Actually, Birth Never Needed to be in the Hospital

Actually, Birth Never Needed to be in the Hospital

Actually, Birth Never Needed to be in the Hospital

Evaluating birth choices while pregnant in the time of COVID-19.

Take a deep breath.

If you read that headline and bristled, let me clarify this before I even begin:  For people who are high-risk, ill, or who personally feel safest in a hospital setting, then the hospital IS the absolute best place to have your baby. 

But for healthy, low-risk people, I’ll say again: 

Birth doesn’t – and never did – need to be in the hospital.

Thanks to COVID-19, people are rushing in droves to explore out-of-hospital options.  Some common concerns we have heard repeatedly from people planning hospital births:

  • A pregnant woman in labor at babymoon birth center leans on the edge of the tub during a contraction.Concern that they will no longer be able to bring a doula to their birth
  • Concern that they will no longer be able to bring their partner to their birth
  • Concern that their partner can be present for the birth, but not allowed in the recovery room afterward
  • Concern that if a partner is allowed in the hospital, they won’t be able to return if they leave the building for any reason
  • Concern that they will be exposed to viruses or illnesses and become sick while in the hospital
  • Concern that they will be separated from their baby if they are showing COVID-19 symptoms or test positive
  • Concern that they will be subjected to mandatory epidural anesthesia, Cesarean surgery, or other unnecessary interventions

News outlets report on this current trend toward out-of-hospital birth as if pregnant people are trading one risk for another. 

And I get it.  I know that: 

PREGNANT IN A PANDEMIC: “I STARTED TO THINK THAT MAYBE I SHOULD JUST GIVE BIRTH IN MY BATHTUB”

is a far more compelling headline than: 

MORE PEOPLE CHOOSING BIRTH CENTERS – AN OPTIMAL AND TOTALLY SAFE PLACE TO HAVE A BABY. 

But the reality is that people aren’t trading one risk for another. There is less risk in birthing at a licensed and accredited birth center. And that’s true all the time, not just during a global pandemic. Accredited birth centers repeatedly and consistently demonstrate improved outcomes for moms and babies – outcomes that translate across race and socioeconomic status.

There is less risk in birthing at a licensed and accredited birth center. And that’s true all the time, not just during a global pandemic.

Do we like that fear is driving people to consider birth options outside of the hospital? No. It’s sad that fear has to be any kind of driving factor for pregnant people. But do we like that something, ANYTHING is driving people to consider birth options outside of the hospital? Absolutely.

In the (hopefully near) future, social distancing guidelines will be relaxed. We will return to grocery stores and birthday parties and sporting events and begin to find our new normal. And we hope that a part of that new normal is a paradigm shift in the way we view birth. We hope that new normal includes a greater appreciation for the incredible work doctors and nurses do caring for sick people in the hospital.

And we also hope that more people will begin to realize that pregnancy isn’t a sickness.

And that birth never needed to be in a hospital.

Diana Petersen M.Ed., LCCE

Director of Education, Babymoon Inn

Diana Petersen received her journalism degree at the University of Arizona and her Master’s degree in education at Northern Arizona University.  She is a DONA-certified doula and Lamaze-certified childbirth educator at Babymoon Inn, an accredited birth center and full-scope midwifery practice in Phoenix, Arizona.

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Dear Pregnant People, You Can Get Through This

Dear Pregnant People, You Can Get Through This

Dear Pregnant People, You Can Get Through This

The following is a guest blog written by Natalie Vitez, who is currently expecting her first child

Natalie Vitez is currently expecting her first child and planning to give birth at at freestanding birth center.

I was ecstatic when my husband and I
found out I was pregnant.

 I’d suffered a devastating miscarriage last year, and finding out we were expecting our rainbow baby inspired much joy for us and our family. I knew without a doubt that I wanted to give birth at Babymoon Inn, a birth center in Central Phoenix. Not only had they provided me excellent care as a client leading up to this pregnancy, but they had become like a second family to me since I began working there as a doula. I had every confidence in their ability to guide me through a healthy pregnancy and birth. I had so much to look forward to: maternity clothes, baby showers, preparing the nursery, and endless baby kicks. Luckily, this pregnancy has been completely normal, and I’ve been able to do all of the daydreaming while soaking in the excitement that everyone was feeling.

And then the world turned upside down.

The Coronavirus, or COVID-19, is spreading around the world and everything has changed. The social distancing mandated to keep it from overwhelming our healthcare system has drastically affected everyone’s daily lives.

