Who Should use birth centers

You are the perfect candidate for giving birth at a birth center if:

  1. You are low-risk
  2. You plan a natural birth without medication
  3. You are between 37-42 weeks pregnant
  4. You have a normal pregnancy without complications
  5. You have good support at home
  6. Your labor progresses normally*
That’s it. It’s pretty simple. Most women could have their baby in a birth center because 85% of all women are low risk.

2)Myths Surrounding ‘High Risk’
There are many myths out there as to what constitutes a high risk pregnancy. Many women believe (and this belief is often fostered and perpetuated by physicians) that they are high risk because they are over 35 years old, or have had 1st trimester miscarriages - whether it be one or several. Many women also believe that if they had to use fertility drugs or techniques to get pregnant, they have a high-risk pregnancy. None of these are high-risk conditions. Neither is having ovarian cysts or having a personal history of cancer. None of these conditions would risk you out of the care of CNMs, OR out of having your baby at a birth center, if that is what you desire.

What “High-Risk” Really Means
The women who are truly too high risk for a birth center are:

  1. Having a breech baby (that was not successfully turned)
  2. Have a history of a previous cesarean section (the state won’t allow VBACs in birth centers)
  3. You have a clotting or bleeding disorder, or are severely anemic
  4. You develop preeclampsia or high blood pressure this pregnancy
  5. You have twins
  6. The placenta is covering your cervix or you have unexplained heavy bleeding
  7. You have too much or not enough amniotic fluid surrounding the baby.
These lists aren’t meant to include every high risk condition, so if you have any questions, please call us. Certified Nurse Midwives can take care of patients with some of the conditions listed above, and can attend their birth in the hospital.

*What is a “Normal” Labor?
What constitutes a “normal labor curve”, or in other words, how long should a woman’s labor last? There are many factors that determine the length of labor. Some of the most important factors are:
  1. Fetal positioning-labor is usually longer when babies are face up
  2. Genetics: If your family history (mom and sisters) is for fast labors, you may have a fast labor also.
  3. Preparation: Women who are relaxed and prepared generally have shorter labors
  4. Level of fitness: women who exercise and keep their pregnancy weight gain down will typically have slightly shorter labors
  5. Condition when labor started: Being well rested and hydrated help labor move along.
  6. Epidurals and sedation may slow down labor
  7. Being induced generally results in a longer labor compared to labor starting on its own.
Read an excellent article on the increase in the diagnosis of “failure to progress”

See the actual length of labor in stages.

Each Woman is Different
At Geneva Woods Birth Center, we understand that labor is different for each woman. We have been fortunate to have cared for many women who have three to four babies with us and we know that each labor can be different for individual women.

We don’t have hard and fast rules about when someone isn’t progressing enough and needs to go to the hospital. Progress is sometimes measured in cervical thinning, or the baby turning her head and dropping lower. We won’t expect you to dilate 2 cms every hour according to some medical curve developed in the 1950’s… But there are ranges of normal, and if your labor is stalling out, we more than likely will try some natural ways to encourage your uterus along. We may use herbs, a breast pump, IV hydration, a nap, sterile water papules or other techniques to get more efficient contractions.

If we have exhausted these natural techniques, the decision to transfer to the hospital is a shared decision with you and your midwife. We have hospital privileges and can take you there without interrupting your care, but we strive to preserve the birth center experience if at all possible, and don’t transfer you unnecessarily or against your will.

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