Birthing Centers: An Alternative to Hospitals

Where should you birth your baby? If a hospital doesn’t feel right but home birth is also out of your comfort zone, then you may want to consider a birthing center. So, what exactly is a birthing center and what type of care can you expect to receive?

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Preggie Pals
Birthing Centers: An Alternative to Hospitals
Episode 23, October 1st, 2012

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.


Susan Melnikow: Where to birth your baby?  It’s one of the biggest decisions you’ll make during pregnancy.  If you are hoping for a more natural labor and delivery experience, then a Birthing Center could be the option that’s best for you.  I’m Susan Melnikow, a Certified Nurse Mid-wife for 30 years, and this is Preggie Pals, Episode 23.

[Theme Music/Intro]

Sunny Gault: Welcome to Preggie Pals, broadcasting from the Birth Education Center of San Diego.  I am your host, Sunny Gault.  Do you have a pregnancy question for our team of experts?  You can call our Preggie Pals hotline at 619-866-4775 and leave us a message, or, you can send us an email and we’ll get your questions answered and we’ll also include those questions and answers on a future episode.  Okay, today is a big day for us.  That’s because, today is the launch of The Preggie Pals Club.  Now, this is an exclusive membership club and it’s available to all of our listeners and it gives you all access to all of our archived episodes, because, what we do, we basically, the ten most recent episodes of Preggie Pals are free, completely free, you can download them, do whatever you want.  But then after the ten most recent, they go into an archive system.  So, this basically opens it up and you can listen to any episode that you want to, but in addition to that, we are going to offer bonus interviews, written transcripts of the shows.  I know some of you guys have been asking about that, plus a special monthly newsletter with special giveaways, discounts and much more.  So you can access all this great information through the web or through our new Preggie Pals App.  If you guys would like some more information on that, you can visit our website which is , click on the Members Link at the top of the page.  Okay and if you have a bunch of clicking going on in the background here, Katie Stevens is joining us.  She is a professional Birth Photographer and she’s taking some behind the scenes photos of our Preggie Pals taping and we’ll include those photos on our Facebook fan page, if you guys want to check them out.  Alright, let’s introduce our panelists.  Stephanie, Iet’s start with you.

Stephanie Saalfeld: Hi, I’m Stephanie Saalfeld, I am 29.  I am a gemologist, due January 9th with my first baby, a girl and we are having a hospital birth.

Misty Davies: My name is Misty Davies, I am 33, I am a gemologist.  I am due October 10th, with a little girl, my first and hoping for an un-medicated hospital birth.

[Theme Music]

[Featured Segments:  The Best Pregnancy Apps - An app to tell you what to eat!]

Sunny Gault: Okay, so we recently launched a new here, on Preggie Pals that focuses on the best Pregnancy Apps, because, there are a lot out there.  And, I wanted to get some feedback from some of our panelists here in the studio.  So Stephanie, Stephanie showed me her iPhone just a little bit ago and it’s loaded with Pregnancy Apps, so, Stephanie, what are some of your favorites?

Stephanie Saalfeld: Well, I have 12 on here…

Sunny Gault: But do you really use all twelve of them?

Stephanie Saalfeld:…definitely don’t…  No, I don’t.  I don’t

Sunny Gault: No.  Okay.

Stephanie Saalfeld: Occasionally, I cruise them every so often, but no.  There are probably three that I use on a fairly regular basis.

Sunny Gault: Okay.

Stephanie Saalfeld: So one is, iPregnancy, which is pretty cool, because you can put in all kinds of information, like your OB visits, you can log your weight and your blood pressure and…, and you know, any notes and journal…

Sunny Gault: Is it free?

Stephanie Saalfeld: Yeah!  Oh wait, no, I don’t think this one was free.  It might have been…., like two bucks.

Sunny Gault: Okay.

