Is a Birth Center Right for You?

When I was thinking about where I wanted to give birth, it was kinda the Goldilocks tale…

I knew that I didn’t want to give birth at home. As beautiful as it sounds, we lived in a small, urban condo that didn’t have a lot of open space, or accessories like big bathtubs, birthing bars or stools.

But, I also didn’t want a sterile, intervention-friendly hospital. Fluorescent lights, hard tables and stirrups didn’t sound appealing either.

That’s when I landed on a birth center. It was just right… It had some of the comforts of home with the resources of a hospital.

So, what is a birth center anyway?

A birth center is a home-like facility for giving birth. Birth centers provide family-centered care to expectant mothers, meaning that the family and midwives collaborate to decide on the best way to care for mom and baby. As a general rule, birth centers don’t perform routine interventions such as continuous fetal heart rate monitoring or IV fluids. Birth center midwives trust that birth is a natural and normal process and they support women to trust that their bodies know what to do.

Keep in mind, there are two main types of birth centers: free-standing centers and centers that are in or near a hospital and affiliated with the hospital. A birth center that is affiliated with a hospital is likely to have a higher intervention rate because it has to adhere to hospital standards. Because hospital standards vary, hospital-affiliated birthing centers can vary too and may not follow the same standard of care that freestanding centers do. If you are considering having your baby at a hospital-affiliated birth center you may want to ask these questions when interviewing them:

  • Does the birth center have it’s own staff?
  • When and how often do they rely on hospital staff?
  • What is the transfer rate?
  • What is the C-sections rate?
  • What is the epidural rate?

Who will attend your natural childbirth at a birth center?

Your birth will be attended by a team of midwives, midwife assistants, and/or student midwives. Many midwives make it a priority to develop and keep a good professional relationship with local OBs and practitioners in the hospital in case of a need for consult or transfer. However, the birth will be attended by the midwives that own and run the birthing center. If you are at a hospital-affiliated birthing center, your birth may also be attended by a hospital nurse.

Why choose a birth center over a hospital?

Safety – A recent study found that, for women experiencing low risk pregnancies, giving birth at a birthing center is far safer than at the hospital. The national C-section rate for low risk women is an astounding 32.7% while the C-section rate for women who intend to birth at a center is 6%.

Comfort – Your room at a birth center is low tech, private and relaxing. There is often a large bed for co-sleeping (and room for dad too!) rather than a small hospital bed. Many birth centers will only have one or two women in labor at a time and their midwifery team, which helps support your privacy. Many birth centers have birthing balls, stools, tubs, and other props to help you find the most comfortable position. You can also bring your own decorations or inspirational items.

Support – Midwives understand that birth is an incredibly personal experience and that every woman needs to make choices for herself and her baby. They believe that parents are capable of making those choices when they are allowed to review the evidence for themselves. Midwives treat women like people not patients. Midwives are supportive of women who are choosing a natural, low-intervention birth. In addition, they can help you work to stay calm, relaxed and unafraid during labor and delivery during your natural birth. They will also support you if you choose to (or have to) go to the hospital last minute and may even be able to meet you on the side of the road if needed!

Cost – A birth center birth is less than half of the cost of a vaginal birth in a hospital. Though the exact cost will vary by state, midwifery care is usually around $2000 while a vaginal birth at the hospital is $8000. If you don’t have insurance the cost savings are obvious. If you do have insurance, and midwifery care is covered, you will pay about the same or less for a birth center birth than for a hospital birth. If you happen to have a high deductible, you may pay less for midwifery care at a birth center than what you are responsible for (after insurance) for the hospital birth.

Individualized care – Birth centers often have a small staff of midwives so you will get to know each midwife throughout your pregnancy and prenatal appointments. Therefore, the women you see during your prenatal appointments are the ones that attend the birth. Additionally, you can choose the length of stay at the birth center, meaning you can go home the same day you give birth if you desire. Birth centers often offer home visits where the midwife will check on you and your baby a day or two postpartum.

What if something goes wrong?

The birth center is part of the healthcare system. If a serious complication arises, transfer to appropriate medical care is made. Birth centers are equipped with oxygen and infant resuscitation equipment and midwives are trained and prepared to use them if necessary.

Midwives are also trained to see a complication arising early enough to transfer in time. In the study mentioned above, of the 12% of women who transferred to the hospital during labor, only 1.9% were emergency transfers.

Additionally, during your prenatal appointments your midwife evaluates your pregnancy and whether a birth center birth continues to be the safest option for you. Midwives are trained to see complications in pregnancy (preeclampsia, diabetes, etc) and recommend a consult with an OB, or a transfer of care if needed. They are also well trained in dealing with some minor complications holistically and naturally so that a transfer of care can be avoided.

