Pregnancy Home > What Are Freestanding Birth Centers?

If you are considering having your baby at a freestanding birth center, it's important to become educated on the potential risks, know what questions to ask of the center's staff ahead of time, and determine if this birthing option truly best meets your needs. These centers tend to be best for women who are at a low risk for problems during labor and delivery.


What Is a Freestanding Birth Center?

Are you a pregnant woman who is trying to look at all of your options for childbirth? Some women may be interested in some of the benefits of a home birth but have concerns and do not want to go through childbirth in a hospital. If you are a healthy woman who has a low risk for pregnancy and birth complications, then a freestanding birth center may be another possible option for you.
There are over 200 licensed birth centers, or "Houses of Birth," in the United States. But what are they and why would you consider one?

Why Consider a Birth Center?

If you are considering a birth center, it's important to understand what they are, the possible benefits they offer, and the potential risks that exist. What a woman wants for her childbirth is a personal decision; one answer is not right for all women. However, by looking at the available options and weighing the potential risks and benefits, it can help you decide which is best for you and your family.
Freestanding birth centers are home-like, independent, outpatient facilities that are designed for women who don't want to give birth in a hospital or at home. It can offer women a sense of control and involvement that they might find at home, but without the routine medical interventions that come with a hospital birth. Freestanding birth centers can bridge the concepts of a hospital birth and a home birth.
These centers have their own staff who are licensed and trained to help with childbirth. In most cases, freestanding birth centers have certified nurse-midwives (CNMs) who have a nursing degree and are also certified with the American College of Nurse-Midwives (ACNM).
CNMs offer a number of services, such as prenatal, labor, birth, postpartum, and newborn care. Because they are also nurses, CNMs can provide a variety of care, including gynecological exams, family planning counseling, and health counseling, just to name a few. Although their services are similar to those of an obstetrician, CNMs might provide more personalized care that focuses on the expectant mother's individual needs.
Freestanding birth centers can provide care for healthy women before, during, and after a normal pregnancy, labor, and birth. Although they are often located near a hospital, freestanding birth centers are not "mini-hospitals." They are usually equipped with IVs, oxygen, medication, and resuscitation equipment; however, they will not perform C-sections, and you will not be hooked up to an IV right away.
In a hospital birth, women are usually hooked up to an IV and have a belt strapped around their belly to allow for continuous electronic fetal monitoring. In a freestanding birth center, your movement won't be as restricted. Instead, a midwife or nurse will usually monitor your baby's heartbeat intermittently with a handheld Doppler, similar to one your caregiver uses during prenatal visits.
These centers allow women to move around during labor and tend to avoid interventions that would restrict a laboring mother to the bed, allowing for a more natural experience without routine medical interventions. They also encourage the mothers to choose various positions for labor and birth, and to eat and drink what they want during labor.
After a mother gives birth, freestanding birth centers do not have any routine policies or procedures that would require you to be separated from your baby. The examinations and first bath usually take place in the mother's room. All accredited birth centers have arrangements with laboratories for screening and other testing, along with specialists for consultations if needed. These centers are also usually associated with obstetricians and a nearby hospital in case an immediate transfer becomes necessary during labor, birth, or postpartum.
Although freestanding birth centers operate independently, in order to be accredited, they must meet the criteria set by the American Association of Birth Centers and are integrated within the healthcare system. As a result, these accredited centers refer clients to physician care and will transfer to a hospital if the need arises.
In some places, the birth center midwives also have hospital privileges so they can continue caring for you in case of a transfer. In other cases, the midwives can stay with you and serve in a support (nonmedical) capacity.
The staff of freestanding birth centers is trained and focused on coaching you through labor and encouraging you to have a drug-free birth if you choose one. Analgesic drugs, such as Demerol®, are usually available if you request them. However, epidurals are not, as these must be administered by an anesthesiologist.
While some hospitals may limit how many people you have during the birth, a freestanding birth center allows you to decide who's with you. Also, freestanding birth centers strongly encourage breastfeeding education and support, both during the prenatal period and after birth.
The atmosphere of freestanding birth centers usually includes a private room, with a rocking chair and a bed large enough for you and your partner, and soothing decor. Some even have kitchens where you can store or prepare food. Some also have whirlpool tubs. In addition, some places have a separate room where your family can go if you decide you want more privacy or if they need to rest.
Another benefit of a freestanding birth center is cost. Because women who go to these centers usually stay for shorter amount of time and tend to not need many interventions, the average cost is less than a hospital birth. On average, hospital birth costs start around $6,000 to $10,000 for a vaginal birth. For birth centers, the costs average around $3,500 to $5,000. Some birth centers may also have the option of a home visit a day or two after you give birth.
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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