According to WHO (World Health Organization), the midwife is the most appropriate professional to care for a normal pregnancy and birth. However, in the hospital delivery room, one-to-one care by a midwife can rarely be provided. For this reason, many women choose to give birth in a birth center. The charm of the birth center lies primarily in its intimate, familiar, and individualized facilities, which women can claim completely and unreservedly for themselves. What should pregnant women know about giving birth in a birth center?
What is a birth center?
Women who find a clinic too sterile, but still do not want a home birth, usually find a good compromise in a birth center. Birth centers and practices are usually run by several midwives, and sometimes doctors are part of the team. In the most favorable case, they are located close to the hospital, so that medical technology can be largely dispensed with. The comfortably furnished birth rooms are equipped with monitoring devices (CTG) and an emergency kit (oxygen) for the baby. In many cases, the midwife looks after the pregnant woman from the beginning of the pregnancy. She can perform the necessary preventive examinations and consultations just like a gynecologist. In addition, courses for birth preparation and postpartum classes are usually offered in the birth center.
What to consider when planning?
Those who decide to give birth in a birth center should contact the birth center of their choice at least two months before the delivery date. This allows enough time for parents and midwives to get to know each other to make the birth the experience parents want it to be. However, due to the limited capacity of many birth centers, it may be advisable to make contact earlier. As a rule, between the 32nd and 34th week of pregnancy (SSW), a detailed exploratory talk takes place to determine how the pregnancy has progressed so far and whether the pregnancy has been free of complications so far – in other words, whether a birth center is the right place to give birth in the individual case. After all, the prerequisite for a birth in a birth center is that no complications are to be expected during the birth.
For whom is a birth center suitable?
A birth center is suitable for all women for whom, from a medical point of view, there is nothing to prevent the baby from being born in a birth center – that is, usually without the presence of a doctor. A birth center is not suitable for high-risk pregnancies, such as:
- Multiple births
- Transverse or breech presentation
- A previous cesarean section
- Complications from a previous birth
- Diseases such as gestational diabetes, preeclampsia or hypertension.
- Malposition of the placenta
- Premature labor
- Pregnancies from the fourth child (multiparous).
- Health problems of the child
The self-determined birth
The philosophy of birth centers is to allow mothers and families to give birth in a self-determined setting. That is:
- If a water birth is desired, the delivery can be done in the water.
- If the mother prefers to deliver in a birthing chair, she will be offered this option.
- Siblings can be brought, but must be accompanied by a caregiver.
- Whether and what music is played for relaxation, the birthing decides.
The charm of the birth center lies precisely in its intimate, individual equipment, which you can claim completely and without reserve. In addition, the active involvement of the birth partner – there may be more than one – is an essential part of the work of the birth center. The competence of the midwives and their holistic care, coupled with emotion and self-confidence of the parents: this is the essence of the birth center.
Natural pain relief
During childbirth, a variety of pain relief options are offered, which may consist of meditation, breathing techniques, massage or homeopathic remedies. However, epidural anesthesia (PDA) is not available at the birth center. If it becomes necessary, the mother must be transferred to a clinic. Many midwives believe that natural perineal tears heal better than perineal incisions made during childbirth.However, as a rule, the midwife will try to avoid the perineal tissue injury altogether anyway. For this purpose, the perineal area is massaged with hazel oil or treated with coffee compresses.
Round-the-clock care
Birth centers can only accept a limited number of births at any given time. There is usually one midwife for a pregnant woman. However, to be able to guarantee round-the-clock care, birth centers also work on-call, either 12 or 24 hours. Competent care is always provided. Qualified examinations, also by the Federal Association of Midwives, prove that births in birth centers are just as safe as in hospitals. Conversely, it is often self-confident and open women and families who decide to give birth in a birth center. Those with a high need for safety usually choose the hospital.
Birth center: simply give birth naturally
There were times when the different views – hospital here, birth center there – led to almost ideological-dogmatic disputes that put women under a lot of pressure when it came to the question “How do I give birth properly?”. There is now a broad consensus that women should decide for themselves and individually where and how they want to give birth. For example, women who have a high need for safety now give birth in a hospital, and those who reject too much “technology” choose a birth center or other natural alternatives (such as home birth). Birth in a birth center takes place on an outpatient basis. This means that after the birth, mother and baby are given time to get to know each other in peace. They are then allowed to go home together a few hours after the birth.
Hospital or birth center?
Differences between obstetric departments in hospitals and birth centers still exist, although today many hospitals have opened up to self-determined methods of birth (for example, water birth, birthing chair, different birthing positions, outpatient birth) and are also open to alternative forms of pain management (for example, acupuncture). Clinics are clearly responsible when it comes to a high-risk birth. This is because a cesarean section can be performed here within minutes, which is not possible in a birth center. Most large hospitals also have a neonatal intensive care unit so that the baby can be transferred quickly if necessary. Birth centers, on the other hand, do not even accept high-risk pregnancies such as multiple births, breech deliveries or pregnancies with a complicated course for delivery. Complications during birth are therefore rare in birth centers. However, if they do occur, the mother is immediately taken to the nearest hospital for emergency care. As a rule, the midwife also accompanies the mother on this journey – but medical care is then the responsibility of the hospital.
Assumption of costs for delivery in a birth center
Health insurance companies usually cover the costs of the delivery as well as the care before and after the birth. In individual cases, a co-payment must be made for the use of the birth center, which ranges from 300 to 600 EUR. Certain additional services, such as acupuncture treatment, must also sometimes be paid for by the mother herself. Details of this, as well as medical and practical questions, should be discussed directly with the respective birth center.
