The birth center
Freestanding (nonhospital) birth centers offer women with uncomplicated pregnancies who want a natural delivery a less high-tech, more homelike alternative to hospitals. Babies generally are delivered by midwives, and women are allowed to give birth in the position that’s most comfortable for them. “Birth centers don’t offer epidurals or [the labor-induction drug] Pitocin, and they only take low-risk patients,” says Kate Bauer, executive director of the National Association of Childbearing Centers, based in Perkiomenville, Pa. “What they do offer is time- and education-intensive care from the prenatal period through six weeks postpartum.” According to a recent study in the American Journal of Public Health, most women who plan to give birth at freestanding birth centers end up succeeding, with fewer C-sections and medical interventions. While about 15 percent of women are transferred to a hospital, this is usually because of failure to progress, Bauer says. “Most of these women go on to give birth vaginally,” she adds. Bauer suggests looking for a birth center with the following features:
> The staff are advocates for natural childbirth and breastfeeding.
> An extensive support system is in place.
> The baby can stay in the room with you.
> The center is accredited by the Commission for the Accreditation of Birth Centers. Today, an increasing number of hospitals have on-site birth centers. In these homey, comfortable rooms, your baby will stay with you and, because it will be assumed that you are breastfeeding, won’t be given a bottle. “Some hospitals have adopted certain of the philosophies of our freestanding birth centers, and we think that’s great,” Bauer says.
Most women who want a home birth believe that having a baby is a natural process that requires little medical intervention. Many also want more control and attention than they might get in a hospital or even a birth center. Here’s what you should know: > Home birth isn’t for everyone. Conditions that make a hospital the safer choice include high blood pressure, diabetes, severe anemia, preterm labor, unexplained vaginal bleeding, carrying twins, a pregnancy that goes beyond 42 weeks or a baby in the breech position.
> European studies show that for a healthy woman with a low-risk pregnancy, home birth is a safe option. However, the American College of Obstetricians and Gynecologists main Home-birth resources
>> The International Association of Parents and Professionals for Safe Alternatives in Childbirth, www.napsac.org.
>> The Thinking Woman’s Guide to a Better Birth, by Henci Goer (Perigee, 1999).
>> A Good Birth, a Safe Birth: Choosing and Having the Childbirth Experience You Want, by Diana Korte and Roberta M. Scaer (Harvard Common Press, 1992).