Our Most Often Ask Questions About Birth Answered Below
Are all birth centers alike?
No, birth centers vary in many ways. Some are located inside hospitals, while some are in the community. Most centers are owned and staffed by one or more midwives. A midwife can be either a Certified Nurse-Midwife (a Registered Nurse Practitioner with additional training and certification by the American College of Nurse-Midwives, www.midwife.org or a Certified Professional Midwife (not a Registered Nurse, but trained and certified by the state or independent organization, https://www.scdhec.gov/health-regulation/healthcare-facility-licensing/facility-specific-info/midwives
Experience and skill vary with each midwife. The transfer arrangements in place with a hospital and a physician depend on the birth center’s history and working relationships with the physicians and the hospital. In SC the birth center must have a collaborative agreement with physicians and the transport hospital, which allows for expanded care if health issues arise. Though all centers are created to take care of low-risk births, complications will develop at least 10 percent of the time. These mothers face the need to be transferred. However, if the birth center’s midwives have expanded skills and options, the client may avoid a transfer by having a modified birth experience. This allows a mother to give birth at the center, with some intervention to solve the immediate problem.
Is it safe to have a baby at a birth center?
We view birth as a natural and healthy experience. Your labor can progress without unnecessary intervention. In fact, it is our lack of intervention that keeps our cesarean deliveries far below the national average.
While we specialize in the management of low risk women, some clients may develop risk factors, needing more advanced medical treatment.
In the event a woman develops a complication during her pregnancy or delivery, we can transition into traditional medical care with ease due to working with physicians who are sympathetic to desires and plans.
A recent Federal study determined that babies delivered by certified professional midwives were significantly less likely to die than those delivered by physicians. Another study, published by the New England Journal of Medicine, representing over 12,000 pregnant women, confirmed that births occurring in midwife-staffed birth centers were just as safe as births that took place in hospitals. An Institute of Medicine study has reported that births assisted by midwives result in fewer premature and underweight babies.
Having your baby at a birth center prevents the need for epidurals, pitocin, augmentation and medications. Mothers who abstain from medications deliver their babies much faster with far fewer interventions and complications. Their babies are born free of the drugs that are commonly used in the hospital environment.
How much does it cost to have a baby at Labors of Love Birth Center?
The total fee for maternity care provided by the Licensed midwife and the birth center facility is less than half the cost of a doctor and hospital delivery.
For insured patients, our insurance specialist will verify the coverage with your insurance company and will work toward maximizing the benefits provided by your plan. Insurance companies will honor your care at Labors of Love Birth Center unless it is a specific exclusion in your plan. To receive a cost estimate with your insurance coverage, click here to complete the Insurance Request Form on the Fees & Cost page. Copy the pin number before clicking link. Use provider pin number 06926.
We will contact your provider and follow up with you to discuss estimated fees at the Labors of Love Birth Center.
For non-insured patients, the fee for uncomplicated pregnancy, labor, delivery and postpartum care will be discussed at our orientations, the first and third Tuesdays of each month at 7PM. If you develop risk factors demanding extended services, there will be additional charges. We are happy to provide you with a list of extended services and associated costs.
What happens when things do not go as planned?
Sometimes in the prenatal period or while in labor, a pregnancy or birth can become high-risk, which means medical intervention is required. At Labors of Love Birth Center, we are able to work with certain complications by providing interventions that allow mothers to give birth outside of a hospital setting. The most common complications we see are Hypertension during pregnancy and Failure to Progress during labor.
At times, a laboring mother may need to be transferred to the hospital to give birth under the care of one of our consulting physicians. Our physicians understand the desires and needs of mothers who have chosen an out-of-hospital experience. They will try to prevent the mother from having a C-section or excessive hospital interventions. Our C-Section rate is less than 5 percent, and our transfer rate ranges from 7 to 10 percent.
Understandably, mothers may feel disappointment or sadness when their births do not go as planned; and yet, our mothers still report great relief and thankfulness for the help when it was needed. Our expanded skill in managing modified birth is an advantage that most facilities cannot offer.
It is always our desire for every mother to experience natural childbirth free of intervention. From years of statistics, we know that 9 out of 10 mothers will welcome their babies into the world at the Center, in moments that we deeply cherish. Only one out of every 10 moms who begins labor at the Center will give birth at the hospital. These special mothers still remain in our care after their births, returning for postpartum care and follow-ups, where they are encouraged to share their feelings and receive emotional support from our caring staff and other new mothers.
Do I have to lie on my back during labor and birth?
Birth is a highly individual experience, and we encourage women to do whatever will make them most comfortable during labor and birth. This may include walking around, relaxing in our deep Sanijet Tubs, sitting in a chair, resting in bed, sitting on the birth ball, or doing anything else that will help you maintain a maximum level of relaxation.
During early stages of labor, we will encourage you to drink ample liquids and eat a light meal. Instead of using electro-fetal monitors that must be strapped onto your abdomen and keep a mother in the bed, we monitor your progress with a special electronic stethoscope in order for you to remain active and out of bed.
