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November 29, 2011

Why we chose a birth center

So with only 62 more days til D-Day, we are starting to feel the pressure of this impending labor & birth of our child. Happily, we have switched care providers and are planning to birth at BirthCare in Alexandria.
There are many reasons that we chose to switch from a hospital to a birth center, and this past weekend while in NJ, I was asked by several people why we wouldn't go the "normal" route of a hospital. It was funny to me b/c "normal" now is so NOT what "normal" was for centuries before.

Because the Husband and I had discussed the various reasons together, we were comfortable with this decision for us and felt it was right. But I never really formulated a response to questions when asked - so as i stumbled a long the few reasons that popped into my head - i realized, blogging about it could potentially help me articulate our personal reasons for why this was the appropriate decision for us a little better.

And before I start on our reasons, I do want to say this: just because we chose a birth center does not mean we disapprove of hospital births, interventions, or doctors - at this time and with a low-risk pregnancy, we just feel this is the appropriate thing for us to do. We respect everybody's personal decisions and are thrilled to say all our friends and family have had beautiful babies and healthy moms at the end of the day!
  1. A Mommy-Baby focused birth - all things being equal, we all want a healthy baby and mom at the end of the day. This is the ultimate goal for all involved. A birth center will give us this just as much as a hospital. Both have the same goal. The procedures involved to get to this goal are different. For us, we wanted a birth that also focused on me & the baby and not the convenience of the Doctors and nurses. Hospital policy can dictate many procedures followed - liability is a big concern, but it is important that we also have a positive experience. For this reason, we chose a birth center since they are more Mommy-Baby focused in the procedure aspect as well.
  2. No Mommy-Baby separation: It is important for us that our baby stay with us at all times. This can be done in both hospital and birth center settings, however, when interventions increase, the chances of separation increase. (i.e., sometimes an epidural can cause a fever. If mom has a fever, the baby catching an infection becomes a concern and can be swept away to the NICU). While, this isn't the case in a majority of the situations, it can happen. And we are not willing to take that chance (unless absolutely necessary).
  3. Allowing our baby to do what s/he needs to do. It is important for us that we allow our baby to do his/her thing. In other words, no inductions or interventions to force the baby out before s/he is ready. Now of course if i'm 43 weeks and baby ain't budging, we will have to work with this, but there is many ways to encourage labor aside from external inductions (physical stimulations etc). As long as our baby stays healthy and I'm healthy, we'd like our baby to do his/her thing, to come out on his/her terms and we trust the process. A birth center won't push, encourage or force us to induce or have interventions we don't want.
  4. A natural birth. While i'm not opposed to epidurals - by any means, we are preparing for a natural birth. Some say i'm "crazy" or trying to be a "hero" or some sacrificial lamb ... but to be honest, I admire those who go this route and fully trust it. I know that epidurals hurt. I know that epidurals don't always work. I know that epidurals can cause reactions. I know that epidurals may not be given at the right time. I know that epidurals aren't going to make your labor pain free. It works for many, but not for all. So for me, its easier to just trust my body than to hope for an easy solution that may or may not work.
  5. Pain is not always bad. I read this book by Tony Dungy several years back. He talks about his adopted son that has a congenital insensitivity to pain (he feels things but does not feel pain). While it sounds cool, never feel pain!!! It definitely can be dangerous. Dungy talks about his son reaching into an oven for freshly baked cookies and not knowing his hands are burning from the heat of the cookie. Dungy also said. "We've learned that a lot of times because of that pain, that little, temporary pain, you learn what's harmful. You learn to fear the right things. "Pain sometimes lets us know we have a condition that needs to be healed." (Source
    In that sense, while I don't welcome pain, i know that being able to feel the pain will help me in knowing how hard to push, when to push, and what my body should or shouldn't do. Sometimes you may be told to just push push push not knowing that you actually may need 20 seconds of rest else something bad could happen with your pelvic floor b/c you can't feel the pain. I trust doctors, but i trust my body more.
  6. Immediate Mommy-Baby bonding. Many hospitals are now following this route of allowing moms to bond with their babies immediately, but some are still taking them away to do the APGAR tests and other analysis. The birth center encourages immediate mother-baby bonding, so this is not something i have to worry about at all.
  7. Delayed Cord Clamping. While its not something that all moms want, I do. I think the body, when allowed to do what it needs, will do it on its own. And the placenta, while still breathing life into the baby, shouldn't be halted too early with cord clamping. So for me, delaying cord clamping until the placenta stops pulsing blood to the baby is important for me. My OB said "i'll accommodate you within reason" which was alarm bells right away. So, i switched to a practice that would accommodate me without reasons!!
  8. Wanted to be surrounded by experienced providers who have assisted in births without interventions.
  9. Encouraged husband involvement. To the extent that we want, the Husband will be my coach. He will be very involved in birthing our child. While he won't be catching the baby, since he doesn't want to be "all up in it", we have decided he will "lead from behind" and will be actively involved in keeping me sane!! I love that he will be an integral part of the birth of our child and not just an observer or mildly involved.
  10. Encouraged movements. I love that i will be encouraged to move around. No straps or monitors and a lot of movement! This will assist in labor since its not natural to lay on one's back and birth (this is done for the Dr's convenience). I like the idea of freedom of movement.
  11. Encouraged eating and drinking. While this is just a side perk and not a main reason, I love the fact that I will be encouraged to eat and drink. Not just ice chips for me!!! A midwife explained that labor & birth is like a marathon, you wouldn't just have ice chips for a marathon - you need to keep your energy levels UP!
I can probably add to this list, but i may just end it here for now. And I'm not saying that our way is the right way for all, but it is the right way for us. And I know that there are SO many of my friends (and strangers) that have had wonderful and beautiful hospital births with wonderful doctors and great experiences. I also know of friends who have had traumatic experiences. Because of this, we are not willing to take that chance. We have done our research and decided the OB we had was very much into Doctor convenience, interventions and not focused on mommy-baby (emotionally) so we happily switched to a place we knew our concerns would be heard and we would be able to birth in a manner we were most comfortable with.