Where can I find a birth center?

  • The best way to find a birth center that’s local to you is to google “Birth center” plus your city name or zip code.
  • Once you’ve found an option or two, see if Google has any customer reviews you can view. Or check Yelp.
  • Of course, asking friends an family is a great option too. Put the question out on Facebook: Has anybody delivered at a birth center? Do you recommend it?
  • Finally, the American Association of Birth Centers has an online locator under the “for parents” navigation option.

Here’s what other natural mamas have to say about birth centers

I asked the moms on my Facebook page if they gave birth at a birth center and what their experience was like. Here are some of their responses.

  • I gave birth at Edenway Birth Center in Cleburne Tx. It was a water birth and it was truly amazing. The care I received was so personalized to our family. So much better than a hospital with an obgyn. I had originally began with an ob but switched to midwifery care halfway through. Best decision I ever did! Our birth experience was the best! The center is so welcoming and comfortable plus the midwives are like family to us! – Jennifer A.W.
  • Both my daughters were born at my local birth centre with a midwife and a doula. Both were really positive intervention-free experiences in a lovely home-like environment. Overall I was really happy with the support I received and highly recommend the experience. – Briana T.
  • I gave birth to my second baby at Natural Beginnings Birth Center in Statesville, NC. I loved that I was able to have a water birth attended by two midwives that I knew well from all my appointments (no unfamiliar nurses). The birth center was a calm, quiet environment and I felt very comfortable there. I also loved that I was able to go back home the same day I gave birth. – Jessica R.
  • Both of my births were at a birthing center. They were INCREDIBLE (Heart 2 Heart in Sanford, FL). I would have preferred home births but my insurance wouldn’t cover it. Next best thing was a birth center. Both of my labors/births were so different (both yielded 10lb babies though! 😬) but the experience in both were amazing! – Jackie A.C.
  • I had an all natural, drug-free water birth in a birthing center in Seoul, Korea. I thought about having a home birth but I was too nervous to do that in a foreign country. It was a great experience. I had a long active labor, (nearly 16 hours), and there was no mention of induction or painkillers. My doctor actually favored natural birth. I was able to do delayed cord cutting, my husband cut the umbilical cord, skin to skin contact and breastfeeding were initiated right away, etc. I pretty much got the birth I wanted, I am extremely blessed. The only part I did not like was the lack of privacy. People still had to come in to “check” on me, (blood pressure, etc), a few times. I really just wanted to snuggle with my baby and not be interrupted. wink emoticon I was ready to go home within hours of giving birth but I had to stay until they said it was OK. (I still went home shortly after, just hated waiting. ) Next time I am considering a home birth. – Keri H.
  • I gave birth in a free standing birth center in March. Best experience ever! It was so comfortable for us. It’s a wonderful setting between hospital and home birth. We got to go home so quickly too which was a huge bonus for me. I would definitely do it again. – Amber M.
  • I gave birth in a birth center last December. It was my first birth and it happened very fast. We were only there for 3 hours when my baby came. It was such an empowering experience and so calm and private. We relaxed with the baby afterwards alone and the midwife and nurse were very helpful with starting breastfeeding . Went home 6 hours after he was born and had lots of follow up visits and phone calls that week, which I always had questions being a new mom smile emoticon my husband was very involved with the delivery since the midwife needed help because the nurse didn’t arrive until I was pushing baby out. – Liz P.
  • Freestanding birth center for our third. Amazing water birth. So relaxing and they just breathed confidence in my body’s ability to birth. – Alissa I.
  • I had an awesome natural vbac birth at Andaluz Waterbirth center is Portland Oregon. They are my angels and they trusted me and my body. I had to transfer to a hospital for postpartum bleeding but my midwife was highly trained and reacted appropriately when the situation required doctor intervention. I birth centers! – Anna R.
  • I had my son at a birth center and it was wonderful. I had a fantastic midwife and it was a much more relaxed, calm, comfortable environment than a hospital. It didn’t feel that much different, for me, than how I imagine birthing at home would be. I wish this were a more accessible option. Where I live now, we don’t have any birth centers. – Heather N.

How about you?

Did you give birth at a birth center? How was your experience there? Share with us in the comments below!

References

Learn how to have an amazing birth with the Mama Natural Birth Course

21 Comments

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  1. I had my delivery in Birth Village in Cochin India. Thanks to Kate and Priyanka Idicula. It’s was the most amazing experience of our life. My labour was very short 5hrs total out of which 2 hrs was in the center. I was back home for breakfast.

