What is a Birth Center?
- The birth center is a home-like facility existing within a healthcare system with a program of care designed in the wellness model of pregnancy and birth.
- Birth centers are guided by principles of prevention, sensitivity, safety, appropriate medical intervention, and cost effectiveness.
- Birth centers provide family-centered care for healthy women before, during, and after normal pregnancy, labor, and birth.
The birth center can be described with 5 Ps:
- Healthy women 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
- 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 cesarean section capability
- 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:
- Eliminates the need for maintenance of costly diagnostic and treatment technology and services in the birth center;
- Reduces the potential for overuse or inappropriate application of tests and treatment.
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