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Birth at the Birth Center

The birth center can be described with 5 Ps:

PEOPLE

  • Healthy birthing people 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

PLACE

  • 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 access to hospital care.

PROGRAM

  • 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