What are Birth Centres? How are they different from hospitals?
If you thought a multi-specialty hospital or a maternity hospital were the only places to deliver your baby, then here’s a surprise!
There are birthing centres which facilitate a safe and natural childbirth, and adopt mother-baby friendly practices. Such centres are typically run by autonomous midwives who follow evidence-based medicine. Best practices like supporting natural birth, vaginal birth after caesarean section (VBAC), twin birth, natural progression of labor, supporting the mother as labor unravels are commonly followed at birthing centres. In fact, they also adopt alternative methods of pain management, allow the mother to move and birth in a position of her choice and even allow her to eat and drink during labor. The most significant of them all being - facilitation of immediate direct skin-to-skin contact between mother and baby post childbirth and delayed cord clamping. Birth Centres typically have very high success rates of natural birth and breastfeeding. On the other hand, they also have low rates of medical interventions, including Caesarean section and episiotomy.
At birth centres, skilled and clinically trained midwives are in charge of birth, and there is no involvement of surgeons/ obstetricians/ obstetric nurses in the process. You are likely to be saved from unnecessary medical intervention.
There is a difference between autonomous midwives and the obstetric nurses working in a hospital. The latter are perhaps not skilled well enough, and they are discouraged from practising independently. They are trained to support the medical model of childbirth and follow the instructions of the doctor.
Thus, one must always be aware of hospitals promoting their nurses as midwives. There are only two Birthing Centres in India, and some mothers travel from far to avail their services:
Birthvillage Natural Birthing Center, Cochin
An Independent, free-standing birth centre. Here, the mother is in the care of one midwife throughout her pregnancy, birth and postpartum period. They have an arrangement with local hospitals, should the need to transfer the mother arise.
Healthy Mother Sanctum, Hyderabad
Located in a building that also houses a hospital, this Birth centre maintains autonomy and independence from the hospital, and is owned and run by autonomous midwives. The centre is independent of the hospital, but not free-standing. The hospital doctors and facilities are employed by the birth centre when required. Here, the trained midwives are in charge of childbirth. The surgery and the neonatal unit are closed.
Be aware of nursing homes and maternity wards referring to their service as “A Birthing Centre”, “Mother-Baby Friendly”, “Well Women Care” or also as “Midwifery Care”. These labels are often marketing gimmicks and not a true representation of services offered. In the absence of any regulation in India, unfortunately, doctors and administrators can behave in a fraudulent and unsafe manner. Additionally, also beware of the testimonials on social media as they are often written by administrators or doctors and not the parents/clients. Read reviews on BabyChakra instead which are written by real mothers based on their experiences with these hospitals and doctors. Many hospitals in India are now under strict control by insurance companies that govern what doctors practise, for example, the permitted time of labor. These rules often have nothing to do with safety or evidence-based medicine.
Choosing a place to birth is no different than buying a phone, house or car. One must always meet at least three doctors before making a decision. Read about questions you must ask the doctor about childbirth. Also, talk to at last three women who have had the kind of experience you desire with that doctor. Your local birth network and doulas can also guide you with regard to doctors who follow the evidence-based model of pregnancy & childbirth.
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