For most of us, when we think of giving birth, two options come to mind: the hospital or the home. And, since only about only 1% of people give birth at home, for the overwhelming majority of us, the hospital seems like our only option.
But there is another option.
Birth Centers are neither hospitals, nor homes, but a facility with a more homelike environment. They are run by midwives or, in some cases, OBs, and provide family-centered care for healthy people before, during, and after uncomplicated pregnancy, labor, and birth.
We chatted with Amy Johnson-Grass, the founder of Health Foundations Birth Center (Abby and Ricki recently participated in their Every Woman Can campaign) to learn more about what makes birth centers a unique option that people should know more about.
BOBB: Tell us a bit about Health Foundations Birth Center.
We were the first birth center to open in the Twin Cities, so we had to do a lot of education around what a freestanding birth center is. In fact, when we were first opening, there wasn’t a birth center licensure in the state of Minnesota. We worked with a small group of dedicated women to get licensure. We put together a bill, and we got it passed in 2009.
BOBB: Whoa! What a feat! What was the process of getting the licensure like? Were people receptive?
Actually, people were really receptive because we talked about it being a facility. We talked a lot about safety.
The interesting thing is, we have a fairly robust home birth community here as well. In trying to get licensure, many times the conversation would go back to home birth, and what the people’s perceptions of home birth were. We continuously had to reframe the conversation and say, “We’re actually not talking about home birth. We’re talking about birth centers.” That was an interesting piece, that education piece, of what a birth center actually is. When we first opened, we would have hospitals, doctors or other providers come through and they would ask us incredibly basic questions, like, “So do you listen to babies in labor?” or, “Do your mom’s get labs?”
It was shocking to realize what their perception of a birth center is- and midwives too! People still think of midwives as being only hippies with Birkenstocks. So we spent a lot of time talking through our routine maternity care. We do see women for all the same type of prenatal visits other providers would. We just tend to spend more time with them. And we still offer all the same labs. Many of our women get ultrasounds. It was a huge education process, and it still is. That perception piece is quite amazing.
BOBB: Well, thanks for all the amazing work you are doing to help expand that perception! Can you share more about what makes your birth center unique?
Yes! I think, in particular, we are unique because we are a lot more than just a birth center and midwifery practice. We are truly an integrative practice with a huge spectrum of offerings on-site. We are not only familiar with herbs, homeopathy, nutrition, and counseling, but we are also prescribers. Plus, we have other providers that work with us too, like chiropractors and acupuncturists. We’re a lactation center. We’re an education center with lots of different class offerings. And, we offer quite a few services for women, outside of maternity care, like annual exams, problem visits, and contraception offerings. This continuity of care (even extending to their kids with our Pediatricians!) really allows for us to focus on community building, which is so important because so many of us lack it. So we hold many events to continue and build those connections ranging from larger gatherings like Every Woman Can to smaller retreats, family picnics, and annual Valentine’s Day party...during Christmas we have about 100 kids come through to see Santa!
BOBB: Wow. You guys really are a one-stop shop! I love that you have partnered with pediatricians as well. What happens if, for whatever reason, you are no longer able to best serve a patient?
There are multiple hospitals here in the Twin Cities, but we primarily work with two. At one of the hospitals, our midwives have privileges. So, if it’s something that allows us to continue care with the client, but our center doesn’t offer the care needed, then we transfer them to that hospital. If it is something that needs an OB’s attention we will go to a different hospital which knows our practice well and with whom we already have really good protocols and systems in place.
BOBB: Having those types of relationships is key. How was it building those relationships?
The different hospital systems have been different. Some have been really receptive and have been really open to building those bridges. They come to the birth center and ask those hard questions of the things they are curious about. They understand that we are for low risk people and that sometimes things do come up that makes a transfer necessary. What makes this system really safe is building these bridges and systems together ahead of time.
But there is that other camp too. The other camp is still very skeptical. They don’t think that anybody should deliver outside of the hospital. They still have those different perceptions of what out-of-hospital birth is regardless of what the research shows.
BOBB: What’s something new and exciting happening at the Birth Center?
We just brought some tubs over from Europe that are super deep. Women can squat in them and partners can submerge themselves in them a lot easier. They’re super cool. I think it’s really exciting; even the little things like that are fun and important. And water birth feels like a hot topic now. ACOG came out with an opinion statement a few years ago and it still feels like there are lots of questions about water birth and a lot of women seeking water birth, but they are still getting some push back from their hospitals. We do many water births and we’ve been trying to do lots of education around them as well.
BOBB: Are water births legal in your hospitals?
They are now. But when ACOG came out with that opinion, and, it was only an opinion, water birth programs actually stopped in a lot of our hospital systems immediately. It wasn’t even like they were giving women notice. They basically put out a statement saying, “We’re no longer doing water birth.” Women were devastated. We got lots of calls, even women who were due, coming from other practices saying, “This was our plan and this was really important to us. Is this still an option that we can do at the birth center?” Since then, slowly, hospitals reopened their water birth programs. It’s something that we’re seeing now. It’s surprising how volatile that is, and how easy that change can just happen. And that was an opinion. It wasn’t even research based.
BOBB: Water Births are not allowed in any hospitals here in NYC. Can you speak to some other laws that allow your Birth Center to operate the way that it does, and what may be prohibiting other states to provide the type of holistic offerings and care you do?
Here in Minnesota, our accreditation through the Commission for the Accreditation of Birth Centers (CABC) really drives everything. That national accreditation is what drives our state licensure.
The state doesn’t have any specific room size requirements, where some other states do- It may be room size, bathroom size, or hallway size. I know that can be really difficult for birth centers to abide by. I think too, Minnesota is unique because we are independent practitioners. We are not required to have a backup physician. We’re not required to have physician collaboration. I know that is quite a bit different from other states as well, which makes it a little bit easier to practice here.
BOBB: Thank you so much for sharing. I can speak for New York City and say, we desperately need a center like yours to move into town! When can you start?
Learn more about Health Foundations Birth Center here (and check out their rooms! Man, NYC, look what we are missing out on!)