For many women, a birth center is the best of both home and hospital, providing care from medical professionals like Midwives in a homey environment.
If you are weighing your birth location options it may be a good fit for you, to help you decide here is everything you need to know about giving birth in a birth center.
What the heck is a birth center?
This is the first question I asked when it was suggested that it might be a good fit for me during my first delivery. To be fair it is a common question.
While every location will have some special circumstances, for the most part, a birthing center is a cozy, low-tech birthing option for mamma’s who are wanting to deliver with a natural childbirth experience.
Most of the time they are free-standing facilities, but occasionally they are next to or even built into a hospital.
The local birth center I’ve delivered at is a free-standing location, however, is within easy walking distance of the hospital should a transfer be required.
To birth in a birth center, you will need to be in the care of a Midwife, as most locations are run by midwives, not OBGYN’s.
Besides offering a comforting atmosphere to birth in most birthing centers provide other services like well-woman exams, preconception counseling, prenatal care, childbirth education, breastfeeding classes, postpartum care and support and much more.
Hospital vs Birth Center – what’s the difference?
While many birth centers collaborate with OBGYN’s they are run by Midwives. Of course, any health care provider will consult with other care providers (like an OBGYN) when needed.
The rooms are cozier, hospitals the world over, look pretty clinical and sterile. In other words they look like hospital rooms and that isn’t a bad thing it just sets a specific atmosphere.
Birth Center rooms are more like a hotel or home environment. The one I delivered in for both my boys had a huge shower I could take my birthing ball into, AND a huge tub to actually deliver in (I was on my hands and knees and the water could easily cover most of my back during labor, and I am by no means a small woman).
The Standard Procedures are different. Now you should ask your particular location about ALL their standard procedures because some are regulated by governing bodies etc so there could be some similarities.
However, common standard procedures in hospitals may include things like continuous fetal monitoring, routine IVs, or induction for labor which are NOT routine at the majority of Birth Centers.
Benefits of Delivery in a Birth Centre
Atmosphere
While more and more hospitals are offering options like dimmed lights and playing music at a birthing center chances are the lights at least will be done for you.
Music is something many women want during labor and in a birthing center, you will catch less resistance over its inclusion.
The bed will be BIGGER… ie instead of the standard single person bed of a hospital, you now have access to a queen or at least a double. That means more room for you and baby to move around and position yourself for your comfort. Or you and your partner can cuddle while laboring.
As I mentioned above, you will likely have a huge tub AND shower big enough to deliver in. Or at least have help while you labor in. The location I delivered in (for instance) the shower was big enough I could easily fit me, birthing ball, and like 3 other people in it. So yeah, you and whomever is with you in the delivery room can get right in it together.
The colors and decore are more relaxed, I remember walking into our delivery room (both times) and thinking I wish my home looked this nice. While I don’t remember the colors of the walls or anything like that I do remember that it was a soothing and warm color. Something I actually would decorate my own home with.
You can personalize it… ok this one may not be in all locations, but I’ve heard tell of some that encourage people to bring things like photos and artwork to hang up. We were also advised that if we wanted we could bring things like candles or other items from home that may help me relax through the process.
Privacy…
Yup, Birthing Centers provide mammas with private rooms! There is no “sharing of labor” like some hospitals do in certian stages of labor.
Also since you labor and recover in the same room that means no semi-private room for your postpartum recovery too.
In many hospitals, unless your insurance covers it (many don’t) you get moved pretty quickly for the next laboring mamma or at the very least the cleaning team to make the room ready again for someone else.
FREEDOM! FREEDOM!
Ok, I’m exaggerating my excitement over this one. But it was a big seller for me. Birthing Centers tend to get less involved in the laboring process which means you get to do more of the things you want to your way.
To be clear, if there is any risk to you or baby your Midwife will step in and keep you both safe. HOWEVER, things, like walking, changing position, eating, drinking and how you handle every aspect of the labor AND delivery, are more in your control.
Many hospitals restrict eating and drinking during and even after labor (except for ice chips). You may also find yourself restricted in your movements, especially when continuous electronic fetal monitoring is involved.
Hospitals are also notorious (though some are getting better) for making women deliver laying on their backs in bed. Whereas Birth Centers allow for more variations on position and location (think water tub, bed, standing etc).
Birth Centers are more Flexible
With a hospital, you need to be in a predetermined stage of labor (usually around 6 cm dilated and with contractions at a set spacing) before you’ll be admitted. Even if you are adamant that you need to get a bed, they have “standard protocols” and usually won’t bend them.
This causes a lot of confusion and frustration for laboring women and their partners.
With a birthing center, you could be “admitted” well before that, even if they have the same guidelines.
When we went into labor with our second I spent more time in the birth center than I would have in a hospital since they admitted me when I was a measly 3 cm dilated. A hospital would have sent me home for another 12 hours… and I likely would have ended up back there causing havoc with my concern not long after.
Baby stays with you
Many hospitals are getting with the times and recognizing the “Golden Hour” after birth, some are even as progressive as being “Baby Centered” and now leave baby in the room with Mamma unless there are complications that prevent this.
However, even many of the hospitals that are more forward-thinking still remove the baby from Mamma’s room for the first exam and at times other procedures that could be done right there in front of the new parents.
Brith Centers don’t have extra rooms for things like baby exams, you and baby will stay in the same room for the duration of your visit.
Everything from preventative care (like the vitamin K shot) to baby’s first checkup and bath (if you ask for it) happens right there in the room with you. You can not only watch what is happening but often you are involved in what is happening.
And unless you want your family kept away they can be with you through the whole thing from admitting to discharge as well.
