Professionals Who Chose Natural Birth…
How is a Birth Center or Home Birth Different from a Hospital Birth?
Hospital Birth is most commonly associated with the Medical Model of Childbirth. Routine interventions are used to medically manage the birth process and may include routine continuous electronic fetal monitoring, not allowing you to eat during labor, routine intravenous solutions (IV), and induction or augmentation of labor with medication to meet their time management protocols. Hospital protocols are designed to help the organization run smoothly and safely, and may not be flexible for a woman seeking a physiologically normal and undisturbed birth.
Birth outside of the hospital is safe for healthy women with uncomplicated pregnancies. We are able to offer the family privacy, and a place where labor and birth are treated as normal life events to be shared with whomever the mother wishes. Laboring women will be carefully and continually assessed by the Midwife and an experienced birthing assistant to assure that mother and baby are doing well. Women are encouraged to walk, eat, drink and get into positions that are comfortable for them during labor and birth. At birth, the baby is immediately placed into the hands of the mother. Each new mother receives careful guidance in the first hours after birth so when the new family leaves the birth center, or the midwife leaves the home (in 4 to 6 hours), the new mother feels confident in her ability to breastfeed and care for her baby. The Midwife and birth assistant closely follow the family in the first six weeks of the baby’s life. Postpartum care includes home visits during the first week with your baby, followed by two more visits at the birth center. Additional visits are done as needed for lactation assistance or other concerns.
Who Can Birth with New Beginnings Midwives?
Any woman who is considered low-risk through continuous risk assessment by the Midwife can birth with us. This could include:
- Women with Rh negative blood
- Women over the age of 35 having a first baby
- Women with a history of miscarriage
- Most women with mitral valve prolapse
- Women with medical conditions which do not affect pregnancy, or medical problems which may affect pregnancy, but are well-managed with a plan of care
Who Cannot Birth at New Beginnings or at Home?
Women with the following conditions:
- Breech at term
- Gestational diabetes requiring oral medications or insulin
- Serious chronic medical conditions, such as essential hypertension, multiple sclerosis, etc
- Women with a BMI greater than 40 at conception
What Complications Can Be Handled at New Beginnings?
Postpartum Hemorrhage – The Midwife, with the same drugs that are used in the hospital, can control excessive bleeding. If necessary, an IV can be started. If needed, the Midwife can transfer the stabilized mother to the hospital for an inpatient stay.
Infant Resuscitation – If the baby is having difficulty breathing, the Midwife and birth assistants are trained and certified in both CPR and neonatal resuscitation. The Midwife has the necessary equipment that would be needed to resuscitate and stabilize an infant. A neonatologist in-hospital is always available for consultation, and the Intensive Care Nursery is available 24 hours a day if transfer of an infant is necessary.
Vaginal/Perineal Tears – Midwives are trained and experienced in repairing tears and episiotomies using local anesthesia. (Episiotomies are rarely done).
What Cannot Be Done in at New Beginnings or a Home Birth?
Anesthesia – While local anesthesia is available for repair of a tear or an episiotomy, regional anesthesia (such as an epidural) is not used outside the hospital for labor because it requires continuous monitoring and may depress the baby. We use coaching, hydrotherapy, and support for mother-to-be and her family so that labor, while challenging, is a good experience for all. On the rare occasion when extensive pain relief is needed, the Midwife will transport the mother to the hospital where this can be done safely.
Forceps, Vacuum or C-Section Delivery – These procedures are done in the hospital by obstetricians if needed with continued support of the midwife.
Pitocin Induction or Augmentation – These procedures require continuous electronic fetal monitoring and immediate access to surgical delivery. For these reasons, if induction or augmentation is needed, your care will be transferred to either a Certified Nurse Midwife or a Physician in the hospital setting.
Blood Transfusions – Intravenous solutions (IVs) and medication to control excessive bleeding after birth are available at New Beginnings. If there is excessive bleeding and/or the need for a transfusion you will be transferred to the hospital where a higher level of care and a blood bank are available.
Is It Safe to Labor without a Fetal Monitor?
Yes, if you have had a normal pregnancy. The Midwife and/or birth assistant will intermittently listen to the baby’s heartbeat with a hand held Doppler. If any abnormalities are heard they will listen continuously. If there is any deviation from normal, the Midwife will transfer you to the hospital. Studies have shown that in normal populations, this routine is safer than continuous electronic fetal monitoring. Clinical trials have also failed to show that continuous electronic fetal monitoring results in healthier babies, except when limited to women and fetuses known to be at high risk. Also, continuous fetal monitoring in normal healthy pregnancy does result in higher cesarean section rates.
Safety of Out of Hospital Birth
- Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009; Melissa Cheyney, PhD, CPM, LDM, Marit Bovbjerg, PhD, MS, Courtney Everson, MA, Wendy Gordon, MPH, CPM, LM, Darcy Hannibal, PhD, Saraswathi Vedam, CNM, MSN, RM; Journal of Midwifery and Womens Health Volume 59, No. 1, January/February 2014
- Outcomes of Care in Birth Centers: Demonstration of a Durable Model; Susan Rutledge Stapleton, CNM, DNP, Cara Osborne, SD, CNM, Jessica Illuzzi, MD, MS; Journal of Midwifery and Womens Health; Volume 00, No. 0, January/February 2013
- HOME BIRTH: An annotated guide to the literature; Vedam S, StollK, Schummers L, Fulton C
Benefits of Laboring in Water
Both the Royal College of Obstetricians and Gynecologists and the Royal College of Midwives support laboring in water for healthy women with uncomplicated pregnancies. The evidence to support underwater birth is less clear but complications are seemingly rare. If good practice guidelines are followed in relation to infection control, management of cord rupture and strict adherence to eligibility criteria, these complications should be further reduced…
Cost of Birth
At New Beginnings:
Pregnancy & Childbirth:
- La Leche League International
- “Newman Breastfeeding Clinic & Institute”
- Best for Babes
- Breastfeeding Guide & Tips
- Citizens for Midwifery
- Midwifery Today Journal
- Idaho Midwifery Council
- Midwives Alliance of North America