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Guiding Principles of a Freestanding Birth Center

Caitlin Goodwin is a Certified Nurse-Midwife and birth nerd with 12 years in obstetric nursing.

What is a birth center?

A freestanding birth center is an out-of-hospital (OOH) birth facility. This intimate facility combines the goal of pairing a healthcare system with a wellness promotion program that focuses on pregnancy and birth. In this article, we will discuss what to expect at a freestanding birth center.

Birth centers give family-centered care for low risk, healthy women throughout the lifespan, and during a normal pregnancy, labor, and birth. Birth centers often have midwives as healthcare providers. Depending on the state, this can vary between professional midwives, lay midwives, or certified nurse-midwives. In some areas, a physician may either act as the birth-center director or healthcare provider.

Birth centers often feature water birth, aromatherapy, hydrotherapy, and hands-on support by professionals. The environment is peaceful and should encourage the family to feel safe.

In order to provide families with autonomy, it's important to provide birth centers as a childbirth option.

Guiding Principles of Birth Centers

Birth centers are guided by the principles of:

  • prevention,
  • sensitivity,
  • safety,
  • appropriate medical intervention,
  • and cost effectiveness.

Let's break this down.

Looking for a more intimate, homelike birth experience?

Birth can be a calm, natural experience.

Birth can be a calm, natural experience.

#1 Prevention

A birth center encourages well-being, disease prevention and positive maternal-child outcomes during pregnancy and birth.

Preventative care has a number of benefits. It contains cost by emphasizing wellness. It encourages responsibility development within the pregnant woman and her family by promoting healthy behaviors. The birth center provides an excellent homegrown starting base for the wellness and prevention programs

An ounce of prevention is worth a pound of cure.

— Benjamin Franklin

#2 Sensitivity

  • Attentive
  • Supportive
  • Choice-oriented
  • Emotional care

#3 Safety

Birth centers are regulated by a variety of institutions and adhere to rigorous safety standards.

The National Birth Center Study I & II (performed in both 1989 and 2013) has shown that:

Few innovations in health service promote lower cost, greater availability, and a high degree of satisfaction with a comparable degree of safety. The results of this study suggest that the modern birth centers can identify women who are at low risk for obstetrical complications and care for them in a way that provides these benefits.


Not only that, but births attended by Certified Nurse-Midwives have records of safety. According to studies, the outcomes of births attended by CNMs are excellent and a viable alternative to traditional physician-led care in this nation.

Routine Medical Interventions

Medications and medical interventions, such as an Intravenous catheter (IV) are not necessary in many cases.  A skilled health care provider should be able to obtain IV access quickly, if needed.

Medications and medical interventions, such as an Intravenous catheter (IV) are not necessary in many cases. A skilled health care provider should be able to obtain IV access quickly, if needed.

#4 Appropriate Medical Intervention

When some people picture birth centers, they picture an unsafe place where disaster is waiting to strike. This is not the case. A birth center is the place where appropriate medical intervention meets appropriate midwifery care.

What does this mean?

This means that your provider will have the best interest of your baby and you in mind at all times. There is no strict timeline set for your birth, and it certainly should not be based on the comfort or convenience of the healthcare provider.

Appropriate medical intervention means that emergent medical situations may arise, and the provider will act prudently. This may mean remaining in the birth center with additional medication, monitoring, or oxygen. It can even mean transfer to the hospital for your childbirth by medical interventions or cesarean section.

In a nutshell, medical interventions and medications are minimal in birth centers, except for emergent situations. If a women becomes high risk at any time in the pregnancy, labor, or immediately following the birth, she will be transferred to physician and hospital care.

Most importantly, appropriate medical intervention means to remain hands off when possible, but provide immediate intervention, transfer or emergent care when necessary.

#5 Cost Effectiveness

How do birth centers reduce costs?

  • Limiting the amount of medical interventions and technology used and focusing on provider assessment skill.
  • Promoting self-reliance in primary care by focusing on education, prevention, and wellness
  • Staffing efficiently: staff is only present when mother is
  • Using existing community and hospital services
  • Adhering to existing policies for screening appropriate birth center clients, and for the transfer of pregnant women with medical issues to acute care

The Case for the Birth Center

Clearly, the birth center provides an important facet of pregnancy, birth and postpartum care. The outcomes are positive when the normalization of birth is paired with a skilled health care provider.

Have you had access to a birth center? Did this article help you understand what to expect at a freestanding birth center?

Are you interested in maximizing the Fourth Trimester (also known as the postpartum period) with your newborn? The US Maternity Leave System leaves a lot of parents in the lurch when it comes to time off with their babies.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

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