One of the things that I thought was the greatest with both my Birth Centre deliveries is that I got to see all the checks they did on baby, while the baby was on my chest or nursing. When they were weighed I had the option of placing the baby on the scale myself, I was never asked to hand my baby over to anyone at any time other than when I needed to get out of the birthing tub.
You choose who comes
Most Birth Centers let you choose who and how many people come to the labor and the delivery.
Unlike hospitals that may restrict the number of people in the room at any given point in time. And often kids won’t get an automatic boot out the door when the time to push arrives either.
Of course, I’m not saying you should pack people in like sardines. Many natural birth advocates recommend limiting the number of people present to reduce the distractions and allow Mamma to focus on what she is doing.
More Doula Friendly
While many hospitals do permit doulas not all welcome doulas in the delivery room.
A doula is a support person who is solely focused on you and your comfort during labor and delivery. They are usually not medically trained but they have loads of experience with all sorts of birth and can often recommend options for pain management, positions that may work for you and so much more.
I used a doula in both my deliveries and it is the BEST money I ever spent.
Increased Momentos…
While you should always check with any birthing facility about what they do and don’t permit, chances are if you are working in a birth center things like photos and videos of the big event are more welcomed.
No Epidural
Epidurals are provided by Anesthesiologists, Midwives are typically not cross-trained in this. And these specialists are licensed to administer epidurals in hospitals only.
So birthing centers focus on alternative pain relief options like hydrotherapy, massage, acupuncture, breathing exercises and other similar options instead. Some locations will also offer nitrous oxide gas, but not all do.
Reduced risk of a C-Section
For women who are low-risk a hospital delivery still has a higher chance of a c-section than in a birth centre.
While I’m not 100% sure on why this is, one of the common theories quoted is that Midwives are more used to seeing variation in “normal” delivery. Whereas those working in hospitals tend to see only a small portion of “normal” before jumping in with interventions that increase the chance of a c-section.
Shortened Stay
Recovery time after birth is shorter when there are fewer medications and medical interventions involved. Add to that Midwives who come to your home after for the early check-ups and you may be out the door within 4 hours of delivery like I was.
Most families leave birth centers within four to eight hours after delivery. Whereas many hospital deliveries result in 24 to 48 hour stay minimums.
The Drawbacks
As much as I LOVED our Birth Center deliveries there are a few things you need to know that are not so great about them.
Low number of locations
Depending on where you are there may not be one in your area. Birth Centers are typically in cities and not as common in rural areas (yet).
Add to that the higher demand than there is space and you may not have the option.
When we first went in to see our midwife with our oldest son we were advised that delivery is a first come first serve basis. Meaning that if we went into labor and all the rooms at the birth center were full we were still going to be heading to the hospital.
Hospital Transfer is still a possibility
You will be transferred to a hospital if there is an emergency or a problem occurs during labor.
For the most part, transfers are at the request of Mamma for things like an epidural when Mamma is having a particularly difficult labor.
Though as a precaution all birth centers keep supplies on hand for things like IV’s, oxygen, and infant resuscitators in case of an emergency.
In the majority of cases though your Midwife will know well in advance if there is going to be a concern so you can discuss options up front.
For example, at one point in my littlest’s birth a transfer was discussed because I was getting so exhausted by the labor. I chose a different option and continued for another few hours and safely delivered a healthy baby without any issues later that day.
Lack of Insurance Coverage for Birth Centers
Where I am this is covered under our provincial health care the same as if I delivered in a hospital.
However, if you are in the US or other similar locations contact your insurance provider to see if they cover delivery in a birth center.
Some insurance companies do and others don’t cover birth center deliveries.
The costs associated with a birth center delivery are lower than a typical hospital delivery though. In the US it can range to higher but averages between $3,000 to $4,000 per stay. But you should check with your location as it could be different, and your insurance provider in case they cover some or all of it.
Birth Registration Paperwork could be delayed.
This usually isn’t a big issue, however, in Manitoba, some recent changes mean that births are registered differently.
And depending on if your birth center is connected to other agencies like Vital Statistics or your Provincial Health Care system, the baby may not show up in the system right away.
Like I said this isn’t normally a huge deal. For the first few months if you need to access the provincial health care system for baby (like take them to the emergency department) they can be registered under Mamma’s health card number and entered as a “newborn”. This permits you to not only access the services baby needs but will let you get them added on your health card after as well.
It may also delay the issuance of things like a Social Insurance Number (Social Security Number in the US) or a Birth Certificate depending on how often the paperwork is sent off from the birth center.
Typically you only need a SIN/SSN or Birth Certificate if you are opening a bank account for baby or planning on leaving the country.
When NOT to deliver in a Birth Center
Birth Centers only handle low-risk pregnancies. If you have any of the following
- Diabetes
- Gestational Diabetes
- Hypertension
- Preeclampsia
- Pregnant with Multiples
chances are you won’t have the option of delivering at a birth center.
When to find your Birthing Center
Birthing Centers do not handle the same volume of deliveries as hospitals, as such you need to book your spot as soon as you know that is where you want to be.
I recommend doing so in your first trimester, and if you get a rejection notice ask if there is a waitlist. With our first delivery I didn’t get in until month 7, and I was so happy that we had put in the request to be on the waitlist.
Just a heads up, some hospitals will call their labor wards a “birthing center”. So just because the word birthing center (or some variation of it) is in the name does not mean it is one.
If you are in the US visit the Commission for the Accreditation of Birthing Centers website to find one near you.
In Canada Google search “Birthing Center” with your province to find ones close by.
Then arrange a tour so you can learn more about the center it’s self, meet the staff and ask questions.
A Birth Centre Maybe for you
If you are low-risk, healthy, and are having a healthy baby. And would like to have an all-natural labor and delivery, in a medical facility with fully trained medical staff to aide you… a Birthing Center could be the right fit for you.
