Tuesday, October 9, 2012

So What's a Birthing Center Birth?

I have really been digging a lot of the "hospital bag posts" to help me pack my bag, and I definitely love the talks that get real about what happens after delivery - and what to do in the weeks before birth! But there is a lot of advice I have to discard because I am going to be in a birthing center, not a hospital. I have found a lot of my friends are very surprised and don't know the difference between a hospital birth and a birthing center birth. So in case you were curious, here are some things that differ...

1. There are a lot fewer interventions, checks, and general "requirements." Most midwives will not check to see how dilated you are until you are over 40 weeks and some won't ever, unless you ask. The reasons for this are usually because they don't want to introduce bacteria into your vagina and because they don't want to put you on some sort of "timetable" or make you feel pressured; the baby will come when the baby is ready. Midwives do not even talk about induction, unless there is a real medical need. That means no automatic induction is you are "over" your due date. My midwife won't talk about induction until you're over 42 wks, unless you bring it up. Also, there is nothing you have to do when you birth there - no IV, no fetal monitoring, no vaccines, no eye ointment after birth, no...nothing. There are options for most of these things (my BC does not offer the Hep B vaccine for instance but does offer the eye ointment), but they are always asked and never presumed.
Oh - there are no restrictions on eating and drinking during labor. But most women don't feel like eating in active labor anyway, from what I hear...

And you might give birth in water, if you want to - or at least you can labor in it. The weightlessness often helps women to labor, because they feel less pressure. 

2. You don't stay overnight. In BCs, most moms and babies head home about 6 hours after birth. Because BCs do not administer major medications with the attendant possible side effects, there isn't really any reason to keep mom and baby longer. In my BC, I can stay for up to 24 hours - but it would be unusual that it was necessary. After a natural birth, women are of course tired, so usually they stay long enough to nap, eat, and freshen up. Then, it's time to go home!

3. You have to bring your own stuff! Unlike a hospital, a birthing center does not care for people long term. So there's not a cafeteria, usually there aren't vending machines, they don't give out those famous mesh panties, or provide diapers or a paci for the baby. Pretty much everything you need, you have to bring. They have a fridge and freezer available, so you can bring tons of food and snacks to store there for your after-birth meal; or ask friends to bring you food! And there's no nursery either - the assumption is that when baby falls asleep, you'll nap too, and probably in bed together.

Again, the incomparable Amanda Greavette

4. Less bureaucracy. At a BC, there is no "checking in." Most BCs are fairly small operations, so you probably are on a first name basis with everyone who works there - no need for ID, although I'm sure it's in your purse anyway! You walk in, they greet you, and tell you which room to go to (there aren't usually more than 3 or 4). You have already paid up front, so there's no need to bring your insurance card, and there's no paperwork to fill out until after the baby is born and you've rested, eaten, done whatever else you want. Also - you don't change nurses or doctors or anyone else; the midwife and her assistant are the ones who will help you through your labor and birth for the entire time - even if you have to transfer to the hospital.

5. Visit away. There are no restrictions on the number of visitors you may have, either in the room or at the center in general. If you want a huge party of people, go for it; if it's just you and the hubs, that's cool too. But since you're not there for very long, the visiting window is pretty small...!

This is what one of the rooms looks like at my birth center

6. You can feel neglected. At my first appointment with my midwife, I felt a bit ignored, honestly. She was fairly quiet, asked very few questions, asked if I had questions...but it was a short appointment and most of it was silence. To this day, my appointments are basically the same, except I don't feel ignored: I come in, go to the bathroom and do my "bathroom routine" - weigh myself and test my urine. Then I come out, report the results to the midwife, and she asks if I have any questions. If I do, we talk about them; if not, she then listens to the baby's heartbeat via doppler, takes my blood pressure, and measures my uterus. She'll alert me of anything upcoming (GBS test, glucose test, both declinable) and sometimes ask about preparations (make sure I get a car seat). Then it's over! Our appointments are usually 20 minutes or less. Now that we know each other more, we enjoy exchanging small talk and pleasantries and she's more than willing to shoot the bull.
At a birth, it can be as disconcerting as that first appointment. Midwives do not stay with you the entire time you are laboring at the BC. They come in and check on you, but they assume the birth is progressing normally - so they leave you with your support people to labor. For most of your birth, you are alone with whoever you brought (doula, husband, mom) until - you feel the need to push, you have a question, she has a question for you, or maybe she wants to check on the baby (doppler again). For many women, this feels like neglect; they are used to having labor managed and monitored very closely. It's just different in a BC; the philosophy of birth assumes that if you've had a normal healthy pregnancy, then labor will progress naturally on its own in most cases and that there's no reason to behave as if it won't unless and until there's an indication.

That's all I can think of for now. So if I'm up and blogging again the day after birth, it's not on hospital wifi!

PS As an update on Blackacre, we are still trying the meds and did a few more minor tests. His condition doesn't seem changed, worse or better, really. We're still crossing our fingers...thank you for all your sweet words. It really means a lot to hear I'm not crazy for being so upset about this!


  1. I had a birth center birth and 1-5 were true for me, but NOT #6. I had a nurse with me the whole time during labor, my midwife was there 90% of the time and my appointments were 30 minutes long and full of questions, advice, etc.

    I moved from a place that didn't have a birth center when I was 5 month pregnant to one that did, so I had experience with an OB for half my pregnancy and my appts. were 5 minutes tops. Definitely felt very loved and not neglected at all with my midwives!

    1. I'm actually glad to hear that! I think this part of my BC experience was definitely very Sam (ny midwife) specific because she just has a more reserved personality.
      If I may ask, was there any reason for your midwife to be with you during your entire labor, ie were you alone or really struggling? I just ask because my sisters had midwives at several of their labors as did my mom and they all said their midwives were in and out during labor. I'm wondering if there is a standard midwife practice and if we're the anomaly!


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