Stephanie Saalfeld: And it, you know, logs everything, and you can post pictures of yourself, you can journal, you can do…., whatever.  It’s an all-in-one.  So it’s pretty neat.  And it also shows you like average pictures of Ultrasounds like, what stage they are in, in 2D and 3D.  So you can see….

Sunny Gault: Oh, I…, see I like doing that.  I would go online, you know, on different websites and check that out.  That’s cool.

Stephanie Saalfeld: Yeah!  So you kind of think “Okay, well I’m 22 weeks.  So I’m going to see like, ‘Oh, that’s what an average, 22 week old…’”

Sunny Gault: “That’s what my baby looks like!”

 Stephanie Saalfeld: You know, literally, because you are curious because you only get so many Ultrasounds at the doctor.

Sunny Gault: Yeah.  Yeah.

Stephanie Saalfeld: Another one that I like is Foods to Avoid while Pregnant.

Sunny Gault: Oooooh.  That’s a good one.

Stephanie Saalfeld: So, it’s like a whole big list of, you know, cheese and dairy, dressings and condiments, fish and seafood.

Sunny Gault: Is that the name of the App?

Stephanie Saalfeld: It’s called Food To Avoid When Pregnant.  And I think that one was 99 cents.

Sunny Gault: Okay.

Stephanie Saalfeld: So.  But, it was worth it because it’s an easy…, you know, when you are out and you’re ordering off a menu, you say, “Wait, can I take that one?”

Sunny Gault: Yeah.

Stephanie Saalfeld: So stuff like that and then also there’s The Bump, which is just like a forum, where a bunch of girls…., sometimes it gets a little crazy and whatever, but it’s a bunch…


Stephanie Saalfeld: ….of girls just posting questions about random pregnancy related questions and you can answer their questions and you can ask your own questions and so, it’s kind of nice, kind of informative, some of its dramatic and you know, unnecessary stuff….


Stephanie Saalfeld: …and I think that’s a lot of like younger, because I’ve seen some, some girls have asked questions like, “Oh, how old is everyone on this App?” and they are all like in their early 20’s and I’m like, “Wow, I feel really old!”


Stephanie Saalfeld: And like there’s like no-one that’s like in their later 20’s or 30’s but, it’s kind of funny for drama occasionally.

Sunny Gault: Right, right.

Misty Davies: Oh, I guess I have some App for young kids.

Sunny Gault: That was young kids!

Misty Davies: Those crazy kids.


Stephanie Saalfeld: So, yeah, so those I use fairly regularly.

Sunny Gault: Well, good!  Well thank you for sharing that with us.  Don’t forget, Preggie Pals now has a free App.  It’s available on the Amazon and iTunes Market Place.  It’s a great place for moms-on-the-go because it automatically updates with the latest episodes and even allows you to connect with the show through our social networking sites.  And so for some of the things that Stephanie mentioned today, we’ll include some links to those on the Episodes page on this website, so you guys can check them out!

[Theme Music]

Sunny Gault: Today, we are learning all about Birthing Centers and how it can be a great alternative to the traditional way of giving birth at a hospital.  Susan Melnikow is a Certified Nurse Midwife who has delivered many babies at Birthing Centers including Best Start Birthing Center here in San Diego.  Welcome to the show, Susan.

Susan Melnikow: Thank you, I’m glad to be here.

Sunny Gault: So, what exactly is a birthing center?  People listening to this going “What are they talking about?!”

Susan Melnikow: Well, there are birthing centers that are inside hospitals and then there are other birthing centers that are stand-alone, out of hospital birthing centers, which is what’s Best Start is here in San Diego.  And it’s a place where we provide Comprehensive Care, so a woman can come and get all of her Pre-natal care, see the midwives and then do her classes there and plan on birthing there.  And then, we provide all of the Post-partum care as well.

Sunny Gault: So you would go to a Birth Center even for your pre-natal care, where you might go to a typical OB?  Wow.

