evidencebasedbirth.com/the-evidence-for-birth-centers/The health of the mother, comprehensive prenatal visits, risk screening, referral and/or transfer to the hospital when appropriate, continuous support and care during labor and birth is what makes birthing with APM safe.
Out-of-hospital birth (at the birth center or in your own home) is as safe as, or safer than, a hospital birth for the majority of women. Multiple studies show 85%-90% of out-of-hospital births occur without complications as well as having fewer interventions and cesarean sections and more satisfying experiences.
APM's has a very low cesarean section rate; about 6% and our VBAC rate is 75%. Most birth centers have c-section rates less than 12% and the national hospital average is 30%. Our local hospitals average 28-40%. This speaks volumes to the type of care we provide as well as the wonderful back-up physicians and hospitals we work closely with.
Our success can be attributed to our committment to excellence in caring for low-risk women and babies and not providing services that increase your risk (induction, continuous fetal monitoring, pain meds, etc). We cannot accept clients who conceived with IVF or have conditions such as insulin-dependant diabetes, high blood pressure, epilepsy, drug use, HIV, hepatitis, heart, renal and kidney diseases requiring ongoing treatment or medications, lupus, MS, a BMI greater than 35%, placenta previa (the placenta is over the cervix), or a medical problem with the baby (such as heart defect, etc) that will require special care.
Conditions occurring during pregnancy such as anemia, gestational diabetes, cholestasis, oligohydramnios, pre-eclampsia or baby in a breech position (bottom or feet first) could also cause you to ‘risk-out,’ although these conditions can often be prevented or even reversed with proper prenatal care and/or nutrition. The State of CA also limits birth services for midwifery clients ranging from 37 to 42 weeks gestation.
We provide complete prenatal care as long as you remain low risk. The focus of midwifery is to catch the little things before they become big problems that would risk you out of care. If a situation requiring medical attention arises, we will refer you to one of several qualified physicians we work closely with or you may visit a doctor of your choice.
In working within the 2014 regulations regarding Licensed Midwifery, all clients must have a care plan in place indicating where they would transfer to if the need arose. Our clients can schedule a visit with one of our consulting OBs to establish a relationship and preregister at the hospital. This way, in the event of transport you have an OB to accept you into care.
If you have a question about your “risk status”, please contact us.
For more research on the safety of out-of-hospital birth:
Evidence Based Birth on Birthing Centers
Citizens for Midwifery