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Are birth centers safe?

Birth centers have been shown to be a safe option for low-risk, healthy women, offering the comfort and reduced stress of a home-like environment with the benefits of a well-equipped health facility. The National Birth Center Study II, published in the Journal of Midwifery and Women’s Health has shown that birth centers have excellent outcomes for mothers and babies, with a significantly lower rate of cesarean sections. The following statistics are extracted from that study, which is nicely summarized in this article.

Among women intending to birth in birth centers:

  • 94% of women admitted in labor achieved a vaginal birth indicating a 6% c-section rate vs. the national average of 26% for low-risk women;
  • Less than 1% of women were transferred for emergent reasons during labor;
  • Less than .5% transferred for emergent reasons for mother or baby after birth; and
  • There were 0 maternal deaths and most cases of postpartum hemorrhage were handled safely in the birth center with no transfer needed

Among women who gave birth in hospitals:
  • Approximately 85% are considered low-risk and eligible for care at a birth center;
  • 87% who labor in hospitals undergo continuous electronic fetal monitoring;
  • 80% receive intravenous fluids;
  • 47% have labor artificially accelerated with medications;
  • 43% of first-time moms have labor artificially induced;
  • 60% of women giving birth in hospitals are not allowed to eat or drink;
  • 76% are restricted to bed; and
  • 92% give birth lying on their backs.

There is strong evidence that routine use of these practices, when carried out without medical indications, has few benefits and often introduces potential risks for healthy mothers and babies.

How can pain be managed during a natural birth without an epidural?

As a culture, we’ve been trained that epidurals are the primary source of pain relief for laboring mothers. While this may be the case in a hospital environment, there are actually many other highly effective methods of managing “pain” during labor. Many women who have unmedicated deliveries using one or more of these methods often report that they wouldn’t have necessarily even described the experience as “painful”, but may choose words like “intense” or “emotional” when describing the feelings they had during birth.

There are a handful of factors and tools that we integrate at the center to help make your birth as comfortable as possible:

  • Fear Release- Being in an environment where you feel vulnerable, are not in control, or don’t know the individuals in or around your space can create an underlying feeling of fear or activate a “fight or flight” response, all of which can increase the sensation or perception of pain. To help avoid these types of feelings during your labor, time is used during appointments and classes to address the mental preparation necessary for healthy birth. We strive to help you to confront any fears surrounding the birthing process and to spend time getting comfortable in the birth center while also developing trusting relationships with the members of the team who will be supporting you at your birth.
  • Movement - Movement is an instinctive way to manage or alleviate pain and is an important element in the labor process as you respond to your body and baby’s cues, working in partnership with your baby to help him or her descend comfortably and to open your pelvis to allow their passage. Positions such as squatting have been shown to enlarge the opening in your pelvis by as much as 30%. At the birth center, you’re baby’s heart rate will be monitored intermittently by doppler and can be accomplished in many positions, allowing you to move around freely to find the positions that are most comfortable for you as you labor. To assist with this, we also offer birthing balls and stools, rebozo, birth slings (or yoga hammocks) and “peanut” balls.
  • Hydrotherapy - also known as nature’s epidural, this form of pain relief uses the therapeutic benefits of water submersion in our deep tubs. Hydrotherapy provides relaxation and pressure relief. Many women enjoy this as the precursor to a calm and peaceful water birth.
  • Heat - compresses made of warm rice socks, heating pads, soaking in warm water, or using the handheld shower with warm water on your back are all great ways of using the natural benefits of heat to provide comfort and to ease any pain.
  • TENS Unit - we offer the use of a TENS unit to reduce pain by using gentle electric pulses to stimulate the nerves.
  • Massage - with the right pressure or touch in the right area you can decrease pain significantly to help in achieving more comfort to support a natural birth. Our team takes an extremely hands on approach to our birthing support using the soothing benefits of touch for mamas who find it helpful.
  • Aromatherapy - specially chosen oils and scents can be used to help to promote total relaxation. Our diffusers, sprays and massage oils stimulate positive emotions reducing anxiety and fear while producing a sense of well-being.
  • Relaxation techniques - our staff is supportive and well-versed in the techniques that will bring mother's body and mind to the state that allows for easier more gentle birthing. Utilizing relaxation scripts and recordings to help with guided imagery and meditation for the ultimate relaxation to help mothers to work with their bodies during labor rather than against them.
  • Partner education - having a confident partner who has been armed with techniques for supporting the mother both physically and emotionally during labor can have a significant impact on the level of comfort and overall experience of labor. Classes offered at the center and time allocated during prenatal visits will help prepare partners for their unique and important role in the birthing process.

