Each birth center has its own independent guidelines on the number of people that attend a baby's birth. "The mother chooses whom she wants to be with her during labor and birth and afterwards. We talk to her prenatally about how to decide who will be a good support for her and bring positive energy to the labor and birth," says Stapleton. "About 35 percent of our families choose to have their older children present for the labor and birth. They are required to attend a sibling class to prepare them, and parents should also have a support person who is there just for the sibling."
In Case of Emergency
Some moms-to-be may experience an uncomplicated pregnancy, only to have unexpected problems arise during labor. Most birth centers and their staff members have backup emergency plans for these cases.
"A birth center has its systems in place in the event a mother needs to be transferred to hospital in labor. This includes relationships with a backup hospital, transport services, obstetric and pediatric consultants. The birth center is part of the healthcare system and wants the family to experience a smooth transition to the next level of care," says Bauer.
When a Center Isn't the Right Choice
Birthing centers may not be an appropriate alternative for the woman who is experiencing medical complications and/or is considered to be having an at-risk pregnancy. According to Stapleton, birth centers are usually for women experiencing normal pregnancies. Each birth center should have a very specific list of risk criteria which defines who may not give birth at the birth center. The list should generally include conditions such as preeclampsia, preterm labor, pregnancy over 42 weeks, breech presentation, twins, and gestational diabetes. Women with such complications may need interventions that are only safely done in a hospital setting.
Dorinda Dove, CNM, of The Birth Center in Wilmington, Delaware, agrees that most facilities should carefully evaluate women who are considering having their babies there. "We are careful to screen women coming into the program for appropriateness for this level of care, and we continue this careful surveillance throughout the pregnancy and labor to ensure that the mother remains in the low-risk category."
Postpartum Care for Mom and Baby
"Our postpartum stay averages five and a half hours," says Dove, who believes that this timeframe benefits the low-risk moms and babies who normally deliver at her center. "We are in touch by phone on day one and day two to review a list of parameters on Mom and Baby, and to ensure normalcy. The baby is seen by the pediatrician within 48 hours after birth. A registered nurse makes a home visit on day three, and a visit back to the birth center takes place after one week for a checkup on both Mom and Baby," explains Dove.