We can't guarantee we won't end up at a hospital, ultimately, the baby does have a mind of his/her own... should s/he come early, decide to be breech, decide to get stuck... whatever the case may be; it isn't up to us and our plans are flexible. However to the extent that we can plan to have the ideal birth we envision, we have done what we can.

One of the things that our birth teacher did tell us was that the moms who had the best experiences were usually the ones who were involved in the decision making process - regardless of hospital/birth center/home birth. So she taught us a couple of good phrases to always ask when procedures are being done, and i thought i'd share
  • What are you doing?
  • What are the risks?
  • What are the alternatives?
  • I do NOT consent - will stop ANY AND ALL procedures that you do not want.
So, for me this whole experience has been so empowering. I've learned a new respect for my body and what it is capable of. I've learned to be flexible and to go with the flow (ok, this is still a work in progress). And i've learned that being informed, regardless of who you birth/deliver with is important b/c it is your body, your well being and your baby that are being dealt with - all very important. It is good to know why they put antibiodics on your baby's eyes at birth, or if you want to do a vitamin K shot, or when you want to clamp the cord. These are decisions that everybody will do differently, but not everybody knows there are different options for.

We have choices and we have options... and that's the greatest thing about where we live, so i encourage you all to make the most of these opportunities afforded to us and do what is the right thing for your family!

How have you decided to birth? What factors played into your decisions?


  1. This sounds great to me and is something I'll definitely consider once it's my turn. Thanks for sharing all of this info. It's really helpful!

  2. I'm glad you made a decision you are comfortable with. Hopefully all will go smoothly so you won't need to go to the hospital.

    I'm delivering at the birth center that is affiliated with the hospital so I'm right there is something goes wrong. Since this is my first I admit I"m putting most of my trust in the doctors and nurses since they have more experience than I do but after my false alarm last week it did make me think more about what I do and don't want during labor so hopefully we don't run into any issues. Ultimately I just want the baby born safetly.

  3. I'm bookmarking this for a later date. Many of my friends and family members have had unnecessary c-sections, inductions, etc. and I don't want to be one of them when the time comes. You've done a good job educating yourself!

  4. I do not consent does not always work. My daughters were born wonderfully with a midwife. My son was a transfer fron the birth center last year due to fever. I was given pitocen without knowledge. Given a spinal block while held down as I sceamed stop, no, I dont want this, I want my husband and various explatives. I was held down to be shaved and cathiterized while screaming those magic words "I do not consent" kicked and screamed at force internal exams. A year later I still get upset about it. I just found out Im pregnant again and I told my midwife that if she tries to send me to the hosoital again I will lock myself in the bathroom till the baby is crowning

    1. This makes me very mad and sad for you. Im sorry you had such a bad experience and I think it's awful that your midwife wasn't there to help you after the transfer. Did you have a doula? I am praying your next birth goes much more smoothly .

  5. She was there. Unfortunatly they would not let anyone except my husband in the room and much of the time they had security "holding" him outside. The spinal (obviously) was not placed correctly and it caused me to have seizures between each contraction and for several weeks after. It only numbed my right hip and from my right knee down and they were about to wheel me out to do a csection on me saying I was lieing and couldnt feel anything when I said hey the baby you said I cant birth is right here then in came the OB to give me am episiotomy a rip the placenta out but not before cutting the cord as I yelled You cant do that!! My daughters births were both so peacefull my sons birth was a total shock. This new baby is a suprise seeing as I have no fallopian tubes. Part of me is looking forward to redemtion the other part is terrified now that Ive really seen the ugly side of obstetrics.

    1. Wow!! I'm so sorry about your birth story. That unnecessary trauma you endured makes me so angry. I pray you find redemption and this upcoming birth is peaceful and wonderful.

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