Frequently Asked Questions

Are there any books I should get to prepare for pregnancy and birth?

We have a large lending library at The Birth Center full of our favorite titles.  When choosing a book, look for authors who support normalcy, the power of your body, and holistic management of pregnancy/ birth.  Some of our top picks include:

  • The Birth Partner, by Penny Simkin
  • Pregnancy, Childbirth, and the Newborn by Penny Simkin
  • Sit Up and Take Notice, by Pauline Scott
  • The Thinking Woman’s Guide to a Better Birth by Henci Goer
  • The Birth Book by Sears and Sears
  • Ina May’s Guide to Childbirth by Ina May Gaskin
  • Gentle Birth Choices by Susanne Arms and Barbara Harper
  • Birthing From Within by Pam England and Rob Horowitz

Can I come to The Birth Center for my annual exams?

Yes!  Midwives are not just for pregnant women.  We provide full-scope care, which means that we care for all women from teens to post-menopause.  You can come to The Birth Center for Pap smears, mammograms, STD testing, pregnancy testing, preconception counseling, menopause, birth control, IUD’s, and other women’s health needs. Midwives in Delaware have full prescriptive authority.

We believe in holistic management.  We use complementary and alternative techniques, nutrition, and necessary “medical” treatments.  We educate our clients, empowering women to care for their own bodies.  The Birth Center accepts all major insurances for gynecologic care, including Medicaid.  Our visits are 30 minutes long.

To minimize your time in the waiting room, please bring completed Registration and Medical History forms to your visit.

Can I eat and drink during labor?

Of course!  Your body is working hard and needs energy.  You would never run a marathon without fluids, would you?  You need to stay hydrated and drink plenty of fluids, especially those with nutrients and calories (like juice, sports drinks, and sweetened herbal teas) to keep your muscles working as effectively as possible.  Many women lose their appetite during labor, but you are encouraged to eat light foods if you feel like it.  Follow your body.

Do you cut episiotomies?

We do not perform routine episiotomies (a surgical cut to enlarge the vaginal opening).  Instead, we use warm perineal compresses and oils during birth to ease the passage of the babies head, thereby minimizing tears.  We are fully trained to perform episiotomies and repair cuts or lacerations/tears, if necessary.

Do you take insurance?

Yes.  We accept all major insurances including Delaware Medicaid.

How do you monitor the baby during labor?

We use a handheld Doppler to listen to the baby’s heartbeat during labor. This is called intermittent auscultation.  Research shows that listening intermittently is equally as effective as continuous electronic fetal monitoring (EFM) in identifying problems during labor and delivery.  In fact, studies show that intermittent auscultation results in lower rates of c-sections with the same neonatal outcomes.

How is a birth center different from a hospital?

A birth center is a place that gives you a caring, warm and homelike setting where you are supported and respected as well as safe and secure.

You will have a private room for giving birth where you can make yourself comfortable, wear your own clothing, have nourishment when you feel hungry, soak in a tub, and even have a water birth.   A Birth Center welcomes your children, your parents, and friends so you can decide who will be with you or near you as you give birth.  It is a place that gives you continuing support and information on infant care, breastfeeding, parenting, and family planning.

How much does The Birth Center cost for prenatal care and delivery?

We have a global fee that covers all of your prenatal care, labor and birth, postpartum care, home visits, classes, and newborn care.  Birth center costs are typically 1/3 to1/2 the cost of a birth in a hospital.  We accept most major insurances including Delaware Medicaid.  We also accept self-pay clients.

How will I cope with labor?

Some women will tell you that they “couldn’t have done it without an epidural”.  Well, take a look at the big picture.  When you strap a woman to the bed (usually on her back) with electronic monitors and IVs, leave her alone in a sterile hospital room, take away her clothes, forbid her to eat or drink, take all power and control away, and stress her out with a constant stream of strangers in the room (many performing exams and “managing” labor), what other coping mechanisms does she have?

We take a very different approach at The Birth Center.  Research shows that stress hormones increase pain and slow the progress of labor.  We try to make your labor as low-stress as possible.  Our clients know the midwives personally from prenatal visits. They are familiar the The Birth Center house and the birth rooms since they visit us for visits and classes frequently!  We do not perform unnecessary interventions or keep you on a “labor curve”.  We hand the power to you when you wear your own clothes, eat your own food, choose who will be present at the birth and trust your body.  During labor, you are encouraged to walk and change positions often.  We have rocking chairs, birth balls, and birth stools to help you get into the most comfortable position.  We use heat and massage on sore backs.  Hydrotherapy (showers and tubs) have been shown to decrease the pain of labor, so we encourage women to labor in the water.  You are surrounded by continuous support from the midwife and your support network.  When you are allowed to follow your body, labor is very manageable. Women instinctively get into the best position for their labor and birth (usually side-lying, standing, or hands and knees).  And we do have IV pain medication, if needed.

I am pregnant and started prenatal care with another practitioner. Can I still come to The Birth Center?

