Delivery in the birth center

According to the WHO (World Health Organization), the midwife is the most appropriate professional to take care of a normal  pregnancy  and childbirth. In the hospital delivery room, however, one-to-one care by a midwife can only rarely be guaranteed. For this reason, many women choose to give birth in a birth center. The charm of the birth house lies above all in its intimate, familiar and individual furnishings, which the women can claim completely and unreservedly for themselves. What should pregnant women know about giving birth in a birth center?

What is a birth center?

Women who find a clinic too sterile but do not want to give birth at home usually find a good compromise in a birth center. Birth centers and practices are usually run by several midwives, sometimes doctors are also part of the team. In the best case, they are located near the clinic, so that medical technology can be largely dispensed with. The comfortably furnished birthing rooms are equipped with monitoring devices (CTG) and an emergency set (oxygen) for the  baby  .

In many cases, the midwife takes care of the pregnant woman from the beginning of the pregnancy. She can carry out the necessary check-ups and consultations just like a  gynecologist . In addition, birth preparation and postnatal courses are usually offered in the birth center.

What should be considered when planning?

Anyone who decides to give birth in a birthing center should contact the birthing center of their choice at least two months before the due date. This leaves enough time for the parents and midwife to get to know each other so that the birth can be the experience the parents want. However, due to the limited capacity of many birthing centers, it may be advisable to contact them earlier.

As a rule, between the 32nd and 34th week of pregnancy (GW) there is a detailed consultation, during which it is determined how the pregnancy has progressed so far and whether the pregnancy has been free of complications so far – i.e. whether a birthing center is the right place of birth in the individual case . Because the prerequisite for giving birth in a birthing center is that no complications are to be expected during the birth.

For whom is a birth center suitable?

A birthing center is suitable for all women who, from a medical point of view, have no reason not to give birth in a birthing center – i.e. usually without the presence of a doctor.

A birth center is not suitable  for high-risk pregnancies, such as:

  • Mehrlingsgeburten
  • Transverse position or breech position
  • a previous  cesarean section
  • Complications from a previous birth
  • Medical conditions such as  gestational diabetes , preeclampsia or  high blood pressure
  • malposition of the placenta
  • preterm labour
  • Pregnancies from the fourth child (multiparous women)
  • health problems of the child

The self-determined birth

The philosophy of the birth centers is to enable mothers and families to give birth in a self-determined framework. This means:

  • If a water birth is desired, the birth can be performed in the water.
  • If the mother prefers to give birth in a birthing chair, she is offered this option.
  • Siblings can be brought along, but must be accompanied by a caregiver.
  • The woman giving birth decides whether and what kind of music is played for relaxation.

The charm of the house where he was born lies precisely in its intimate, individual furnishings, which you can claim completely and unreservedly for yourself. In addition, the active involvement of the birth partner – there can be more than one – is an essential part of the work in the birth center. The competence of the midwives and their holistic care, paired with the emotion and self-confidence of the parents: that is the essence of the birth center.

Natural pain relief

Various options for pain relief are offered during childbirth, which may consist of  meditation , breathing techniques,  massage  , or homeopathic remedies. However, epidural anesthesia (PDA) is not possible in the birth center. If it becomes necessary, the mother must be transferred to a clinic.

Many midwives believe that natural perineal tears heal better than episiotomy done during childbirth. As a rule, however, the midwife will try anyway to avoid damaging the perineal tissue altogether. The perineal area is massaged with hazel oil or treated with coffee compresses.

24/7 support

Birth centers can only accept a limited number of births. As a rule, a midwife is there for a pregnant woman. In order to be able to guarantee all-round care, there is also on-call service in the birthing centers, which lasts either 12 or 24 hours. Competent care is always provided.

Qualified examinations, also from the Federal Association of Midwives, show that giving birth in a birthing center is just as safe as in a clinic. Conversely, it is often self-confident and open-minded women and families who decide to give birth in a birth center. Anyone who has a high need for security usually chooses the hospital.

Birth center: just give birth naturally

There were times when the different opinions – hospital here, birth center there – led to almost ideological and dogmatic arguments, which the women had when asked “How do I give birth correctly?” properly put under pressure.

There is now a broad consensus that women should decide for themselves and individually where and how they want to give birth. For example, women who have a high need for security give birth in hospital today, and those who reject too much “technology” choose the birth center or other natural alternatives (such as home birth).

The birth in a birthing center takes place on an outpatient basis. This means: After the birth, mother and child are given time to get to know each other in peace. A few hours after the birth, they are allowed to go home together.

Hospital or birth center?

Differences between obstetric departments in hospitals and birthing centers still exist, even if today many hospitals have opened up to self-determined methods of birth (e.g. water birth, delivery chair, different birth positions, outpatient birth) and also to alternative forms of pain control (e.g. acupuncture). to be open to.

Clinics are clearly responsible when it comes to a risky birth. A caesarean section can be performed here within minutes, which is not possible in the birth center. Most large hospitals also have a neonatal intensive care unit so that the baby can be transferred quickly if necessary.

Birth centres, on the other hand, do not even accept high-risk pregnancies such as multiple births, breech presentations or pregnancies with a complicated course. Complications during childbirth are therefore usually rare in birth centers. If they do occur, the mother is immediately taken to the nearest hospital for emergency care. As a rule, the midwife also accompanies the mother on this journey – but the medical care is then the responsibility of the clinic.

Coverage of costs for childbirth in the birth center

Health insurance companies usually cover the costs of childbirth and care before and after the birth. In individual cases, an additional payment of between EUR 300 and EUR 600 must be made for the use of the birth center. Certain additional services, such as acupuncture treatment, sometimes have to be paid for by yourself.

Details on this, as well as medical and practical questions, should be discussed directly with the birth center in question.

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