IS A MIDWIFE-LED BIRTH CENTER RIGHT FOR ME?

You can see listings for midwife-led birth centers in the Chicago-area by choosing “I’M LOOKING FOR A MIDWIFE-LED BIRTH CENTER” in the drop down menu here.

The information on this page will help you think through whether a midwife-led birth center is the right setting for you. The more you learn about your options, the better you’ll feel about the choice you finally make. There’s a lot to consider, including the practical and emotional advantages and disadvantages of each setting, the scientific evidence on outcomes, how to find a provider, and what other options you have.

 

OVERVIEW

If you want to avoid the high-tech, high-intervention approach of many hospitals but don’t feel comfortable with home birth, a midwife-led birth center can offer a middle way. Birth centers support natural birth in a home-like setting. If issues arise during labor, a detailed plan for transfer to a hospital labor & delivery unit will be in place and transfer will be well coordinated.

There are two kinds of midwife-led birth centers: freestanding and in-hospital. There is one freestanding birth center in the Chicago area. There is also one in-hospital midwife-led birth center. This is a separate units within the hospital that have their own protocols and policies to support natural birth. (Be aware that many hospital “birthing centers” are not run by midwives. These may have appealing home-like décor, but the approach to care is likely to be the same as in a typical hospital labor & delivery unit.)

There are many practical and emotional advantages and disadvantages that you’ll want to consider as you decide whether a midwife-led birth center is right for you. (Scroll down to see Considerations.)

A midwife-led birth center is just as safe as a hospital as long as you are low-risk, and you are less likely to have interventions than low-risk women who plan hospital births. (Scroll down to The Research Says to see a summary of the research. You can also go directly to a more in-depth discussion of the evidence by clicking here.)

If you decide you might be interested in a midwife-led birth center, research your options. There are a handful of midwife-led birth centers in the Chicago area. Depending on how far you’re willing to travel, you may have several birth centers to choose from. (Scroll down to see Choosing a Midwife-Led Birth Center.)

And if you decide a midwife-led birth center isn’t quite right for you, you have other good options. (Scroll down to see Alternatives to Consider.)

CONSIDERATIONS

Each birth setting has advantages and disadvantages. Different people will weigh those differently. You need to sort through what matters most to you. Here are some considerations that may help you decide whether a midwife-led birth center is or isn’t right for you.

THE RESEARCH SAYS . . .

There is a significant body of research suggesting that outcomes for women who choose midwife-led birth centers are as good as those for low-risk women who choose hospital birth, including rates of perinatal mortality (babies dying around the time of birth).

Women who choose birth centers also have lower rates of interventions, including:

  • cesarean birth
  • induction and augmentation of labor
  • episiotomy
  • epidural

You can learn more about the research here.

CHOOSING A MIDWIFE-LED BIRTH CENTER

Once you decide that you might be interested in having your baby in a midwife-led birth center, plan to meet with staff midwives at a couple of different birth centers. You are looking for providers you trust. This is also a good way to test whether your choice holds up as you begin to learn more.

Here are some prompts you may find helpful before and after your appointments. Pick the ones that seem important to you.

General questions for your provider:

  • What kind of birth do you see the most often?
  • What part of your job do you enjoy the most? What are you best at?
  • What do you think makes pregnancy and birth safer?
  • How likely is it that you would be the one actually attending my birth, and who else might end up being there?
  • How would you handle the situation if you recommended something to me and I ended up choosing a different option?
  • What kind of prenatal testing do you require? Recommend?
  • What do you do if I go past my due date?
  • Will a tub be available and do you ever use it for labor? For birth?
  • What is your cesarean birth rate?
  • What can I expect to pay out of pocket?

Questions specific to midwife-led birth centers:

  • What kind of health conditions would exclude me from giving birth at the birth center?
  • [For freestanding birth centers]: Where would we go for a non-emergency transfer to the hospital? And in an emergency? How long does it take to get there?
  • What kind of arrangement/relationship do you have with the back-up doctors?
  • Will you continue to care for me if I transfer?
  • Who can be with me during labor? How do you feel about doulas?
  • What pain management options will be available to me?
  • How long do families stay at the birth center after birth?
  • Is the birth center accredited by the Commission for the Accreditation of Birth Centers (CABC)?

Questions to ask yourself after an appointment:

  • Did you feel at ease?
  • Did you feel rushed?
  • Did you feel listened to?
  • Were your questions answered?
  • Did the provider ask your permission before touching you?
  • How did your partner feel?

It can take awhile to get to know and trust your provider. If after several months you start to have doubts, don’t hesitate to make a change.

ALTERNATIVES

If you are attracted to midwifery care but you or your partner would feel safer in a hospital, you have two options: either look for a midwife-led birth center that’s located within a hospital, or consider a hospital-based midwife practice. If it’s important to you to labor in familiar surroundings with the people you’ve chosen to be there, you might consider a home birth.