Susan Melnikow: Definitely!  Yeah, as nurse midwives, as midwives, we provide, you know, full scope, comprehensive care so the woman really gets to know whose going to be with her, at the time of her birth and get comfortable with being in the facility where she will be birthing.

Sunny Gault: So the care that they are going to be receiving is from a Certified Nurse Midwife which is what you are?

Susan Melnikow: Correct.

Sunny Gault: Okay.  And I think we should probably explain the difference between a midwife and what an OB is.  So can you kind of give us an overview?

Susan Melnikow: Certainly!  Well, there is a couple of different kinds of Midwives.  I am a Certified Nurse Midwife which means I was a Registered Nurse before I went into mid-wifery and then I went back to Graduate School with a Masters Degree to become a mid-wife.  And usually, the programs are about two years in length.  We learn how to be Specialists in Normal Birth.  And how to identify when something is not normal.

Sunny Gault: What’s normal birth?


Susan Melnikow: Okay, normal pregnancy.  When mom is healthy.

Sunny Gault: Okay, got it.

Susan Melnikow: No high-blood pressure, no kidney problems, no heart problems.  You know, when mom is healthy and then we know how to identify if there is a problem that comes up.

Sunny Gault: Okay.

Susan Melnikow: So that we can work with the system and get the appropriate care.

Sunny Gault: Okay. How are mid-wives assigned to…, do you call them patients?  Wouldn’t that come in?

Susan Melnikow: We actually call them clients.

Sunny Gault: Clients. Okay.  How are they assigned?

Susan Melnikow: We do work as a group.  So we…, that is the one thing we don’t guarantee, which mid-wife it will be, unless the client and the mid-wife agree that she’s going to be available.  But there are five of us right now.  We work together as a team and we take “Call”.  And that’s the way that we have been able to do this and keep it sustainable.

Sunny Gault: Yeah.

Susan Melnikow: I…, I did home-birth when I first became a mid-wife for about 7 years and it really, really takes its toll on your family and your personal life.

Sunny Gault: You don’t…, you don’t have one!


Susan Melnikow: Yeah!  So, this is a compromise, but we find that it works really well and women have the opportunity to meet all five of us.

Sunny Gault: Yeah.  I was going to say.  That was going to be my follow-up.  Yeah.

Susan Melnikow: They have the opportunity to meet all five of us, so that it’s not a stranger that’s going to be with them.

Sunny Gault: Okay.

Susan Melnikow: And we all have the same Philosophy, similar skills, the only difference is our personality.


Sunny Gault: Okay.

Susan Melnikow: And it’s really interesting.  If it’s really important to a woman to have a specific mid-wife, often-times, you know, she may talk to us and say that, and we give her our call schedule and I don’t know, how many times over my career, women have gone into labor when I’m available, if they really wanted me?


Susan Melnikow: It’s really interesting!

Sunny Gault: Nobody knows.  They are like, “Wait, Susan’s not on call yet.  Okay, now…, now I can go into labor.”


Susan Melnikow: But it really hasn’t been a problem for the clients that we have.

Sunny Gault: Okay!

Stephanie Saalfeld: So if you start out with a particular client, they come into labor and it’s your call, do you stay then, the entire time?

Susan Melnikow: It depends. Sometimes, well, we take 24hrs of call.  So, we try to avoid a woman having to have more than one mid-wife by doing 24.  But it depends on how our 24 hours has gone.  You know, if we’ve been up and busy and we were up the night before and now we’ve gone through a full night, then when our time is done, we are really glad to see the other mid-wife and probably it’s better to have the other mid-wife because we are not at our top.

Sunny Gault: That’s true.

Susan Melnikow: So, that’s how we look at it.  And I think it works really well that way.

Sunny Gault: Okay.  Now why would someone choose to give birth at a birthing center over a hospital?  What are some of the common reasons?

