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« The 10 Most Cesarean-Happy States in the U.S. | Main | Issue 9, July 2015 »
Friday
Aug072015

Top 10 Reasons a Birth Center Birth is Not For You

 

           

 

 (…and Why You Might Be Wrong!)

Guest post by Poppy Daniels, MD

  1. “A hospital is the safest place to give birth.” The American Congress of Obstetricians and Gynecologists (ACOG) has stated that a hospital-based or freestanding accredited birth center is a reasonable option for low risk women.

  2. “What if an emergency happens, a hospital is prepared for emergencies?” Birth centers are typically equipped with oxygen, IV fluids, medications to slow bleeding and providers are trained in CPR and neonatal resuscitation. True emergencies are very rare, although most birth centers are located in close proximity to hospitals should a transfer become necessary. Most birth center transfers are non-emergent (mom develops risk factor during prenatal care, dysfunctional labor, maternal exhaustion, etc).

  3. “My insurance requires me to go to the hospital to give birth.” Insurance often covers birth center births. Since the cost of a birth center birth is approximately 50% less than a low risk hospital birth, you get more bang for your health care buck. Cost savings are significant for patients without insurance.

  4. “My husband, family, friends or in-laws would be upset if I didn’t deliver in the hospital.” Most people aren’t aware of the beautiful surroundings, safety features, and low cost of birth centers. Tours of facilities and researching your options can help you to determine if a birth center is a good fit for you. Remember, your birth is about YOU, not what makes other people feel better.

  5. “I’m not a hippie, why would I deliver at a birth center?” Increasing numbers of highly-educated, professional people choose to have their babies in a birth center as well as many non-professionals and non-hippies. With so much information available online, women of all kinds are seeking out high quality prenatal care and empowered birthing options.

  6. “I’m high risk, I can’t deliver at a birth center.” Some people ARE truly high risk (moms who have diabetes, hypertension or history of cesarean section*). However, each pregnancy is different and there are many women who would qualify for a birth center birth (miscarriages, infertility, advanced maternal age, etc.).

  7. “Isn’t continuous fetal monitoring better for my baby?” Continuous fetal monitoring has not been shown to be a benefit over intermittent fetal monitoring in low risk women.

  8. “The hospital has pediatricians for my baby.” Pediatricians don’t attend low risk births at the hospital. Birth center providers are trained in newborn assessment and resuscitation.

  9. “There are lots of people checking on me in the hospital.” Many women appreciate the midwifery model of care and the time spent during longer prenatal visits (30-60 minutes vs 10-15 minutes) as well as the continuity through birth and post-partum. Some families get annoyed with constant interruptions by multiple people in the hospital for vital signs, dietary, housekeeping, nursery or lab draws at 6 AM.

  10. “I can’t have an epidural in a birth center.” True. But you CAN have increased mobility to move around in labor: walking, standing, birth balls and birth tubs help provide many women pain relief in labor.

 

ACOG has acknowledged that birthing in a hospital-based or freestanding accredited birth center is a reasonable option for low risk pregnant women. They have recently released a statement with the American College of Nurse Midwives affirming evidence-based models of care and the need for collegial relations and collaboration between obstetricians and midwives.  (Joint Statement of Practice Relations Between Obstetricians and Gynecologists and Certified Nurse Midwives/Certified Midwives, Feb 2011, Reaffirmed by ACOG Executive Board July 2014)

 

Dr. Poppy Daniels is an OB/GYN who works with midwives at the Family Birth & Wellness Center in Springfield, MO, www.familybirth.com. You can follow her at “Dr. Poppy” on Facebook and @drpoppyBHRT on Twitter.

 

 

*Edit (8/11/2015): The author clarified this statement about history of cesarean section.If a woman has had a successful VBAC then her risk is less than a primary VBAC. The most risky situation is a woman who has a cesarean after a failed VBAC attempt. This is clear in the literature. It is not that people CANNOT do it. That is not the point. The point is that most birth centers are under a lot of scrutiny and in some states, laws that prohibit women who’ve had prior cesareans.”

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