What is a Birth Center?
The birth center is a health care facility for childbirth where care is provided in the midwifery and wellness model. The birth center is freestanding and not a hospital.
Birth centers are an integrated part of the health care system and are guided by principles of prevention, sensitivity, safety, appropriate medical intervention and cost-effectiveness. While the practice of midwifery and the support of physiologic birth and newborn transition may occur in other settings, this is the exclusive model of care in a birth center.
The birth center respects and facilitates a woman’s right to make informed choices about her health care and her baby’s health care based on her values and beliefs. The woman’s family, as she defines it, is welcome to participate in the pregnancy, birth, and the postpartum period.
The birth center can be described with 5 Ps:
- Healthy women anticipating a low-risk pregnancy and birth
- Licensed, qualified staff with full comprehension of limits of midwifery practice and insured for professional liability
- Qualified obstetric/pediatric consultants
- Home-like (a maximized home rather than a mini-hospital)
- Meets all construction, fire and safety, and health codes
- Equipped to provide routine care and initiate emergency procedures
- Freestanding facility – separate from acute obstetric/newborn care with autonomy in formulation of policy and management of operation
- Located so that there is reasonable cesarean section capability
- Orientation and informed consent
- Antepartum care including continuous screening by history, physical exam, routine laboratory tests and health counseling
- Plan for participation of family members as defined by woman receiving care
- Educational program that includes component of self-care/self-help
- Plan for payment of services
- Twenty-four hour telephone access to care provider
- Intrapartum care with a midwife or physician in constant attendance during active labor
- Postpartum/newborn care supervised by licensed nurse or midwife
- Required newborn laboratory screening tests
- Plan for newborn health supervision at center or by referral
- Home-office visits for postpartum newborn follow-up
- Provision for support in parenting and breastfeeding
PRACTICE OF MIDWIFERY
Midwifery is Primary Care that emphasizes:
- Support for pregnancy and birth as a natural physiological process – “normal until proven otherwise;”
- Prevention of disease/promotion of health;
- Individual responsibility and self-sufficiency through education;
- A systems approach to the delivery of health services;
- That midwifery may be practiced by any qualified, licensed provider willing to embrace the philosophy of midwifery and obtain the knowledge and skills needed for midwifery practice
Midwifery Primary Care is a first-level entry into a health-oriented system, triaging when the process of pregnancy and birth departs from its normal course.
It is dependent upon:
- Laboratory services;
- Availability of specialist services;
- Access to acute care services;
- Separation of primary care from acute care in pregnancy and childbirth is the most important principle of the birth center concept.
The interdependent relationship between the birth center and acute care services:
PART OF THE SYSTEM
- Has written policies and procedures that reflect standard quality assurance
- Relationship with other community health agencies for complementary services
- Arrangement for referral and transfer to other levels of care
- Access to an acute care obstetrical/newborn unit
*Information provided by American Association of Birth Centers