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| · What is a freestanding birthing center?
A freestanding birthing center is a facility not associated with any hospital or university. It is designed to provide professional, cost-effective prenatal, birthing and postpartum care.
Birthing centers focus onhealthy pregnancy diet, exercise and care to facilitate an optimal birth experience. Family-oriented care encourages parents to invite those closest to them to participate in the birth experience. Mother and baby usually remain at the center for approximately six hours after a normal delivery before returning home.
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| · How safe are birthing centers? The New England Journal of Medicine released a study in 1989 concluding that birth centers are as safe as hospital environments for delivering babies to low-risk mothers. Because birth centers reduce many standard hospital interventions such as labor induction, electronic fetal monitoring, epidurals and routine IVs, birth centers perform approximately half the number of cesarean sections as traditional hospitals.
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| · What is a midwife? Midwives are trained to assist in the management of pregnancy, labor and birth.
AABC midwives are Certified Nurse Midwives (CNMs), certified by the American College of Nurse-Midwives, and Certified Professional Midwives (CPMs), certified by the state of Texas, who have been trained in both nursing and midwifery.
Midwives at AABC take extensive medical histories of our clients, order routine lab tests and provide thorough prenatal, labor and postpartum care.
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| · What about epidurals? Due to the risks involved, epidurals are not administered at freestanding birth centers such as AABC. The rise in the routine use of epidural medication – anesthesia injected through a catheter threaded through a needle and inserted near the spinal cord – has been linked to the rise in cesarean births throughout the world.
Epidurals are often the first intervention in what is sometimes referred to as a “cascade affect,” or the first medical intervention leading to a multitude of subsequent interventions.
An epidural can slow a woman’s labor, and she is more likely to be given a pitocin drip to speed up the labor process. Movement of the mother during labor is either eliminated completely or severely limited. Epidural administration necessitates fetal monitoring, to ensure the baby’s heart rate is not affected by the drug. The second stage of labor is often particularly slowed, sometimes leading to the use of forceps. All of these interventions can lead to unnecessary cesarean sections.
While epidurals can numb the sensations of pain associated with labor and delivery, they also numb the muscles that aid in pushing the baby out.
The International Cesarean Awareness Network, Inc. published a white paper written by Dr. Sarah Buckley outlining the risks for mother and baby of epidural use. The report concluded that “there is a noticeable lack of research and information about the effects of epidurals on babies. Drugs used in epidurals can reach levels at least as high as those in the mother (Fernando et al.), and because of the baby's immature liver, these drugs take a long time--sometimes days--to be cleared from the baby's body (Caldwell, Wakile et al.). Although findings are not consistent, possible problems, such as rapid breathing in the first few hours (Bratteby et al.) and vulnerability to low blood sugar (Swantstrom et al.) suggest that these drugs have measurable effects on the newborn baby.”
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| · Is any pain medication is available? Pain medication – an injectable, synthetic analgesic called Nubain – is available at AABC. Nubain (nalbuphine hydrochloride) like Demerol, mimics the effects of naturally occurring pain-reducing chemicals (endorphins). Nubain seems to have the least affect on the newborn of all the injectable-type medications.
Most clients do not ask for or need pain medication. Our clients find that good childbirth education addressing fear of birth is beneficial in preparing for a natural childbirth. Warm water therapy available in AABC’s deep birthing tubs also cuts down on the need for medication. Freedom of movement for the laboring mother (who is not confined to a narrow hospital bed) along with being able to choose various laboring and birth positions, aids in lessening pain and also helps to speed deliveries.
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· What experience does AABC have with challenging births?| Our knowledgeable staff has experience with the following birth challenges: | • Low lying placenta
• Infant resuscitation
• Shoulder dystocia
• Maternal hemorrhage
• Prenatal Down’s Syndrome diagnosis
• Prolonged rupture of membranes
• Maternal dehydration
• External version
• Meconium aspiration syndrome
• Dysfunctional labor (hypertonic, hypotonic)
• Under water births
• C.P.D.
| • Vena previa
• Uterine infections
• Beta strep infection
• Fetal distress
• Gestational diabetes
• Placental abruption
• Polyhydramnosis
• Transient tachypnea
• Toxemia
• Difficulty delivering placenta
• UGR
• Placenta previa
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| · What birth circumstances require transfer to a hospital? About 90% of our first time mothers deliver successfully with AABC. This means that only one in 10 first time moms will need hospitalization to complete delivery. Women who have birthed vaginally in the past have an extremely low rate of hospital transport - about one in 300.
The most common reason for transport during labor is slow progress and/or fatigue. Our midwives are extremely experienced at using age-old techniques to promote progress and support the mother. Since they are also modern nurses, they use emergency drugs, IVs, oxygen and other supplies to assist with difficult deliveries. However, if hospital support is required, AABC is prepared to transport. We never compromise the health and safety of the mother.
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| · What if something goes wrong? Again, the staff at AABC has expertise in many challenging birth situations. However, if it becomes necessary, transport to the hospital is easily arranged with private car or ambulance, depending on the mother’s preference and the situation.
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| · Are there doctors affiliated with AABC? AABC’s medical director is a perinatologist who approves all protocols and is available for consultations; clients with specific challenging medical issues may be evaluated prenatally by the medical director.
Also, AABC utilizes a group of obstetricians available at our backup hospital to provide emergency care for our mothers in labor who are having problems delivering. These obstetricians are friendly, compassionate and highly experienced with problem deliveries and are in-network with most insurance.
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| · Will I have an ultrasound during my prenatal care? Most clients prefer to receive an ultrasound at least once in their pregnancy. We have our own 2D and 3D state-of-the-art ultrasound machine and our technician has over 28 years experience. If a scan is abnormal or the mom has risk factors, we refer to a Perinatologist. Ultrasounds are useful in dating a pregnancy when the mother is not certain how far along she is. They are also used near 20 weeks gestation to examine the baby and placenta. Occasionally, ultrasounds are used when a pregnancy lasts past the due date.
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| · Is water birth an option at AABC? Each birthing room has a deep bathtub appropriate for laboring and/or actually delivering the baby in the water. Approximately 30% of AABC moms chose to deliver in the water.
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| · Who can attend my birth? In addition to your midwife and her assistant, you can select anyone you wish to support you during your labor and birth. At AABC, we are committed to providing a warm, calm and nurturing environment for mothers as they labor and in the important first moments of bonding with their newborns. We encourage you to choose support persons who understand what is important to you during this special time.
Our waiting area is available for family and friends to relax outside of your birthing suite, allowing them to share the experience.
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| · How long will we stay at the birthing center afterwards? The birthing center is an outpatient facility, so unlike a hospital, mothers stay for 6-8 hours after the birth.
During that time, the postpartum caregiver looks after the mother and baby and provides detailed instruction and support.
Postpartum checkups at AABC are more frequent than the hospital, as you and your baby are seen at 3 days, 2 weeks and 6 weeks.
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| · How much does it cost? AABC is many, many times less expensive than a traditional hospital/doctor delivery.
We offer an affordable self pay plan and work with most major insurance
companies.
Financial questions are best answered by Denise Garcia, our insurance specialist and accounts receivable coordinator.
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