Research is limited on the effects of the virus on pregnant people and their babies, so the best option is to be extremely cautious and stay home. Now that I’m working exclusively from home as an administrative assistant, I have to be careful with how much toilet paper I use during my frequent bathroom visits because toilet paper is scarce.

Let me repeat that to highlight the absurdity: toilet paper is scarce.

The unknown is scary.  What you’re feeling – whatever it is – is valid. You are allowed to be scared. You are allowed to be unsure. You can feel disappointed that your baby shower was cancelled. You can feel alone even with your phone ringing off the hook and text messages flooding in. All of these thoughts and feelings are okay. I’m right there with you. There are so many that are right there with you too.

You are not alone. We’re in this together.

My greatest hope for you is that you won’t let those negative feelings take over. If everything feels out of control, look for what you can control. We all know the health recommendations of washing our hands frequently, social distancing, and avoiding touching your face.

But here are a few things you can do to help keep your sanity and
have the best pregnancy and birth possible:

  • Re-evaluate your birth plan:

Take the time to evaluate what is truly important to you and plan how to accommodate and adjust for any restrictions of your birthing place. Consider your options for where to give birth, which may include home, the hospital, or a freestanding birth center.

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  • Get creative:

Have a virtual baby shower or mother blessing.  Use Zoom or Facetime to have your doula or family “present” at your birth. Join that virtual support group for pregnant people. When we let go of one idea or preconceived notion, it opens the door to so many new and creative ideas.

  • Hire a birth doula:

Even if the doula can only provide virtual support on the big day, they can help prepare you and empower you beforehand as well as give excellent support postpartum.

  • Talk to your provider:

Either during in-person visits or over the phone, take the time to really talk about how you’re doing and prioritize your pregnancy.

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  • Talk to other pregnant people:

No one is going to understand what you’re going through more than another pregnant person.

  • Take a childbirth class:

Learning everything you can about childbirth and what your options are can provide a more satisfying birth experience. Now more than ever, it’s important to be informed and prepared heading into your birth.

  • Read positive birth stories:

Surround yourself with positive and uplifting stories to remind yourself what is waiting for you at the end of this. Include recent positive stories of people who have given birth too!

  • Move your body:

Moving is not only good for you physically, but it also does wonders for the mind and reduces stress.

  • Keep a journal:

If it’s something that is up your alley, write everything down. Not only can it help clear your head, but it’ll be fun to show your child what crazy things were happening when they were born.

Above all else, find the light. You can still feel exhilaration when the baby kicks. Or still delight in unpacking new baby onesies, even if they had to come in an online order. Or still laugh at all of the funny pregnancy posts online and the social distancing memes. New babies still represent, as they always have, our most precious hopes for the future.

I hope that you still feel the magic this baby brings and have big dreams. This crisis will not last forever. Don’t let it steal your joy. Please reach out if you need support and remember that you are not alone. Your provider, your doula, your friends and family, they are all here for you.

I am here for you.

You can get through this.

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You CAN still transfer care to a birth center: Five myths busted!

You CAN still transfer care to a birth center: Five myths busted!

Transferring care to a birth center more than halfway through my pregnancy turned out to be one of the best decisions I ever made. All of the concerns I had about switching providers later in pregnancy turned out to be myths, as you’ll read below!  

“I won’t have time to get to know my midwives.”  I easily spent more time with my midwife in my first appointment at a birth center than I did with my prior provider in the first 20-plus weeks of my pregnancy. The amount of time the entire team – from midwives to office staff – will spend getting to know you, your family and your pregnancy will amaze you. With 30-60 minute appointments, there’s ample time to build a relationship and discuss any concerns you may have before birth. In a hospital setting you may rotate through several providers during a long labor or only see your OB for a short time during delivery. The midwifery model of care focuses on personalized and continuous support throughout labor, which has been shown to lead to better outcomes.  

“It’s too late to make a completely new plan for my birth.”  If you’ve been hearing, “we do/don’t allow,” or it seems taboo to bring up requests with your provider, or you’re feeling like you don’t really have input into your own birth experience, change providers! Shared decision-making is a key component in a client-focused environment. It’s a process where you work together to make evidence-based decisions that balance benefits and risks with your preferences and values. Birth center care is always personalized, and your midwife will help support your plan for your birth whether you started care at 4 weeks or 40 weeks.   