Absolutely!  We would love to have you come to The Birth Center.  We accept transfer of care for eligible clients until about 32-34 weeks of pregnancy.  You will fill out a “records request” form that allows your previous provider to send us your medical records.

I heard that birth centers only care for “low risk” pregnancies.  What is “high risk”?

We believe that pregnancy is normal and that your body knows how to give birth.  Your age and number of prior pregnancies do not matter to us, as long as you are healthy.  We can deliver babies after 37 weeks gestation (3 weeks before your due date) and up to 42 weeks gestation (two weeks past your due date).  However, there are high-risk situations that are not appropriate for out-of-hospital birth.  We cannot accept clients with twins.  We cannot do vaginal breech deliveries or vaginal birth after cesarean (VBAC), but we can do your prenatal care until 30-34 weeks.  Other high-risk situations that are not suitable for a birth center include chronic high blood pressure, diabetes requiring insulin, placenta previa (the placenta is over the cervix), pregnancy induced hypertension/ preeclampisa (aka toxemia), or a medical problem with the baby (heart defect, etc) that will require special care.  If you have a question about your “risk status” feel free to call and speak with a midwife about your personal concerns.

If I come to The Birth Center for my prenatal care, can I still get an ultrasound?

Of course.  Midwives are not anti-technology; we believe in the appropriate use of technology and informed choice/consent.  Your pregnancy and birth are yours—we are here to educate you and make it as positive an experience as possible.  You can opt for as many or few interventions (ultrasounds, labs, amnios, etc.) as you like, as long as you understand the risks and benefits of accepting or declining.

Is it true that I go home the same day I have the baby?

Yes, we have early discharge at The Birth Center.  Our clients are healthy women with normal, un-medicated births and healthy babies.  Women stay here an average of six to eight hours after the birth.  After that, most moms are ready to get home to their own beds.  Birth Center families must take the Maternal Infant Assessment class during the pregnancy, which covers normal changes and problems with mom and baby during the first three postpartum days.  Before you leave The Birth Center we show you how to check “vital signs” on you and the baby.  The first day you check “vitals” four times and call us with the results.  The pediatrician sees the baby 24-48 hours after the birth.  The second postpartum day you take vitals twice, then call us.  The third postpartum day you take vitals twice and we come to you for a home visit.  We check on you and the baby, taking blood for the baby’s metabolic screen, checking the baby’s weight, and helping with breastfeeding.  Both you and the baby come back to The Birth Center for a one week check-up.

What happens if there is a problem during my pregnancy or birth?

Midwives specialize in normal pregnancy, labor, and birth. We focus on creating healthy women and families to prevent complications.  All midwives work with a collaborating Ob/Gyn to discuss complications and transfer high-risk clients.  If complications arise during your pregnancy, we may consult one of the collaborating physicians, have you make a visit with the physician, or transfer your care to the hospital- based physicians.  During birth we carefully monitor both the mother and baby.  If we sense the potential for a complication, we do not hesitate to transfer care to the hospital.  Our goal is a healthy mom and a healthy baby.  We would never jeopardize safety to have a birth center birth.  Our collaborating physicians are at Christiana Care Hospital.  We are trained to recognize and manage emergencies, should they arise. The Birth Center is located half a block from a hospital, and in the case of an emergency, we can have you in the hospital in minutes.

What is HypnoBirthing?

HypnoBirthing is a method of using deep relaxation, slow breathing patterns and self-guided release of endorphins (the body’s natural opiates), to help the birthing mother enjoy an un-medicated, safe and gentle birth, often more quickly and without pain.  Classes are offered at The Birth Center for an additional fee.  See Classes and Groups for details.

When should I begin prenatal care?

If you are newly pregnant, congratulations!!!  You should schedule your first prenatal visit for about the 6th-10th week of pregnancy.  That is about two to six weeks after your first missed period.

Who can be at my birth?

There are no restrictions on how many people you can have at The Birth Center.  You can bring as many friends and family members as you like, or you can come alone with your partner/ labor support.  We have a family room and kitchen for friends and family gather, cook and await the new arrival if you choose to not have them in the birthing room.  A midwife and a nurse are present for deliveries.  The midwife is with you for your entire labor and birth; the nurse comes for the birth and stays for your postpartum care.

Why should I go to a midwife?

Midwives provide better care!  We focus on the entire family.  Your visits are 30 minutes long.  We spend time getting to know you and educate you about your body and pregnancy.  We believe that you are an equal partner in you care.  We also believe in the power of your body to give birth.  Instead of treating pregnancy as a “disease” we work on creating healthy women, healthy pregnancies, and healthy babies.  We are fully trained to handle complications and emergencies, should they arise.

CNM’s attend over 9% of the births in the United States. Data supports the quality care CNM’s provide. According to a 1998 study comparing outcomes for births attended by CNM’s and physicians, births attended by CNM’s had:

  • a 31% lower risk of delivering a low birth weight infant
  • a 33% lower risk of neonatal mortality
  • a 19% lower risk of infant mortality

For more information, see the American College of Nurse Midwifery website.