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

Healthcare Revolution:  AHCCCS Thinks Its Members Are Not Interested In Birth Center Care

Healthcare Revolution: AHCCCS Thinks Its Members Are Not Interested In Birth Center Care

I recently sat down with Stina Sieg to discuss why the struggle birth centers face in getting AHCCCS coverage for our services.  Ms. Sieg also interviewed AHCCCS spokesperson Heidi Capriotti.  According to AHCCCS:

We haven’t heard directly from members that that’s their preference,” said AHCCCS spokesperson Heidi Capriotti.

Capriotti explained that if you’re a mom-to-be on AHCCCS and a birthing center experience is something you want, you should definitely contact her agency. But that’s probably not enough.

You’ve got to contact managed care provider – your health-care plan. They’re the ones who set the reimbursement rates. And Capriotti said they’re the ones who ultimately choose whether or not to include birthing centers in their coverage.

“But we are actively working with our managed care providers to explore options to expand the number of birthing centers available to our members,” she said.

If you are a member – do you agree?  It’s time to call AHCCCS and let them know that you do want birth center care!  Let’s actively work together for the change we want to see.

Read or listen to the entire piece here.

Birth Center:  More than a facility!

Birth Center: More than a facility!

When I first experienced the birth center model of care as a client, I was so focused on the excellent prenatal care and different model for birth that I did not realize “birth center” encompasses so much more.  As we explored the model of care in our start-up phase looking at other birth centers, the depth of the community support and access point for the medical system was our goal.

The Business of Being Born recently featured the Health Foundations Birth Center in Minnesota, who has beautifully achieved this “birth center” model of care with the depth of services that have come to define the birth center experience.  Amy Johnson-Grass, the birth center’s founder and the current President of the American Association of Birth Centers explains:

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!

Read the entire interview and see more photos of the beautiful birth center.

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