More about Birth Centers

What is a birth center?
A birth center is a home-like setting where women receive care and give birth assisted by midwives.

Who provides care at birth centers?
Midwives provide pre-natal, post-natal and well-woman care at birth centers and attend births. Midwives follow the Midwives Model of Care, which provides the woman with "individualized education, counseling, and prenatal care" and has been proven to reduce "the incidence of birth injury, trauma, and cesarean section" (Source: Citizens for Midwifery).

Where do birth center midwives attend births?
Birth center midwives attend births at home, in their centers and in hospitals.

How is giving birth in a birth center different from giving birth in a hospital?

• Labor is typically allowed to unfold at its own pace.
• Pain relief typically emphasizes immersion in water, changing positions, and the mother's own internal psychological resources, instead of drugs (although some pain relief drugs are available).
• Mothers are typically encouraged to eat and drink during labor to keep up their strength. Most birth centers have kitchens on-site where the mother's family can prepare this food.
• Mothers are encouraged to walk around and try different positions (standing, sitting, leaning, squatting, etc.) to ease pain and facilitate birth.
• Midwives and birth assistants attend births in long shifts, striving to provide the mother with continuous support from the same people throughout her entire labor.
• Birth centers typically put the mother in greater control of her environment, allowing the mother to choose her own clothes, light level, music, aromatherapy, etc.
• The mother is typically allowed to have whomever she wants to support her in labor, without a restriction on the number of people or relationship to the mother. Husbands, partners, friends, relatives, children, doulas... all are welcome if invited by the mother.
• Mothers, their partners and their newborns typically all stay together, without the baby being separated from parents in a nursery. Mothers are encouraged to breastfeed immediately after birth and are given help getting started.
• Stays in birth centers are typically short, with most families going home the next day.

Who uses birth centers for childbirth?
Birth centers are able to serve the vast majority of pregnant women who are classified as low risk; 83% of women are low risk at the end of pregnancy, according to data from the Centers for Disease Control and Prevention's National Center for Health Statistics (Source: Childbirth Connection).

How do I know if I'm low risk?
Birth centers have clinical practice guidelines that specify under what conditions the center can accept a woman as a patient and under what conditions the woman should be transfered to the care of an obstetrician. Midwives use their guidelines, combined with years of experience and judgment, to identify, to the greatest extent possible, the need to transfer before it becomes an emergency. The backup hospital for the Seasons of Life Women's Health and Birth Center will be Washington Adventist Hospital's new location in Silver Spring, Maryland, which is 8 miles away from the birth center's location in Takoma Park. This meets the common standard for emergency cesarean sections: "30 minutes from decision to incision".

Are birth centers safe?
Yes. The seminal study on outcomes in birth centers appears in a 1989 New England Journal of Medicine article. The article concludes: "Birth centers offer a safe and acceptable alternative to hospital confinement for selected pregnant women, particularly those who have previously had children, and that such care leads to relatively few cesarean sections." A new study with more recent data is expected later in 2009.

Are birth centers just for pregnant women?
No. Women of all ages can receive individualized care from skilled midwives at birth centers. Seasons of Life Women's Health and Birth Center will provide care to women throughout the life span, from the onset of menstruation, through the childbearing years (including pre- and post-natal care, birth, birth control, and fertility), to menopause and beyond.

Do birth centers take insurance?
Yes. Most birth centers take insurance. In a national survey of birth centers conducted by the American Association of Birth Centers, major insurance companies that cover birth centers included Aetna/US Healthcare, Blue Cross/Blue Shield, CHAMPUS and Humana. Seasons of Life Women's Health and Birth Center will strive to negotiate contracts with numerous insurers, including Medicare and Medicaid, so that as many women as possible can use the center.

How common are birth centers?
There are about 200 birth centers in the U.S. There are two birth centers in Maryland, both in the Annapolis area: Special Beginnings and Bay Area Midwifery. There are two other birth centers in the Washington, D.C. area: BirthCare in Alexandria, Virginia and the Family Health and Birth Center in Washington, D.C.

Do birth centers have to be licensed?
Licensing requirements vary from state to state. Birth centers in Maryland are required to be licensed. Maryland's requirements are set by the Department of Health and Mental Hygiene's Office of Health Care Quality. Seasons of Life Women's Health and Birth Center will be licensed.

Do birth centers have to be accredited?
About 25% of birth centers earn accreditation through the Commission for the Accreditation of Birth Centers (CABC). The Commission offers a one-year provisional accreditation for new birth centers, so that they can be accredited from Day 1 of operations. Seasons of Life Women's Health and Birth Center will seek this accreditation for new centers. Some of us recently took the Commission's "Preparation for Accreditation" workshop to begin this process.

Do birth centers offer water births?
Yes. Many birth centers offer water births, in which the mother gives birth in a tub specially made for this purpose. Her partner can also be in the tub, supporting her in labor. Some birth centers charge a modest fee (about $150) for water births, due to the non-reusable equipment involved. Seasons of Life Women's Health and Birth Center will seek to offer this highly popular birth option.

Do birth centers offer VBACs - vaginal births after cesarean section?
Yes, to an extent. Birth center midwives use their clinical practice guidelines to determine if a woman is a good candidate for a VBAC. If this is the case, then the woman can proceed with a VBAC either in the hospital assisted by midwives or in the birth center, under certain circumstances. Seasons of Life will seek to offer VBACs, both at the center and at the hospital, in compliance with CABC standards. VBAC is a subject of much debate at this time, and CABC standards regarding VBAC are currently under review.

Are birth centers usually public non-profits or privately owned businesses?
Most birth centers are privately owned businesses, but about 25% are non-profit organizations run by either community boards or public agencies. Seasons of Life Women's Health and Birth Center will be a non-profit organization. All profits from the center will be reinvested in patient care, community education, and other public service activities.

Who else is opening birth centers?
According to the American Association of Birth Centers, there are over 20 centers that plan to open their doors in the next few years, including one in Baltimore.

I'm pregnant now and can't wait until 2013. Or I have other health needs and want to be seen by a midwife right away? What are my options?
The local consumer advocacy group Birth Options Alliance maintains an online directory of Washington, D.C. area options to see a midwife. If you are currently pregnant, keep Seasons of Life Women's Health and Birth Center in mind for your post-baby health needs, such as birth control and menopause. Join our Yahoo group to stay informed of developments.