    And then i wrote this ode to natural birth

    A picture perfect birth
    A frozen moment of ecstasy
    Amidst trees, candles and watchful silence
    At dawn in the pool, in Birth Village
    Restoring the love, respect and faith it deserves,
    A birth in Mother Nature’s way.

    To the midwives of the world

    Thank you for engraving wonderful moments of parenthood.

    Lakshmi Shyam

  2. What do you do if you want a natural birth via birthing center but there are NONE anywhere near your area?

    • This is a pretty common scenario. I’d start by seeing if there are any midwives in your area. They’ll have solutions for you. Also, look into “baby friendly” hospitals in your area. Baby Friendly is an actual accreditation – call local hospitals and ask them if they are. If so, choose one of them and prepare to have a natural hospital birth.

  3. Are there birth centres in the UK? I’m thinking of my sister….even though I’d rather homebirth whenever I have children…

  4. I love you, Mama Natural! And I am so happy to see New Beginnings Birth Center as the lovely illustration for this post! I have birth to my first child there in September 2011. It was a 24 hour labor, with 12 of those hours spent in a cozy birth room there. At the time, the center had a beautiful walking path in the backyard that my husband led me around and around as contractions came and went. My daughter was finally born a few hours after the midwife broke my water (I’d been stuck at 8cm for most of the day). It was a tough experience but totally worth it when we were all tucked into a cozy bed in our own room and left undisturbed for the entire night. To make it even better, we lived only five minutes down the road! We moved out of state a couple years later and my next daughter was born at another birth center (this time in Colorado) just three months ago. I am beyond grateful for the midwives that make these centers possible.

  5. I gave birth to my second daughter in a hospital birth center and it was a horrible experience. I had my first daughter at the same hospital (but not the birth center area because it wasn’t built yet). In the birth center, I was virtually ignored through most of my labor and the support that was offered was almost thrust on me despite my protests. I ended up having a very fast delivery, tearing, and being miserable and just happy to have it over with. Postpartum care was the worst, no food was offered to me after birth (like at the hospital) and I ended up fasting for almost 12 hours until I got home and then had to cook breakfast for myself and my family (not the birth center’s fault on that count). They also required that the day after the birth, we be discharged at 8 a.m. in the morning which didn’t happen because of paperwork until 11 a.m. discharge time. Then I had to go home, make breakfast, take the new baby to the pediatrician and then back to the birth center for newborn testing. All of this with a February blizzard bearing down on us. During the newborn testing, I questioned some of the procedures and was bullied into having the heel prick test done and threatened that the baby would be taken away if she showed positive for jaundice. It was a scary experience.

    And to top it off, six weeks after my birth, my midwives fired me stating they didn’t agree with my parenting. A year later, I’m still fighting off PPD.

    • Where was this? I live in NY and am considering a hospital birth center. It will be in the winter too!

  6. I have given birth in both the rooms pictured from New Beginnings Birth Center. I felt very cared for. I originally wanted to do a home birth with my first, but couldn’t find anyone to deliver. I’m happy with our decision to go with a birth center. I personally feel women should birth where they feel most comfortable and loved and they should be well informed.

  7. Reading this brought back some of those sad feelings that I didn’t get to finish my delivery at the birthing center where I started. I was one of those 6% that had to be transferred to a hospital for a C Section (which is what I was trying to avoid by choosing a birth center and midwife!) I love my midwife and the birthing center experience, but I would think twice before attempting it again. The journey to the hospital was torturous, and it was scary going into a place for unplanned surgery where I was a completely new patient. Even with the best of plans, the birthing process is not always in our control. I’m simply grateful for a positive outcome 🙂

    • Amen! We never know how it will all unfold. Sorry it wasn’t smooth and easy for you. I grieved when things didn’t go the way I wanted with my first birth too.

      But like you said, you got the best gift of all after it was all said and done.

  8. I gave birth to my first child at a birth center. It was the best decision ever!!! I knew I wanted an un-medicated out-of-hospital birth, but didn’t feel ready for a home birth yet. Our experience at the birth center was so beautiful and empowering that with our second child we were ready to give birth at home.

  9. My insurance unfortunately doesn’t cover a natural birthing center. 🙁 However, thankfully the birthing center at my local hospital has tubs and midwives available!

