A new study on birth centers has just been released yesterday in the Journal of Midwifery and Women's Health, and of course it has a special place in my heart not just because of my midwifery aspirations but because we chose to welcome our son in a free-standing birth center.
We moved to a new state halfway through my pregnancy and the midwives at Connecticut Childbirth & Women's Center were the first ones I saw prenatally when we got to town. We drove 45 minutes up a snowy forest-lined highway to meet the first of our three midwives. I felt warmed when she told us of her own home births and understood the freedom I wanted in my birth experience. She showed us around the center where she hoped to help recreate the home-environment. Our nearest homebirth midwives were an hour and a half away, and with this being my second birth (and an instinct I had that it might be quick) I wanted to have a little more control over proximity/travel time to/from my care providers. Even at 45 minutes away I felt lucky to be this close to the only free-standing birth center in the entire state. I labored in water, ate and drank freely, had the quick labor I imagined, and was home happy and healthy after a morning of cosleeping rest in the same big comfy bed where my son was born. My midwives visited my home the next day to check up on us.
I had a positive experience with the care I received in a birth center, and the study shows that many other women are having equally stellar outcomes.
A birth center as defined by the study is "a homelike facility existing within the health care system with a program of care designed in the wellness model of pregnancy and birth. Birth centers provide family centered care for healthy women before, during, and after normal pregnancy, labor, and birth.”
Because of the growing concern for rising Cesarean Rates (visit CesareanRates.com for real stats and resources) this study should be of interest for both advocates for normal birth and those concerned with controlling health care spending.
*The Cesarean Rate for women in the birth center study was only 6%, compared with the United States rate at 32.8% (in 2010). For similar low risk women in the hospital setting the rate is 24%, which is still four times what the birth centers' outcomes is.
*Of the 15,574 women who were included in the study planning to birth in the birth centers, 84% of them actually did. That's only a 16% transfer rate. Transfers can be done prenatally due to risk factors that present during pregnancy, but the study clarified that only 1.9% of those transfers were for emergency medical complications of labor.
*No mothers died in birth centers. The newborn mortality rate was comparable to that in the hospital (0.47/1000), though the study did not give the specific low-risk hospital statistic.
*Given the lower costs in a birth center setting as well as the low rates of Cesarean Birth, the 15,574 births in this study may have saved more than $30 million dollars in facility costs alone based on Medicare/Medicaid rates, not even including the costs of anesthesia, newborn care, and other care providers that are involved in a hospital setting.
*If 10% of the 4 million U.S. births each year took place in a birth center setting, the savings in facility service fees would be as much as $1 billion per year.
I could rehash more of the facts here for you, but you're a smarty and you can read the study yourself--I would rather talk about what it means. Or what I think it means, as someone who isn't giving you medical advice, doesn't have anything to gain by the way you do things, but wants you to have an awesome birth.
What it means to me is that a low-tech but high-touch approach is helping women have normal births, that viewing pregnancy as a healthy part of a woman's life instead of an illness to be managed increases the likelihood that a woman will be able to birth healthily.
It also means that when healthy women avoid unnecessary medication and intervention (including inductions and epidurals) and allow low-risk pregnancy and birth to happen naturally, that it typically does. It happens. It doesn't need to be messed with.
I respect every woman's choice to birth in the way that she feels safest and most comfortable. I have seen beautiful and healthy births unfold in every setting, in spite of and sometimes even because of interventions that occurred. I recognize that pain relief, labor augmentation, and surgical birth are sometimes what a mama and baby want and need. I understand that Cesarean Birth is sometimes life-saving. I know technology is there for a reason. I appreciate it when it is necessary, for sure.
However, my opinion is that birth is at its best when it's allowed to be, when a mama trusts her body and her baby, when a care provider believes in birth. When from the very start we give birth and the women who do it the respect they deserve.
When I'm a midwife one day, in addition to serving women in home births, I hope/plan to open my own birth center. Though the safety capabilities birth centers have are very similar to home birth, many women prefer the seperate environment, and I love the idea of creating a safe and sacred space for women to come and have their wishes honored and freedom granted while they welcome their babies to the world.
In the Tampa Bay area we have a handful of birth centers, all worth exploring for those considering an out-of-hospital birth.
Go visit! Meet the midwives, imagine where your ideal birthing place might be, and if it's a birth center, now you've got the statistics to show your family and friends...
you'll be in good hands.