Freestanding Birth Centers

Written for graduate students and professionals in the fields of midwifery, women’s health, and public health, this book explores the freestanding birth center model in the United States from its conception by pioneering midwives and others in the early 1970s to the present day. Compared to the hospital-based birth model, the freestanding birth center offers a well-documented, healthier, more cost-effective, and more humane way to care for women and newborns, consistent with the goals of the Affordable Care Act. This rapidly expanding model of care has many positive implications for high-quality, individualized care and birth outcomes across the United States. Written by U.S. leaders in midwifery, Freestanding Birth Centers: Innovation, Evidence, Optimal Outcomes offers a comprehensive guide to the evolving role of birth centers, clinical and cost outcomes, regulatory and legal issues, provider and accreditation issues, and the future of the birth center model. Woven throughout the text are descriptions of "exemplar" birth centers representing diverse geographical, business, and service models. These cases illustrate the possibilities for expansion and replication of this model of care. Key Features Provides a thorough history of the birth center movement from its inception through future expansion of the model Serves as an essential resource with up-to-date evidence on clinical and cost outcomes Includes case studies linking the unique service focus of individual birth centers to the associated sections of the book Provides practical and comprehensive coverage of all issues involved in running a U.S. birth center

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

Based on her 12 year study of a free-standing birth center, Turkel analyzes the medical model of childbirth in contrast to the midwifery model. In the medical model of birth, women are defined as patients and birth takes place in hospitals where women have little, if any, control over their experience. The midwifery model views birth as a healthy process where midwives act as teachers and guides for women during pregnancy and birth, helping women and their families to shape and define their experience to meet their needs and expectations. Under existing legal and cultural circumstances, free-standing birth centers face a dilemma. They must continually accomodate the medical model while trying to maintain the midwifery model and give women an option to home birth or to hospital birth.

"This book is a major contribution to the global struggle for control of women's bodies and their giving birth and should be read by all obstetricians, midwives, obstetric nurses, pregnant women and anyone else with interest in maternity care. It documents the worldwide success of programs for pregnancy and birth which honor the women and put them in control of their own reproductive lives."—Marsden Wagner, MD, author of Born In The USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First

More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.

Written by two of the professionís most prominent midwifery leaders, this authoritative history of midwifery in the United States, from the 1600s to the present, is distinguished by its vast breadth and depth. The book spans the historical evolution of midwives as respected, autonomous health care workers and midwifery as a profession, and considers the strengths, weaknesses, threats, and opportunities for this discipline as enduring motifs throughout the text. It surveys the roots of midwifery, the beginnings of professional practice, the founding of educational institutions and professional organizations, and entry pathways into the profession. Woven throughout the text are such themes as the close link between midwives and the communities in which they live, their view of pregnancy and birth as normal life events, their efforts to promote health and prevent illness, and their dedication to being with women wherever they may be and in whatever health condition and circumstances they may be in. The text examines the threats to midwifery past and present, such as the increasing medicalization of childbearing care, midwiferyís lack of a common identity based on education and practice standards, the mix of legal recognition, and reimbursement issues for midwifery practice. Illustrations and historical photos depict the many facets of midwifery, and engaging stories provide cultural and spiritual content. This is a ìmust-haveî for all midwives, historians, professional and educational institutions, and all those who share a passion for the history of midwifery and women. Key Features: Encompasses the most authoritative and comprehensive information available about the history of midwifery in the United States Considers the strengths, weaknesses, threats, and opportunities for midwifery Illustrated with historical photos and drawings Includes engaging stories filled with cultural and spiritual content, introductory quotes to each chapter, and plentiful chapter notes Written by two preeminent leaders in the field of midwifery

Birth as every woman would like it to be • Recommended by Lamaze International as one of the top ten books for pregnant women and their families • Includes a 45-minute DVD of six live gentle births • More than 32,000 copies sold of the original edition New parents are faced with a myriad of choices about pregnancy, labor, and birth. In Gentle Birth Choices Barbara Harper, renowned childbirth advocate, nurse, former midwife, and mother of three, helps to clarify these choices and shows how to plan a meaningful, family-centered birth experience. She dispels medical myths and reimagines birth without fear, pain, or violence. Harper explains the numerous gentle birth choices available, including giving birth in an independent birth center, at home, or in a hospital birthing room; finding a primary caregiver who shares your philosophy of birth; and deciding how to best use current technologies. She also provides practical advice for couples wishing to explore the option of using a doula or water during labor and birth to avoid the unwanted effects of drugs and epidurals. The Gentle Birth Choices DVD blends interviews with midwives and physicians and six actual births that illustrate the options of water birth, home birth, and vaginal birth after a prior Cesarean section. The DVD clearly reveals the strength of women during childbirth and the healthy and happy outcome of women exercising gentle birth choices. It is a powerful instructional tool, not only for expectant parents, but also for midwives, hospitals, birth centers, and doctors.