With the upcoming screening of the locally produced documentary Why Not Home? The Surprising Birth Choices of Physicians and Nurses, we thought it was a good time to have a community conversation about the importance of birth location.
In Part Three of this series, Melissa Wiseman, LM, CPM, looks at why the studies show us that birth centers are not only safe but ideal for low risk families. Enjoy!
Are Birth Center’s Safe? A look at the studies, your choice, and why it works!
More and more families are seeking the care of midwives for their pregnancy and birth. Some preferring hospital birth with Nurse-Midwives and others choosing home birth or birth center care with Licensed Midwives. The choice of where you give birth is highly personal and is based on your own set of values, ideas and knowledge about birth. We give birth where we feel safe and despite the past century of being told that hospital birth is the safest place for birth to occur, women who give birth in free standing birth centers are experiencing much better outcomes.
A recent article Maternal Outcomes in Birth Centers: an integrative review of the literature presented maternal outcomes from 23 quantitative and 9 qualitative studies of 84,300 births planned to occur in freestanding birth centers throughout the United States and internationally. The outcomes were certainly favorable for healthy, low-risk women who choose to give birth at a freestanding birth center. These positive outcomes included higher rates of vaginal birth and lower rate of cesarean birth, greater perineal integrity and fewer episiotomies, less use of oxytocin for labor augmentation, and less use of epidural or other pharmacologic pain management. A review of this magnitude is a highly valuable comparison tool, especially if you are pregnant and deciding whether a hospital or birth center or home birth is right for you.
In addition to this study, the American College of Obstetricians and Gynecologists recently released a statement that healthy low-risk women should be supported in their choice to give birth in birth centers. So, what is it about birth centers that promote better outcomes for you and your baby?
Midwifery Care provided in birth centers
Women report greater satisfaction with the comprehensive and individualized care and a more egalitarian relationship with their midwives, where a personal connection helped them to engage and be an active participant in their care. When we provide you with unbiased information, access to high quality clinical care and ample opportunities to make your own choices, then will we really see superior outcomes for both you and baby.
A place where your choices are respected
Women who are respected as the prime decision maker throughout her and her baby’s care feel a greater sense of empowerment. Becoming an empowered voice in your care and in the care of your baby is essential as you transition into parenthood. We encourage you to be engaged and active participants in your care, and in turn your midwives trust and respect the informed choices the you make.
Birth Centers are home-like environment that is set up specifically to promote uninterrupted, natural birth. Birth suites are often spacious with a large tub, should you choose to labor or birth in the water. The layout is created to ensure safety and privacy during birth, each piece of furniture carefully chosen for both comfort and function, and our cabinets are stocked and organized to hold the necessities for labor and birth.
Out of sight, not out of reach
In birth centers, your midwives give you the room to labor and give birth without pressure to submit to common interventions such as pharmaceutical labor induction, augmentation and epidural pain management. These are still accessible, but do require a short car ride to the hospital to obtain. Because these options are associated with risk of further interventions and cesarean section, they are best used when only absolutely necessary. To promote the most physiologic birth and best possible outcomes, healthy low-risk women should have the opportunity to go into labor when their baby and body is ready. They should also have the space to labor and give birth on her own terms with the watchful guidance of skilled midwives through the process.
But what if something goes wrong?
Complications can arise in labor and birth and such is life, we don’t drive with our airbags out just in case they don’t do their job and inflate on impact. And it certainly doesn’t mean a healthy low-risk woman needs to give birth in the hospital “just in case”. Because midwives are experts in normal birth, midwives are especially good at identifying patterns in labor that are not following the normal progression for birth. Remember, there are yellow lights before there are red lights. With the undivided attention your midwife, she can address issues that might arise in a timely and dignified manner. You are the number one priority of your birth team! As midwives, we are readily equipped to treat some of the more common complications that may arise in labor, birth or in the immediate postpartum. If there are more complex or emergent issues, we are able to make a timely transition to the hospital.
The choice around where to give birth is only for you to make. But the tides are starting to turn as we are seeing our health care system encouraging healthy, low risk women to seek birth center care. And why? Because our mamas, our babies and our outcomes are strong.
~Melissa Wiseman is a licensed midwife practicing at Thrive, Ultimate Frisbee enthusiast, and all around birth nerd.