How to Choose the Right Birth Center for Prenatal Care and Delivery

Childbirth is one of the most significant events in the lives of most families. Therefore, choosing a health care provider for prenatal care and labor is not a decision to be taken lightly. Families who desire a natural birth and minimal intervention may be interested in delivering with a midwife at a birth center. When choosing a birth center, it is essential to know whether a particular center can help you meet your birth goals. It is important to ask the right questions to find out whether a birth center is right for you.

Does the birth center accept your medical insurance? If not, do they offer a payment plan?

For many women, payment is a major concern when choosing a health care provider during pregnancy. If you have health insurance, ask whether the birth center accepts your plan. Be sure to ask specifically what your plan covers - some insurance plans may offer different coverage for a birth center birth than they do for a hospital birth.

If you are without health insurance, or if your birth center does not accept your plan, find out what payment options are available. Many birth centers will allow clients to pay in installments for their prenatal care and delivery, and some even offer "scholarships" to help clients who are unable to pay in full.

How many midwives work at the birth center?

If the birth center employs a large number of midwives, it may be difficult to get to know all of them during the course of your pregnancy, leaving the possibility of giving birth with a relative stranger. For some women, this may not be a problem, but it is a real concern for many. Be sure to ask how you can get to know as many of the midwives as possible before giving birth.

What birth options are available at the birth center?

If you have a particular type of birth in mind, make sure that the birth center is equipped to handle that type of birth. For example, not all birth centers are equipped for water births, so that may be something to consider in choosing the right birth center for you.

Does the birth center work closely with any hospitals or obstetricians?

Most birth centers will work closely with an obstetrician or hospital in the case of special circumstances or "high-risk" pregnancies. This can be a good thing for women with special health concerns. However, there is such a thing as working too closely with a hospital or physician, and some birth center clients may find themselves faced with labor interventions that they may feel are unnecessary if the consulting physician has his/her hands too deep in birth center procedure. Which leads to our next question:

What are the birth center's hospital transfer and c-section rates?

Birth centers of course cannot perform c-sections, but birth center with a high hospital transfer rate may not be the best choice for a woman in search of a natural birth. If a high percentage of a birth center's clients end up in hospital with a c-section, that may be even more cause for concern. Since most birth centers accept only patients who are termed "low-risk," high transfer and c-section rates should be viewed as a red flag for women who want to avoid unnecessary labor interventions.

What procedures are in place at the birth center in case of emergency?

If something goes wrong during labor, is there a hospital nearby? Is an obstetrician on call to help out with any unforeseen circumstances? What happens if you go into preterm labor? All birth centers have procedures in place in case of emergency, but you need to be aware of these procedures to ensure that you feel safe. Many women are comfortable with a birth center that does not have an obstetrician on-call, but many are not - it is up to you to determine your personal comfort level.

A birth center can be a wonderful place to receive prenatal care and to deliver your baby, provided that the center is equipped to help you meet your personal birth goals. These and other questions can help you determine whether a particular birth center is right for you. For more information on nurse-midwives and freestanding birth centers, please refer to the websites listed at the end of this article.

ADDITIONAL RESOURCES:
American College of Nurse-Midwives (http://www.acnm.org/)
MyMIdwife.org (http://www.mymidwife.org)
American Association of Birth Centers (http://www.birthcenters.org/)