weren’t allowed to do in the hospital. I didn’t want a full frontal recording of my deliveries, but it would be neat to “relive” that amazingly special time! Childbirth was so awesome! Both my husband and I enjoyed our kids’ births so much!!

  • Gravatar February 25, 2009 @ 6:03 am

    [...] had never even considered a birth center until I read Amelia’s article, “Are Birth Centers Safe?” here at The Mom Crowd.  I feel very fortunate to have had a textbook delivery with my first with no medicine in the [...]

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