Birthing center
Encyclopedia
A birthing center or centre is a healthcare facility, staffed by nurse-midwives
, midwives and/or obstetricians, for mothers in labor
, who may be assisted by doula
s and coaches. By attending the laboring mother, the doulas can assist the midwives and make the birth easier. The midwives monitor the labor, and well-being of the mother and fetus during birth. Should additional medical assistance be required the mother can be transferred to a hospital. Some hospitals are now adding birth centers to their facilities as an alternative to the high tech maternity wards commonly found at most hospitals.
A birth center presents a more home-like environment than a hospital labor ward, typically with more options during labor: food/drink, music, and the attendance of family and friends if desired. Other characteristics can also include non-institutional furniture such as queen-sized beds, large enough for both mother and father and perhaps birthing tubs or showers for water birth
s. The decor is meant to emphasize the normality of birth. In a birth center, women are free to act more spontaneously during their birth, such as squatting, walking or performing other postures that assist in labor. Active birth is encouraged. The length of stay after a birth is shorter at a birth center; sometimes just 6 hours after birth the mother and infant can go home.
There are certain requirements that a woman needs to meet in order to be able to birth at a birth center. First, she must have an uncomplicated, low-risk pregnancy. Free-standing birth centers require hospital backup in case complications arise during labor that require more complex care. However, even if a delivery can not happen at the birth center due to a high-risk pregnancy, birth center midwives might provide prenatal care up to a certain week of gestation or at the hospital alongside an obstetrician.
The nationwide organization supporting and promoting birth centers is the American Association of Birth Centers (AABC) http://www.birthcenters.org/ Many birth centers nationwide, like hospitals, chose to become accredited through the Commission for the Accreditation of Birth Centers (CABC) http://www.birthcenteraccreditation.org/. There are strict guidelines for this accreditation to support birth centers as a place for normal birth. These include things such as no continuous fetal monitoring in labor to allow women full mobility.
There has been much research in recent years to support out of hospital birth- especially birth center birth- as not just safe but at times safer than hospital birth because of its judicious use of technology, licensed professionals and connection to the health care system.
, known for their great respect for tradition, usually have homebirths or give birth at birthing centers. Only when there is risk to mother or child, do Amish women go to hospitals for the birth of their children. Two books have been written about Amish medical issues including their birthing practices: Dr. Frau: A Woman Doctor among the Amish by Dr. Grace Kaiser and House calls and hitching posts: stories from Dr. Elton Lehman's career among the Amish by Elton Lehman. Lehman is known for his work in founding a freestanding Amish birthing center. The Mount Eaton Care Center, Ohio
's first such center, was established in 1984. In her book, Kaiser recounts the private nature of birthing among the Amish. She points out the practice of Amish women keeping labor a secret to all except their own husbands and midwife or obstetrician, as well as the practice of women waiting till active labor before summoning a midwife or OB. Due to the latter practice, fathers occasionally end up delivering their own children before the midwife or OB can arrive if a homebirth is selected. Amish women who choose a homebirth often continue with household duties until they are no longer physically able to continue. If birthing in a birth center, they are free to labor similar to that of homebirths: eating, drinking, visiting with their family members, etc.
, State and Territory Governments in 2002 started to respond to consumer demand for an increased number of birth centers to be made available to women. Whilst most birth centers are attached to hospitals, some are being established as free-standing centers much further away from hospital back-up. As long as they are within 90 minutes of a hospital, they are considered 'safe'. Most birth centers are now being run solely by midwives, with obstetric back-up only used when there are complications.
Some birth centers in Australia are moving away from the 'low-risk' model and are moving to an All risk model where women with medical complications are accepted into the birth center but extra care is provided to them where necessary.
Hospitals do offer this option, and it is available at special clinics.
Midwifery
Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also help care for the newborn and assist the mother with breastfeeding....
, midwives and/or obstetricians, for mothers in labor
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
, who may be assisted by doula
Doula
A Doula is someone who provides non-medical support to women and their families during labour and childbirth, and also the postpartum period. The term can also be used to describe other supportive roles for other life events such as abortion, death and more....
s and coaches. By attending the laboring mother, the doulas can assist the midwives and make the birth easier. The midwives monitor the labor, and well-being of the mother and fetus during birth. Should additional medical assistance be required the mother can be transferred to a hospital. Some hospitals are now adding birth centers to their facilities as an alternative to the high tech maternity wards commonly found at most hospitals.
A birth center presents a more home-like environment than a hospital labor ward, typically with more options during labor: food/drink, music, and the attendance of family and friends if desired. Other characteristics can also include non-institutional furniture such as queen-sized beds, large enough for both mother and father and perhaps birthing tubs or showers for water birth
Water birth
Water birth is a method of giving birth, which involves immersion in warm water. The immersion can mean giving birth to the infant in the water or using it as a tool during the labor process. Proponents believe that this method is safe and provides many benefits for both mother and infant,...
s. The decor is meant to emphasize the normality of birth. In a birth center, women are free to act more spontaneously during their birth, such as squatting, walking or performing other postures that assist in labor. Active birth is encouraged. The length of stay after a birth is shorter at a birth center; sometimes just 6 hours after birth the mother and infant can go home.
