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:














• 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:

• Midwifery is Primary Care that emphasizes:









• 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:

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

• 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.

• 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: