Birth Centers

Today, women have more options than ever to find and select a suitable birth center. Options include increasing numbers of hospitals, obstetricians, and midwives that are offering women the choice of giving birth at a birth center.

For women with a low-risk pregnancy who desire a more natural birth experience, a birth center might be a good option. It is always best to research the birthing centers in your location to find one that best meets your needs. If you are one of the many women weighing the pros and cons of home birth, or if you and your partner have a desire to compromise on a birth location, a birthing center can be a good alternative.

What should you expect from a birth center?

  • Relaxed and warm atmosphere
  • The option of returning home shortly after the birth
  • A team of health care providers that can include nurse-midwives, direct-entry midwives, or nurses working with an obstetrician
  • A facility that may be free-standing, on hospital grounds, or inside a hospital

Because birthing centers can vary significantly, you should become familiar with their philosophy of care, mission statement, and objectives. Also, take the time to interview their personnel.

Acceptable birth centers can be identified by the following:

  • No induction
  • No augmentation of labor with Pitocin (oxytocin)
  • No electronic fetal monitoring except Doppler ultrasound
  • No drugs for pain relief except local analgesic to suture tears in the perineum
  • Very few episiotomies
  • No operative deliveries
  • In many birth centers, the only equipment is oxygen and catheters used to clear a baby’s airways if necessary.

If the birth center is connected to a hospital, medical intervention can be a routine part of their care. When choosing a birth center connected to a hospital, ask if it has its own staff or is staffed by hospital personnel. You might also want to know when and how often the birthing center would rely on the assistance of hospital personnel.

A birth center might not be the right fit for you if:

Questions to ask:

  • What is the transfer rate of women from the center to a hospital? (A rate of 7-12% is reasonable).
  • In what situations would you induce labor with Pitocin (oxytocin) or by breaking the amniotic sac (amniotomy)?
  • Is electronic fetal monitoring used? If so, in what situations and what kind: Doppler ultrasound, scalp clips, or abdominal belts?
  • Is intravenous glucose given? If so, in what situations, and can the mother refuse it?
  • Are analgesic drugs used?  Do they offer epidural anesthesia?
  • Do they have a time limit on the second stage of labor?
  • What percentage of their women have episiotomies?  (Less than 10% is normal).
  • Do they ever provide assisted deliveries with forceps or suction? If so, in what situations?
  • Can I walk around during labor?
  • Can I give birth on the floor if I wish?
  • Can I give birth standing up?
  • How do you help a woman who is having back labor?
  • Can I take a bath or shower during labor?
  • Can my other children be present during labor and/or birth?
  • Can I eat and drink during labor?
  • Will there be a midwife with me throughout the first stage?
  • Is there a birth pool?

Women are designed to give birth. As such, some women prefer not to view labor and birth as a medical condition, but rather as the culmination of a beautiful and natural nine-month process. Birthing centers are typically committed to providing prenatal care and educating women in order to optimize their personal birth experience.

Your Next Steps:

  • Contact your local hospital to find out if they are affiliated with any birth centers
  • Read more about using a midwife for your birth

Want to Know More?

Compiled using information from the following sources:

American Association of Birth Centers,

Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 1.