A freestanding birth center is a facility designed and equipped to provide prenatal, childbirth, and postpartum care to pregnant individuals who prefer a more home-like or natural birth experience outside of a hospital setting. These centers are typically staffed by certified nurse midwives, nurse practitioners, or other trained healthcare professionals with expertise in childbirth and women’s health.
The American Association of Birth Centers defines a birth center as a home-like setting where care providers, usually midwives, provide family-centered care to healthy pregnant women. Most birth centers are located separately from hospitals, while a few are inside hospital buildings. In-hospital birth centers must meet specific standards for independence and must be separate from the Labor and Delivery unit to be considered true birth centers
Family-centered Care
Pregnancy and childbirth are healthy, everyday life events for most women and babies. In birth centers, midwives and staff hold to the “wellness” model of birth, which means that they provide continuous, supportive care, and interventions are used only when medically necessary.
Birth centers are universally committed to family-centered care. In birth centers, the childbearing woman’s right to be the decision-maker about the circumstances of her birth is fully respected. For example, at birth centers, women are encouraged to eat if they are hungry, move about and spend time in a tub as they wish, and push in whatever positions they find most comfortable.
Birth centers recognize that the mother knows what her body needs to give birth. The midwives and staff attend to her needs while diligently watching for signs that are outside the realm of wellness,
History of the Birth Center
As a demonstration project, the Maternity Center Association established the first birth center in the United States in New York in 1975. This was done to show that costs could be cut while providing good outcomes for babies and mothers when they were born outside of a hospital. The American Association of Birth Centers was founded in 1983 to advance this model of maternity care. Since then, the number of birth centers in the United States has steadily increased. There were over 300 in 2015 alone. All freestanding birth centers must be licensed by their states. However, not all birth centers adhere to the AABC guidelines.
Birth centers, similar to clinics, were established as an alternative to institutionalized healthcare on the East and West Coasts in 1970. Birthing centers are now covered by insurance. The main hospital labor and delivery floors are adopting many of the birth center innovations.
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- Whirlpools and bathtubs for labor and delivery
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- Showers for mothers who are about to give birth
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- Acceptance by the hospital for the mother who chooses to walk during labor. Use a labor or birthing balloon and not pain medicine during work.
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- The infant can be placed with their parents soon after birth.
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- By providing beds, family members can stay with the mother during labor or birth.
To be allowed to give birth at a birthing center, a woman must meet specific criteria. To be able to give birth at a birth center, a woman must first have an uncomplicated, low-risk pregnancy.
Freestanding birth centers will need hospital support in the event of complications during labor. Midwives at birth centers may be able to provide prenatal care to pregnant women who cannot deliver at the center due to a high-risk pregnancy.
Accreditation
The American Association of Birth Centers (AABC) established national standards for independent birth centers in 1983. The Commission for Accreditation of Birth Centers (CABC) was created in 1985 to provide a method of accreditation similar to how hospitals are inspected and credentialed.
The 1989 National Birth Center Study was published. The Birth Center Study II, the most recent large-scale study on birth center outcomes, was conducted in 2013. It concluded that “few innovations in the health service promise lower costs, greater availability, and a high level of satisfaction with a comparable level of safety.” It used data from only CABC-accredited national birth centers. This study confirmed the findings of the 1989 study. Accredited birthing centers provide safe places for low-risk women to have babies.
Accreditation is based on indicators, which birth centers are evaluated against during site visits by CABC Accreditation specialists. These indicators are used to ensure the safety of the mother and baby and the integrity of the birth center model of care. Continuous fetal monitoring is standard in hospitals and delivery units. In birth centers, however, intermittent monitoring with a handheld electronic device ensures the mother’s mobility during labor and birth.
Indicators
CABC indicators require that birth centers have a written plan for transferring patients to the hospital in an emergency. Members of the CABC’s board of trustees are commissioners. They review birth center accreditation applications. These commissioners are Certified Nursing-Midwives and certified professional midwives. They also have the authority to review birth center accreditation applications.
The Commissioners meet every quarter to discuss issues related to the development and education of birth centers. In addition, they publish a monthly newsletter to CABC-accredited Birth Centers for continuing education. To promote and advance birth centers and the midwifery care model, the CABC works with policy advocacy groups. Although the CABC is closely affiliated with the AABC and has distinct roles in accreditation and national birth center standards, they are independent.
The CABC is the only accreditation body dedicated solely to birth centers. Its site visitors are specially trained to conduct a center site visit, and its review panels have firsthand knowledge of birth center philosophy, care, and operation. The American Association of Birth Centers, on the other hand, is a membership and trade organization for established and emerging birth centers, as well as other agencies and institutions that support the birth center model of care.
Conclusion
A birth center is a healthcare facility for pregnant women. Doulas or coaches, nurse midwives, midwives, and obstetricians may provide care. Midwives keep an eye on the mother and her baby. Doulas are available to help midwives during labor and the birthing process. If the mother requires further medical attention, she can be transferred to a hospital. If the mother requires an epidural, her baby is in prolonged labor, meconium is present, or they need intensive care, she can be transferred to a hospital.
It’s important to note that freestanding birth centers are equipped to handle low-risk pregnancies and births. If complications arise during labor or delivery that require medical interventions, they typically have protocols in place to transfer the birthing person to a nearby hospital for appropriate care.
References:
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- Our birth center. History of Birth Centers – Anchorage. (n.d.). Retrieved December 4, 2022, from https://www.genevawoodsbirthcenter.com/history.html
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- What is a birth center? Our Community Birth Center. (2020, April 3). Retrieved December 4, 2022, from https://www.ourcommunitybirthcenter.org/what-is-a-birth-center/
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- Wikimedia Foundation. (2022, November 18). Birthing center. Wikipedia. Retrieved December 4, 2022, from https://en.wikipedia.org/wiki/Birthing_center