“It will be too expensive.” While everyone’s financial situation is different, birth centers provide transparent billing practices, and care is often covered by insurance. The world of hospital billing is complex and can be full of hidden costs and surprise billing.  


Transferring to a birth center late in pregnancy still gave me plenty of time to join the community and soak up all birth center care had to offer.

“I’m not going to fit in or be part of the community this late.” Birth center care is individualized – it’s not a cookie-cutter approach. With personalized childbirth education classes to fit your time table, you and your partner will feel more prepared to rock your birth than you ever thought possible. Community also rarely stops when your baby is born. Most birth centers welcome you back (even to visit the room where your baby is born for the sweetest photo op ever!). From postpartum and lactation support to community playgroups, well-woman and family care, the community bonds are so strong among birth center families that it becomes an extension of your support network. It’s a village that will love on you, lift you up and celebrate you and your family for years to come. 

“A hospital is safer for my first birth.” The way you are made to feel during and after your birth will stay with you for the rest of your life. There is no do-over. Studies continually show that for healthy, low-risk people, birth centers are a safe (if not the safest) place to have a baby. And while they are home-like and rarely feel sterile or medical, they contain medical equipment and medications. Additionally, midwives are skilled medical professionals trained to handle complications of pregnancy or birth, such as shoulder dystocia, hemorrhage, or neonatal resuscitation. 

If you know a birth center birth is right for you, I encourage you to follow that instinct now rather than waiting for the next one – even if you’re currently in your second or third trimester. Every birth matters and you deserve the very best start into the journey of parenthood. 

Michelle Petkovic

Michelle Petkovic

Social Media Manager, Babymoon Inn

Michelle Petkovic received her degree in International Affairs from Sweet Briar College. She is a mother of one energetic toddler born at a birth center and loves spending time outside camping, hiking and traveling with her family.

Building Birth Centers and Community Support

Building Birth Centers and Community Support

Recently, we launched an Indiegogo campaign to help raise funds to support expansion to Tucson – a city of more than 500,000 people left without a freestanding birth center after the closure of the beloved El Rio Birth Center earlier this year. We heard and felt the heartbreak from the Tucson community upon suffering this loss and decided, after almost 10 years as a singular location in Phoenix, to expand to Tucson and fulfill the need for a freestanding birth center.

Anyone who has ever set foot in a birth center knows they are an integral part of communities. And they often rely on community support to be born and subsequently thrive. We see building a birth center as the modern-day equivalent of a barn-raising, where people come together to create something that is vital to their community. It truly takes a village, and we are grateful for the support in many forms that we have received thus far!

A few things to understand about birth centers and why we are asking for community support through a fundraising campaign to get Babymoon Inn of Tucson off the ground:

Birth center profits are lower than most healthcare organizations, including not-for-profit organizations. Most birth centers earn no profit for the first couple of years, and when a profit margin shows up, it almost always goes toward program development. In 2018, eight accredited birth centers in the United States closed. So far in 2019, eight more accredited birth centers have closed, with a ninth announcing their closure after 13 years in operation literally as we were writing this post.

Obtaining funding for birth centers is difficult. We are not attractive to private investors for start-up money because we are too small, don’t have rapid growth opportunities, are not quickly scalable, and are not a well-understood service or industry. (How many of you struggled to get your friends or family to understand why you chose a birth center? Now try explaining it to them and asking them to invest money on top it! 😂)

Birth centers provide extensive community support and services, much of which is provided at no charge to the clients and solely at the expense of the birth center.  At Babymoon, we frequently discount, extend payment plans, and provide pro bono services for families with financial hardship.  These services are not subsidized by grants or foundations who support our organization. They come directly out of our bottom line.  This philosophy is shared by every member of our team, who frequently volunteer their time and talents to serve our community – offering free classes, providing pro bono doula services, speaking in high school and college classes, making meals for new or bereaved parents, and donating their time in countless other ways.

While some birth centers have chosen to be not-for-profit entities, Babymoon has not. This was a well-researched and thoughtfully made choice upon our opening in 2010. Non-profit organizations are governed by a Board of Directors who retain ultimate decision-making power. If profit margins are too low or consistently in the negative, the board may choose to shut the business down. This has happened to many, many not-for-profit birth centers. Babymoon’s founders didn’t and don’t want to put control of so many people’s care into someone else’s hands. Deciding against being a non-profit was a purposeful choice that doesn’t prevent or stop our desire to help underserved populations and make birth center and midwifery care attainable for all.

