Birth centers have become increasingly popular among pregnant people who want to birth in a low-intervention setting. In the last decade, birth center deliveries have doubled with nearly 20,000 births taking place in a free-standing birth center in the United States in 2019. While birth center deliveries only account for 0.5% of all births in the United States, growing interest indicates that this alternative to a traditional hospital delivery is worth exploring. In this blog post, we will discuss what a birth center is, how it differs from a hospital, how to choose a birth center in New York City (and the surrounding area), and how Oula brings elements of a birthing center experience into a hospital delivery. It is important to note that Oula is not currently affiliated with a birth center.

What is a birthing center?

A birth center is a facility that provides a home-like setting for low-risk pregnant people to deliver their babies. It can be attached to a hospital or can be a free-standing location. Birth centers are often staffed by midwives (CNMs, CMs, and/or CPMs) and nurses. Birth centers are designed to recreate the comforts of home for pregnant people with some possible amenities including birthing tubs, larger birthing beds, and ambient lighting. The idea behind their existence is that pregnant people tend to have faster and easier labors in a space they perceive to be comfortable and safe.

Who qualifies for a birthing center?

Because birth centers are out-of-hospital, only low-risk candidates are typically eligible to deliver there. The criteria for birthing centers are similar to that of home birth candidates. While each provider’s evaluation criteria for what deems someone “low-risk” enough to deliver safely at a birth center can vary a few common considerations include:

• A term pregnancy, between 37 to 42 weeks
• A single gestation pregnancy (in other words, not twins or triplets)
• A baby who is head down
• A placenta not covering the cervix at the time of labor
• No ongoing chronic medical conditions such as high blood pressure or diabetes managed with medication, clotting disorders, large or numerous fibroids, elevated BMI (greater than 40)
• No prenatal conditions such as gestational hypertension or gestational diabetes managed with medication
• No history of a previous C-birth, though some birth centers are open to pregnant people who have already had a successful VBAC in a previous pregnancy. Read more about Types of Births: Differences & Benefits.

Birthing Center Services

Birthing centers are sometimes described as a midpoint between homebirth and hospital birth. Delivering in a birth center certainly does offer benefits from both types of delivery locations – let’s explore what some of these are!

Birth centers are by design intended to feel like being in your own home. The rationale is that labor may be faster and easier when a pregnant person can feel centered in a place they perceive to be safe. While birth centers have access to medical equipment intended for routine and emergency use, it is often hidden to not distract during labor. Birth centers may also have less restrictive policies including freedom of movement and eating/drinking. They may not limit how many individuals can be in the birthing space, allowing for more family (and even kids!) to be involved in the delivery. For those without medical insurance, a birth center delivery can be more affordable than a hospital delivery. Most birth centers do not accept commercial medical insurance.

Birth center deliveries are typically attended by one midwife and nurse, similar to a low-risk hospital delivery. Birth center midwives and nurses are trained to address common obstetrical emergencies including hemorrhage, shoulder dystocia, and neonatal resuscitation. Birth centers do not have quick access to a full nursing team, neonatal team and NICU (neonatal intensive care unit), pediatrics team, anesthesia team, surgical team and operating room. Hospitals can offer a wide range of medical interventions including pain medication (epidurals), inductions of labor, and the ability to perform operative vaginal deliveries (OVD) and C-births. Accredited birth centers in the United States must be located within a 20-minute drive from a perinatal hospital but this distance can contribute to delays in access to prompt medical care in the event of a complication or emergency.

Birth centers may have access to several options for pain management including hydrotherapy via birth tubs and nitrous oxide. Birth centers cannot administer IV narcotics or administer an epidural for pain management.

How do I choose a birth center in New York City? (or nearby!)

If you are interested in using a birth center as part of your pregnancy journey, there are several options in the New York, New Jersey, and Connecticut area that are taking new clients. Explore all of the birth centers that are currently accredited by the American Association of Birth Centers.

What can I expect from Oula?

Oula is not currently affiliated with a birth center. However many of Oula’s midwives have worked in birth centers prior to joining the team and carry with them this spirit of creating a sacred birthing space. It is not lost on us that a hospital environment is very different from a birth center or delivering at home. Yet the benefits of being in those environments, the feeling of safety and comfort, can be recreated in the hospital setting. Some of the key elements that Oula’s midwives incorporate into the “birthing center approach” of labor include intermittent monitoring with a doppler or continuous wireless monitoring, hydrotherapy by shower, a hep-lock allowing for a greater range of motion while still maintaining vascular access. Oula’s midwives emphasize the importance of natural laboring techniques such as positioning of the body, breath work, meditation, and creating space and time for the body to find a steady rhythm in labor. Routine use of birth balls, peanut balls, rebozos, squat bars, and intuitive positioning for the pregnant person can create a sense of a natural flow and progression that make birth center/home birth deliveries feel less challenging. Oula also loves working with doulas and strongly encourages our pregnant patients to explore this option!

The decision of where to give birth is a personal one that should be made after careful consideration of the risks and benefits of each option in the context of your unique pregnancy. Explore all of your options early into your pregnancy and ask lots of questions.