How to Choose a Birth Center

This post is written in honor of my best bloggity friend, Astrid. Even before I got pregnant, I knew I wanted to land myself in a freestanding birth center with a midwife for my prenatal care and birth. I thought it would be a simple matter of choosing between the three birth centers that are within driving distance of my house. But after that first tour and information session, I realized that birth centers have their differences, which are well worth exploring.

If you’re just now starting your pregnancy journey, take these tips into consideration before making your selection. And even if you’re well into the second trimester, it’s never too late to revisit your choices.

Know Your Options. After my first prenatal appointment, I found out that there are actually four freestanding birth centers within 30 miles of my house. I discovered this through casual conversation with a coworker, but it would have been obvious if I had just entered my information into the free Find a Midwife service my work offers.

Take Time for Tours. I had the privilege of visiting two of my birth center options while attending events for my job. I signed up for an official information session and tour of the third location and came away with the most valuable information from that one-hour investment. The birth center ended up looking a lot like my home—old and small. On the big day, I want plenty of room to spread out and not get caught up worrying whether I’ll be one of three people in labor at the same time when only two birthing rooms are available.

Ask Questions. I also learned so much from other people’s questions at the information session I attended. Here are a few I especially appreciated and recycled in future discussions with other birth centers:

• How long is a typical prenatal appointment?
• Is parking available for prenatal appointments and on delivery day?
• After I give birth, how long am I able to stay in the birth center?
• If a hospital transfer is necessary, which hospital will I go to? How long does it take to get there? Would we go by ambulance or in my vehicle?
• If I have to transfer to the hospital, what will the role of my midwife be? Will s/he still be in charge of my care? If not, will s/he stay with me for support? 
• If I decide I need an epidural, is that a sufficient reason to transfer to the hospital?
• How many of your patients transfer to the hospital or have a cesarean section?
• What methods of pain control are available at the birth center?
• Can I labor in water? Can I give birth in water?
• Are food and beverages available at the birth center or am I responsible for bringing my own?
• How many people are allowed in the birth room with me? (Some birth centers want you to get out of the water when it’s time to push so that the midwife can see the position of the baby.)
• Do you have prenatal testing options available, including ultrasound? Are any of these required or is it my choice?
• Will I be with one midwife during prenatal appointments and birth or will I get to know all of the midwives on staff? How many midwives are on staff?
• What are the credentials of your staff midwives? Do they each have a degree from an accredited midwifery education program? (Some midwives learn through an apprenticeship instead of an education program. While hands-on experience is critical, my opinion is that I’d also like for the person attending my birth to have a college-level anatomy and physiology course under their belt.)

Consider the Distance. I’m willing to drive up to 30 miles for a birth center that fits my needs and preferences. In rush hour, in the DC metro area, that’s a long drive. It took me an hour and 40 minutes to get to my last prenatal appointment. God help me if I go into labor at rush hour. Be sure you know what you’re getting into and accept the distance willingly.