Hospital birth comparison
A high level metareview article compared traditional hospital births with "home-like" settings in or near conventional hospital labor wards. In comparison with traditional hospital wards, home-like settings had a trend towards an increase in spontaneous vaginal birth, breastfeeding at six to eight weeks, and a positive view of care. The study also found that having a birth at an alternative birth center decreased the likelihood of the use of an epidural, oxytocin, and an episiotomy. There was no effect found on serious perinatal or maternal morbidity/mortality, other adverse neonatal outcomes, or postpartum hemorrhage.Birth centers in the United States
Like clinics, birth centers arose on the coasts of the U.S. in the 1970s, as alternatives to heavily institutionalized health care. Today, use of birthing centers is generally covered by health insurance. Several of the practices which were innovated in birth centers are beginning to enter the mainstream hospital labor and delivery floors including:- Bathtubs or whirlpools for labor and/or birthingWater birthWater birth is a method of giving birth, which involves immersion in warm water. The immersion can mean giving birth to the infant in the water or using it as a tool during the labor process. Proponents believe that this method is safe and provides many benefits for both mother and infant,...
- Showers for mothers to labor in
- Hospital acceptance of the mother choosing to walk during labor, use a labor/birthing ball, not use pain medication during labor and rooming in of the infant after birth
- Beds for family members to stay with the mother during labor and birth
There are certain requirements that a woman needs to meet in order to be able to birth at a birth center. First, she must have an uncomplicated, low-risk pregnancy. Free-standing birth centers require hospital backup in case complications arise during labor that require more complex care. However, even if a delivery can not happen at the birth center due to a high-risk pregnancy, birth center midwives might provide prenatal care up to a certain week of gestation or at the hospital alongside an obstetrician.
The nationwide organization supporting and promoting birth centers is the American Association of Birth Centers (AABC) http://www.birthcenters.org/ Many birth centers nationwide, like hospitals, chose to become accredited through the Commission for the Accreditation of Birth Centers (CABC) http://www.birthcenteraccreditation.org/. There are strict guidelines for this accreditation to support birth centers as a place for normal birth. These include things such as no continuous fetal monitoring in labor to allow women full mobility.
There has been much research in recent years to support out of hospital birth- especially birth center birth- as not just safe but at times safer than hospital birth because of its judicious use of technology, licensed professionals and connection to the health care system.
Amish birth centers in the United States
The AmishAmish
The Amish , sometimes referred to as Amish Mennonites, are a group of Christian church fellowships that form a subgroup of the Mennonite churches...
, known for their great respect for tradition, usually have homebirths or give birth at birthing centers. Only when there is risk to mother or child, do Amish women go to hospitals for the birth of their children. Two books have been written about Amish medical issues including their birthing practices: Dr. Frau: A Woman Doctor among the Amish by Dr. Grace Kaiser and House calls and hitching posts: stories from Dr. Elton Lehman's career among the Amish by Elton Lehman. Lehman is known for his work in founding a freestanding Amish birthing center. The Mount Eaton Care Center, Ohio
Ohio
Ohio is a Midwestern state in the United States. The 34th largest state by area in the U.S.,it is the 7th‑most populous with over 11.5 million residents, containing several major American cities and seven metropolitan areas with populations of 500,000 or more.The state's capital is Columbus...
's first such center, was established in 1984. In her book, Kaiser recounts the private nature of birthing among the Amish. She points out the practice of Amish women keeping labor a secret to all except their own husbands and midwife or obstetrician, as well as the practice of women waiting till active labor before summoning a midwife or OB. Due to the latter practice, fathers occasionally end up delivering their own children before the midwife or OB can arrive if a homebirth is selected. Amish women who choose a homebirth often continue with household duties until they are no longer physically able to continue. If birthing in a birth center, they are free to labor similar to that of homebirths: eating, drinking, visiting with their family members, etc.
Birth centers in Australia
In a response to the National Maternity Action PlanNational Maternity Action Plan
The National Maternity Action Plan is an Australian document prepared by maternity consumer groups to alter the way Governments fund and resource maternity services.-History:...
, State and Territory Governments in 2002 started to respond to consumer demand for an increased number of birth centers to be made available to women. Whilst most birth centers are attached to hospitals, some are being established as free-standing centers much further away from hospital back-up. As long as they are within 90 minutes of a hospital, they are considered 'safe'. Most birth centers are now being run solely by midwives, with obstetric back-up only used when there are complications.
Some birth centers in Australia are moving away from the 'low-risk' model and are moving to an All risk model where women with medical complications are accepted into the birth center but extra care is provided to them where necessary.
Birth centers in Canada
Birthing centers remain a controversial issue in Canada, but using one is an option for Canadian women.Hospitals do offer this option, and it is available at special clinics.