We wish people were lining up in droves to open birth centers all over the country. And we wish investors were pounding on our doors wanting to help fund them! The reality is that freestanding birth centers are usually created and staffed by people who are simply passionate about the model of care and willing to work twice as hard for a lesser profit margin.

We hope you will join us in our “barn-raising” and help bring a freestanding birth center back to Tucson! If you would like to contribute, please find our Indiegogo link here. To join our mailing list, please click here.

Thank you for your support!

Diana Petersen M.Ed., LCCE

Diana Petersen M.Ed., LCCE

Director of Education, Babymoon Inn

Diana Petersen received her journalism degree at the University of Arizona and her Master’s degree in education at Northern Arizona University.  She is a DONA-certified doula and Lamaze-certified childbirth educator at Babymoon Inn, an accredited birth center and full-scope midwifery practice in Phoenix, Arizona.

What determines risk factors in pregnancy?  New research

What determines risk factors in pregnancy? New research

If you’ve seen a Babymoon Inn staff member lately, you’ve probably noticed a shirt that reads, “Evidence-based care with a hug. #birthcenters.” As an accredited birth center, we have a long history of providing holistic and personalized care, but also care that is driven by evidence and what research has shown to lead to the best outcomes for parents and babies.

What that research has demonstrated again and again is that for healthy, low-risk people, accredited birth centers tended by midwives are the safest place to have a baby.

But what makes someone low-risk? New research has identified factors to help determine a person’s risk status and help guide them to the choice of birth location that is appropriate for them.

Jeanette McCullough, IBCLC and co-founder of BirthSwell, interviewed one of the researchers, Melissa Cheyney, PhD, CPM , about the results of the study and its implication on maternity care and policy-making.

Cheyney acknowledged that “there is actually very little agreement on what constitutes ‘low-risk” and that the majority of research on risk factors has been limited to a hospital setting, whereas this new study includes nearly 50,000 people seeking planned birth center or home birth.

The study looked at eight risk factors:

  • primiparity (having your first baby)
  • history of a prior cesarean (with or without a history of also having a vaginal birth)
  • multiple pregnancy
  • breech presentation
  • gestational diabetes
  • preeclampsia
  • post-term pregnancy (greater than 42 weeks
  • advanced maternal age
  • elevated body mass index.

The study compared the risk factors with the following outcomes:

  • likelihood of transfer
  • cesarean section
  • any genital tract trauma
  • any postpartum hospitalization for a maternal indication in the first 6 weeks
  • low 5-minute Apgar score (<7)
  • very low 5-minute Apgar (<4)
  • any neonatal hospitalization in the first 6 weeks
  • any NICU admission in the first 6 weeks
  • combined fetal and neonatal death

The outcomes of Cheyney’s research showed that:

“Older than average mothers (35 years and older), women with an elevated BMI (30 and over) and women who labored after a cesarean who had also had a vaginal birth all had very little additional risk relative to our comparison group… Women who are older, heavier, or who have had a previous C-section and a vaginal birth who have no other complications actually do quite well in the community setting, and we are hopeful that state regulations will be modified to reflect these findings where needed.”

The research also gives insight into the risks of VBAC (vaginal birth after Cesarean) in an out-of-hospital setting.

“Women who labored after a cesarean who had also had at least one vaginal birth had excellent outcomes in the community setting. In fact, their risk was lower than what we found for women having their first baby.  However, we also found that clients laboring after a cesarean who have not had a vaginal birth were at higher risk than anticipated. Their outcomes grouped among the highest risk of the subgroups we analyzed, which included breech and preeclampsia. Women laboring after a cesarean without a previous vaginal birth had a risk of fetal or neonatal death that was ten times higher than the low risk comparison group of healthy multiparous women with no risk factors. Their rate of fetal and neonatal death was 10 out of 1000 compared to a less than one out of 1000 among multiparous women with no risk factors.”

Cheyney continues:

“To complicate matters, among women laboring after a cesarean with no prior vaginal birth, the repeat cesarean rate was just over 22%, which is less than our overall national cesarean rate of 32%. This means that 78% of women in this higher risk group had a vaginal birth! Pregnant people with this risk factor who are considering a community birth are forced to navigate a complex balance of risks and benefits associated with laboring after a cesarean in a community setting.”

Navigating through the research to understand the benefits and risks of any birth setting can be a challenge. Have questions? Ask us.

Read the rest of McCullough and Cheyney’s interview

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