Monday, February 4, 2013

birth centers

I was very happy to see this new study come out about birthcenters. I have to put a disclaimer out there though. We chose to have birth at a free standing birthcenter, it is not right for everyone. I wanted as little interventions as possible and quite honestly, my experience with OBs was never great, but there are great OBs. I love my midwives. But the birth experience is really very individualized and your decisions where and how to birth are the only right ones ( unless you decide to do it in a parking lot, who does that?). This all said, I want to encourage those of you who are passionate about it to please support your local birth center. They provide not only maternity care but many, many other services.

While the whole nation has been watching the cesarean section rate and cost of maternity care climb ever-higher, midwife-led birth centers have been providing low-risk women with a safe, low-cost model of care with excellent outcomes and a c-section rate orders of magnitude lower than the national average.

The long-awaited National Birth Center Study II (Stapleton et al., 2013), published today in The Journal of Midwifery and Women’s Health (the journal of the American College of Nurse Midwives), reported on outcomes of over 15,000 women planning to give birth at birth centers around the country between the years of 2007 and 2010. The American Association of Birth Centers has published an excellent summary of the study results for consumers.

Briefly, the main results showed:

84% of women who started labor at the birth center, had their babies at the birth center.
94% of women had vaginal births (whether they remained at the birth center or transferred to a hospital), with no evidence of compromised outcomes for babies. (That is, only 6% of women who started labor at a birth center had a cesarean birth.)
The national average is 32.8%. According to the authors, the national c-section rate for low-risk women comparable to this sample is 27%.
The fetal and neonatal death rate was extremely low and comparable to what has been reported in other studies of low-risk populations.

Why is this study important for consumers to know about? The overall number of birth centers has been growing over the last ten years. However, if you Google the phrase, “birth center closing,” you will see story after story of communities around the country despairing as their birth centers were closing their doors for all sorts of reasons.

In some states, the regulations for birth centers represent barriers to getting them started. In others, the financial or physician back-up structure was not sustainable. The loss of birth centers leaves significant gaps in the continuum of care options for women, leaving them to choose care that is not optimally suited to their situation.

The solution to lowering the cesarean section rate and the astronomical maternity care costs in this country will be multifaceted, for sure. Today we have been given empirical evidence that support for birth centers, with their low-cost and excellent outcomes, should be a substantial piece of the equation.

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