What is it like to give birth in an in-hospital birth center?

Many hospitals realize the demand for the benefits of a birth center or a home-like environment and offer birth centers within the hospital. This may be a good choice if you appreciate the home-like individualized care of a birth center but want emergency care to be available in the same building.

A word of caution: A birth center within a hospital does not necessarily offer the same type of care as a freestanding birth center. Many hospitals call their regular labor and delivery area their “Birth Center” and while this area may look more home-like than the rest of the hospital (rocking chairs, wallpaper), the care may be more like a routine hospital delivery than you would experience in a freestanding birth center. The organization that accredits out-of-hospital birth centers has also accredited a small number of in-hospital birth centers.

If you are considering a hospital birth center, you should learn about the type of care that is offered there. It is important to clarify how, if at all, a hospital's birth center policies and practices differ from regular hospital care, including:

  • Availability of midwives during labor (the most common care providers in out-of-hospital birth centers, midwives are generally skilled in high-touch, low-tech measures for labor progress and comfort).
  • Availability of continuous support during labor (trustworthy research clarifies that a doula who is present solely to support you is likely to make a much bigger difference in your care and outcomes than a member of the hospital staff or someone from your social network).
  • Use of a Doppler of fetal stethoscope to check on the baby intermittently during labor (intermittent auscultation); this enables you to be up and about and use gravity and movement for labor progress and — unlike continuous electronic fetal monitoring — does not increase your risk of cesarean birth.
  • Availability of a choice of methods for pain relief (tubs, showers and birth balls can be good drug-free choices; nitrous oxide has many benefits among pain medicines).
  • Policies and restrictions (e.g., who can be in the room with you; whether you are allowed to eat or drink; whether you are free to move about).
  • How often they use certain procedures or tests (e.g., intravenous lines, breaking your membranes).
  • Situations in which you would be required to relocate to receive standard hospital care.

In short, does the staff have a commitment to the birth center concept, or is the name “birth center” used primarily for marketing purposes?