  10. I lived in Illinois when I gave birth to my son. I really, really WANTED a birth center, but there were none in that state at the time, and the closest one was an hour and a half away (and in another state). But, like you, I knew I did not want a hospital birth. All of the hospitals in my area (that took my insurance) had high c-section rates, and pretty much required IVs, continuous EFM, and other interventions I did not want. I ended up having a home birth (paid for entirely out of pocket), because that was the best option for me at the time, and while I loved it (best experience of my life!), I do still think a birth center would have been a great choice for me as well.

    Birth centers are awesome, and a great choice for healthy women with low-risk pregnancies! I just wish this country had more of them.

    • The first birth center in Chicago opened recently -it’s called PCC. I have my second appointment today and am very pleased so far!

  11. I did a lot of research and visits to birth centers and interviews with midwives before deciding on a hospital birth. I met some wonderful midwives and could tell from conversations with them that my care experience would be much different with a midwife than with my ob, but one thing I think people should realize is that birth at a freestanding birth center is not really an in-between the hospital and home; it is really just a home birth, maybe in a more comfortable or luxurious environment than home, but the midwives have the same capabilities and equipment as what they would bring to a home birth. Friends I know worked with birth centers but ended up doing the birth at home because doing it in the center was an extra charge and it was really the same level of safety and care. If you wouldn’t be comfortable with a home birth, a freestanding birth center birth might not be for you either. And though overall the costs are cheaper insurance is less likely to cover it, me and others I know had an extremely difficult time trying to figure out insurance, most people ended up just paying out of pocket. I ended up going with a hospital, both because I am expecting a baby with special needs that could need additional support at birth, and because the costs were adding up, with not having my insurance guarantee reimbursement and the closest transfer hospitals to the center I chose not accepting my hmo. I could have ended up paying out of pocket for the birth and then also for hospital admission if I or the baby needed transfer. I love the idea of a birth center and hope I can do it in the future but people should know that, depending on your insurance and where you live, it’s not always so simple. If you know you want to do it try to get ahead of it and start looking into insurance and payment options as early as possible.

  12. Hey! That’s in Idaho 🙂 I have a friend that just gave birth there.

  13. I had a water birth in March 2014 at a freestanding birth center in St. Paul, MN. My labor and birth went smoothly and my midwives handled everything wonderfully. They give great care there and are well trained. I was able to relax and do what I needed to do to give birth because I knew I was in good hands and that they wouldn’t push things on me that I didn’t want. The hospital setting gives me anxiety and you have to be able to relax to give birth. I wish I could give birth there again when we have another child but we are moving to Michigan. I’m already looking into birth centers within hospitals there for future reference 🙂

  14. My first birth was at a medical center/hospital where my midwife had all privileges. Although not a traditional birth center, I felt so at ease and relaxed in this environment. I wasn’t required to wear a gown, I could eat, drink, walk around the medical center during labor and was in no way forced to have (or even offered) ivs, medications etc. It was a wonderful “hospital” experience and I was so grateful that I was able to have an unmedicated vaginal birth . For my last 3 children, I gave birth in a large tub at a birth center in Laguna Woods Ca. Thankfully, my midwife had just opened her birth center 2 months prior to the birth of my second child. It was a lovely experience and I’m am so grateful to God for the opportunity to birth there 3 times.

  15. If I were in my 20’s maybe I would deliver in a birth center. I was 40 when I had my first baby and even though midwives did my pregnancy care and with midwife I labored I ended up needing a team of doctors to deliver my baby. The good thing it was I was in a university hospital and the team of doctors were on the same floor and in the same clinic/department to continue where the midwives were not skilled. They did assisted delivery with forceps and did very careful job. And they saved me from C-section.
    In my personal experience I noticed that doctors as we know really know more with complications and can recognize them sooner and act upon it. I do not mind the sterile hospital environment. Now they strive to make the rooms look more home like, what I care is that they can recognize the problem on time and react promptly. And in some situations it is good that woman in delivery does not have to wait for transfer. But for uncomplicated deliveries birthing centers are fine.

  16. I had my first at a birth center and my second at a hospital. Both were 100% natural and I labored in water for both (could have had both babies in water, but for some reason or other, I got out mid delivery – crazy stories for both). I prefer the hospital 100x over the birth center. I was a total skeptic going into my hospital birth but my midwife rocked it and I had such a great experience.

  17. I gave birth to my second son in January 2014 at a freestanding birth center in Pittsburgh. I can not say enough great things about it, and felt the care was better than my experience with my first son, whom was born in a hospital.
    I wish everyone knew how respectful care should be. I always said with my first that he was born and he still didn’t feel like MY child until we left the hospital, bc of all the regulations and things done to me and him. But from visit one with my birth center, I felt like I mattered and they knew whose child this was…my FAMILY’S!

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