Our laboring mothers rarely request to lie down in labor and often never do. We will encourage you to find the position most comfortable for you. You can lie on your side, kneel, squat, sit upright, or float in the Deep Sanijet Tub. We will advise you on positions to optimize an efficient delivery of your baby.
What kind of pain relievers do you offer?
Mothers having their babies at the Birth Center usually do not need pain medications. In this supportive environment, our nurturing midwives work with moms to achieve their goals of natural birth. Our mothers are active in labor, using freedom of movement to assist the baby to come quickly and to deal with discomfort.
Epidurals are not offered at the Birth Center, but we do have water therapy which many call the midwives epidural. If stitches are necessary we provide lidocaine as a numbing agent.
What is your philosophy regarding pregnancy and birth and your role in it?
Our goal is to help you to have the birth experience you desire. We believe that God made the woman’s body to give birth, and that it is a normal and natural process. We also believe that interference usually starts a cascading effect that leads to interventions and even emergencies.
What are your policies on episiotomies, intravenous fluids, and newborn treatment?
The use of an episiotomy is an infrequent, rarely used event. We do not routinely perform episiotomies (surgical enlargements of the vaginal opening). We are qualified to do episiotomies should a medical emergency necessitate the need for one. We often use perineal massage and oil to increase stretching without tearing.
We can provide intravenous fluids to prevent dehydration if you are unable to drink enough liquid, have episodes of vomiting, have excess blood loss during delivery, or if your infant shows any signs of stress during labor.
We will provide you with information regarding the SC requirements for newborns, such as antibiotic ointment for eyes, newborn screening, and vitamin K injections. We support your right to make responsible decisions regarding your newborn’s care.
What kind of medical equipment do you have at Labors of Love Birth Center?
Our birthing suites have the same equipment that hospital labor-and-delivery units have to evaluate you and your baby during labor and after birth.We have emergency medical equipment available as well, including oxygen/suction to aid breathing, heat to keep your baby warm, and medication to stop bleeding, If a mother needs more medical intervention, she can quickly be transferred to the hospital.
What happens if there is an emergency during labor or birth?
The midwives at Labors of Love Birth Center are highly qualified to deal effectively with emergency situations associated with labor and birth. If a medical emergency arises, or you become high risk, you will be transferred to the hospital where more specialized care can be provided by an obstetrician & hospital equipment.
Who can attend the birth?
Having a baby is a highly personal experience, and we feel you should be able to share it with anyone you choose. This may include your husband or other primary support persons, as well as other children, relatives or friends. Your primary support person can actively participate in the birth experience. If you decide to have other children present, they’ll need to have advance preparation and be supervised by a secondary support person.
Most fathers deliver their babies, and fathers will decide how much they want to participate. Your birth will be attended by a two midwives and a possibly a Birth Assistant.
Our goal is to have your spouse be the best coach possible, and our midwives will be in assisting your spouse to support you.
Doulas may accompany you to the Birth Center; however, our support to the fathers allows them to act as your doula.
What do I say to my family and friends who do not support my choice of a midwife or birth center?
People who do not have education or personal experience with birth centers, or who gave birth in a hospital, do not understand the advantages of giving birth outside of the hospital environment. Less medical intervention creates fewer complications, thus supporting your body to give birth naturally as it was created to do.
It may be difficult for you to explain the advantages in a conversation that has taken many hours/days of personal study that helped you make this choice.
Advising them to watch the documentary “The Business of Being Born” by Ricky Lake on you-tube is a good start. Assuring them we are minutes away from the labor & delivery unit where epidurals and emergency care is quickly available should your plans need to change also helps reduce their concerns.
We are certainly available to discuss the many benefits of natural birth at Labors of Love Birth Center. Please let any concerned friends and family know that they may call us at any time.
What kind of care will I get after my baby is born, and how soon can I leave Labors of Love Birth Center??
After your baby is born, all vital signs for both you and your child — including breathing, temperature, and cardiovascular systems — are assessed to ensure you and your baby are completely stable. Your baby will get a complete physical examination, and you will be checked to ensure you are breastfeeding successfully and are experiencing no complications or bleeding.
Most mothers and babies go home approximately two to four hours after birth.
Some mothers request to leave sooner, and some mothers stay longer due to medical concerns. We keep in close touch with you after you leave. You will receive a home visit from your midwife between 24 to 36 hours to do a PKU test, and to be sure mom and baby are doing good. Then we see you for a 2 week, and 6 week visits. You are always welcome to call and get any help that you need.
Why would I choose a birthing center over a hospital?
Choosing Labors of Love Birth Center will decrease your risk of complications to mother and baby, and your baby is born free of drugs that most women receive in hospital deliveries. Very few women who choose to deliver at our Birth Center need epidurals or C-sections. Less medical intervention creates fewer complications, thus supporting your body to give birth naturally as it was created to do.
Our mothers experience an incredible sense of accomplishment and euphoria when their infants are born without the use of drugs. Their sense of power and strength often sustains them for the remainder of their lives. Giving birth totally numb from an epidural robs a woman of this sense of accomplishment and strength. We offer a drug-free environment that helps you achieve your goals of natural childbirth.
How many births have you attended?
Our midwives have delivered with over 1200 births in the last 20 years.