At Denver Center for Birth and Wellness we are committed to helping provide a strong foundation of support for your breastfeeding relationship. Our staff consists of an IBCLC, lactation educator and doula, along with several nurses and midwives that have supported countless families to establish and continue breastfeeding successfully. Our program integrates breastfeeding support through the following:

  • Breastfeeding Class: offered to all birth center parents to help to inform and empower them to achieve success.
  • Postpartum support: All families receive breastfeeding support immediately following birth to help get breastfeeding established well. Our longer allowed length of stay also allows for access to support around the clock for the first 48 hours after birth.
  • Weekly mamas group: for on-going support as your baby grows and your questions change along with your baby’s changing needs. This group alternates topics but is moderated regularly by our lactation educator who answers questions and offers tips, and is an opportunity for weigh-ins and peer-to-peer support as well.

What happens if something goes wrong during labor or I decide I want an epidural?

Denver Center for Birth and Wellness is located approximately a minute and a half from the nearest hospital with emergency services and a level III NICU. All staff of the center regularly participate in emergency drills and we involve local EMS responders in our emergency protocols, as well as having direct lines of contact with the hospital to facilitate a smooth transfer or records, advance notice that we are coming, and as smooth of a transfer process as possible.

For non-emergent transfers, we also have relationships with hospital-based midwifery practices who are happy to accept our clients into their care and will respect and preserve as many aspects of your original birth plan as hospital policy and circumstances will safely allow.

Do I qualify for birth center care?

The most common conditions that would prevent delivering your baby in the birth center include:

  • previous cesarean
  • diabetes
  • hypertension requiring medication
  • five or more previous births
  • morbid obesity (100% over ideal body weight)
  • any medical condition that requires continued supervision, such as a neurologic condition or heart condition

It is best to call or schedule a free consultation if you have concerns about your particular health history.

What is an Advanced Practice Nurse?

Advanced Practice Registered Nurses (APRNs) practice independently. They generally do not need physician supervision. They are extremely valuable in areas that are underserved by physicians. APRNs have many specialties to choose from and are an integral part of our healthcare community.

There are 4 types of advanced practice registered nurses:

  1. Nurse Practitioners
  2. Clinical Nurse Specialists
  3. Nurse Midwives
  4. Nurse Anesthetists

What is a Certified Nurse Midwife?

A Certified Nurse Midwife (CNM) is a licensed independent health care provider educated at the master’s degree level and frequently at a doctoral level. Many Certified Nurse Midwives(CNM) have also been obstetric nurses before continuing their formal education to become a certified nurse midwife (CNM). Certified Nurse Midwives (CNM) can prescribe medications, order testing, perform ultrasounds and physical examinations. Nurse midwives have been practicing in the USA since the 1920s.

Most importantly, midwives are passionate about providing exceptional personalized care for women. Typically, nurse midwives choose their profession because of a desire to serve and to improve the quality of care for pregnant and non-pregnant women. 

Midwifery education is standardized and the official accrediting body is the Accreditation Commission for Midwifery Education. Certified Nurse Midwives (CNM) are required to have continuing education in order to maintain their certification.
Decades of research indicate that primary care services provided by advanced practice nurses and nurse midwives compare favorably to those provided by physicians. In a recent systematic review of studies comparing midwifery care to physician care, researchers examined multiple outcomes. Results indicated that women cared for by CNMs compared to women of the same risk status cared for by physicians had

  • Lower rates of cesarean birth 
  • Lower rates of labor induction and augmentation 
  • Significant reduction in the incidence of third and fourth degree perineal tears 
  • Lower use of regional anesthesia
  • Higher rates of breastfeeding

More information about Certified Nurse Midwives can be found via the following:

What is a Family Nurse Practitioner?

Family Nurse Practitioners (FNPs) are registered nurses with advanced education and training in assessment, evaluation and treatment of the entire family to include well visits, screenings, treatment of chronic and acute medical problems. They offer a wide range of healthcare services from healthcare promotion and disease prevention to direct care across the lifespan.

FNPs possess graduate level education including clinical training in family medicine. Their advanced education qualifies FNPs to serve as hospital and clinic administrators and policy makers as well as functioning in a clinical setting providing direct care to the family.

FNPs are lifetime learners as they participate in continuing education through out their professional careers. There are accrediting agencies that work directly with advanced practice nurses in the many specialties available.