What percentage of women successfully have a natural birth under your care?
Our percentage rate of successfully natural births are 90 percent, with a 10 percent transfer rate.
Do you have hospital privileges? At what hospitals?
We have a wonderful working relationship with the doctors at the area hospitals. If the need to transfer care arises. we will go with you and hand off care and records to the on call physician. We will either stay with you as an advocate or step back and give space to your doula or family member who may be there to support you.
What usually happens at prenatal appointments? How many? When? How long are they?
During your initial visit we will review your health history, your pregnancy up to that point and set out a plan for your care. We will be able to hear your baby’s heart beat, take your vitals and urine test. At this appointment we will also spend time in education so you may participate in shared decision making.
Each visit after this will last about 45 minutes. We will spend time getting to know one another, discuss events since your last visit and what you can expect in the coming days or weeks.
You will see your midwife every 4 weeks until week 32, every 2 weeks until week 36, and then every week until delivery.
My water broke, is my baby coming?
Rupture of the Membranes is an excellent sign that baby is on the way. One usually starts labor immediately or if already in labor the labor will increase which is what causes the birth of your baby.
Premature rupture of membranes means the water broke and labor does not begin. The body is not ready for labor and therefore it does not get the clues to put itself in labor. This can happen many weeks before your due date or even around your due date yet labor does not begin.
If labor does not start, most likely the mother will need some means of induction. The baby is exposed to bacteria entering the uterus which can cause an infection in the uterus or the baby itself. The longer the time from rupture of membranes to the delivery increases the exposure of infection and therefore puts mom and baby at a higher risk for complications.
Standard hospital procedure includes intravenous antibiotics starting at 18 hours and continuing until the baby is born, and blood cultures being taken on the baby to watch for infection. Your baby needs extra observation if 24 hours has lapsed and may need NICU admission if the baby is symptomatic.
Knowing that these added risk occurs, we start giving all Moms advice and assistance to get her into labor once the water breaks. We are pushing the clock knowing that the sooner the baby delivers the less chance of needing antibiotics or hospitalization. While some patients want to just wait for labor, we know that some Moms will not start labor until we intervene. Waiting too long has resulted in mothers and babies having to be hospitalized.
Why would a mother not go into labor? Cervical ripeness and the application of the baby’s head on the cervix is the key factor for the body to be stimulated to go into labor. If the baby has not engaged or the cervix is firm and not ripe for labor, the body will not be stimulated. Labor does ensue if your cervix is ripe and the baby is moving into the birth canal, hence most women go into labor once the water breaks.
What can I do if my water breaks and labor does not begin? Call your health care provider so we can confirm that your water broke. If confirmed we usually start with things such as walking, nipple stimulation, assistance with the baby’s head applying to the cervix. During your exam we determine if your cervix if not ready and decide the best plan of management to ripen the cervix and to get contractions to begin.
If a mother gets a fever or the baby is born with one, hospitalization is critical to prevent severe infection. Our goal is to prevent prolonged rupture of membranes and a fever or infection starting.
We wish that PROM was never a problem, yet if it is we will work with you to go into labor so your baby does not become exposed to an infection or need hospitalization. CALL US IF YOU ARE LEAKING WATER EVEN IF YOU ARE NOT SURE.
What happens if my baby comes after my due date?
Babies will come before or after the due date. Babies after 42 week, and before 36 weeks have to be born in the hospital where they can receive specialized care if needed. Babies born after 41 weeks are considered post mature and are at increased risk of complications during labor or delivery. Our babies home the uterus is programmed to perform well until the 40 week mark, and slowly declines in its efficiency every day after 40 weeks. Therefore we will give you advice and homework to encourage your baby to come close to the 40 to 41 week point.
How do I know if my baby is okay? We will have your baby checked by a sonogram to determine if there is sufficient water around the baby, the placenta is working, and the baby has good body tone and breathing movements. We will watch your baby closely every 3 to 4 days thru sonography.
We are also checking your cervix to be sure it is ripening and getting ready for labor. We will give you advice as to things you can do to encourage labor.
Once a mother passes the 40 week point the cord of the baby begins to lose it curls and firmness. By 41 weeks it is thinner and less curled, and by 42 weeks it will be thin like a pencil with no curls. The lack of cord health and thickness means the cord can be compressed before or during labor and cut off the blood supply to the baby. This is the reason mothers are not allowed to go past 42 weeks and the need for extra surveillance to be sure all is well.
What causes a Mother to not go into labor?
The cervix prepares itself by getting soft and open so labor will begin. If the cervix remains, high, thick, closed it is not being signaled to go into labor. Cervical ripeness is one of the key factors in a mother going into labor. What ripens the cervix? The baby dropping down into the pelvis stimulates the cervix to prepare itself. Why do some babies not drop down on the cervix? If the baby is not in the optimum position it often does not engage. Lack of engagement, stimulation, or poor abdominal tone of the mother can prevent the cervix from being ready and labor does not begin on its own.
We will work with any mother who goes post dates with daily suggestions and help to support your body going into labor. We will try to avoid you getting to 42 weeks and needing a hospital induction.
Our goal is a happy mother and baby close to its due date.