Susan Melnikow: We…, for women who are having a subsequent baby, a lot of times, they really weren’t happy with their first experience and they are looking for some alternative way, where they feel it will be a more satisfying experience for them.   And, I’m…, we’re finding that a lot of first time moms now, are coming, oftentimes because they are afraid of what’s going to happen at the hospital.  There’s a lot of films out there now like The Business of Being Born and a lot of people have been watching this and they are kind of coming as a way to avoid what they are afraid of at the hospital.  Sometimes, that’s a good reason and sometimes we talk about, how, you know, it’s good to go and explore the hospital and really make a choice.

Sunny Gault: An educated choice, yeah.

Susan Melnikow: An educated choice on what’s really going to be good for them.

Sunny Gault: Okay.

Susan Melnikow: It’s my belief system that’s it’s not one size fits all.  That there should be alternatives of hospital, birth center and home for women and that women need to seek where…, wherever they are going to feel most comfortable.

Sunny Gault: Okay.  Have you ladies considered giving birth at a Birthing Center or what was that process like for you?

Stephanie Saalfeld: I would have liked to, had I really thought a little further in advance as far as my care, you know, I have my OB and you know, I have an HMO Insurance and then you kind of think, “Okay, well, I’m kind of stuck, like, there’s two hospitals that I can choose from…” and I mean, my preference, yeah, it would have been a birth center, but next time I’ll plan a little bit better!


Sunny Gault: I didn’t mean to shame you!

Stephanie Saalfeld: No! No, I mean, because it is. It is something that I really wish that I had investigated earlier, prior to getting pregnant.  So….

Sunny Gault: Yeah.

Susan Melnikow: I think that brings up a problem with our Health Care System.

Misty Davies: Yeah, it does.

Sunny Gault: Yeah. It does.

Susan Melnikow: That, you know, women are dependent on what their insurance will provide.

Sunny Gault: It is.  Of course.

Stephanie Saalfeld: And we are so limited, especially.  We work together, Misty and I, so you know, we have the same insurance, we like, we basically are kind of pigeon holed to these little two options.

Misty Davies: Yeah, I was going to say, I thought exactly the same as Stephanie and then I also thought, “Well, what if there’s a complication?”

Sunny Gault: That’s a scary thought too.

Susan Melnikow: Well, one of the things that we do at Best Start and most birth centers do is, we try to be a part of the Health Care System and not totally separate from it.  So, in our situation, we have three alternative options, if hospital becomes necessary.  We have a contract with UCSD Hospital and we can always transfer there, which is very close to the birth center.  We also have two private physicians who work with us and one of them practices at Sharpe Mary Birch and the other one practices at Scripps Mercy and Sharpe Gross Mart.  So we have all of those as options.  And a woman will choose what her back-up plan will be prior to labor and then if a problem comes up, we know exactly what we are going to do.

Misty Davies: Yeah.  That’s great.

Susan Melnikow: Yeah.

Sunny Gault: As far as the type of birth experience you want to have, are birthing centers just for women that want to have natural birth?  So obviously, you know, for medication and stuff like that.  Where do you…, where’s the line drawn?

Susan Melnikow: Birth centers are all a little bit different but most birth centers and Best Start included, we do not use any pain medication at this time and certainly epidural and anesthesia like that are not available.  We do have tubs though.


Sunny Gault: I know you guys are big on giving birth in tubs.  It’s all over your website.

Susan Melnikow: Warm…, warm water is worth a lot of pain medication.


Misty Davies: Yeah.

Susan Melnikow: It works beautifully.  So for some women, that’s all they need.

Misty Davies: Okay.

Susan Melnikow: And that get’s them over the hump.

Sunny Gault: Okay. What additional…, and you mentioned this a little bit before, but I didn’t want to back up.  What type of services do birth centers offer pregnant women?  We talked a little bit about pre-natal care.  So what does that look like?  So, I decided that I want to give birth in a birthing center.  So from…, you know, I’m eight weeks pregnant or whatever.  From the get-go.

Susan Melnikow: The way we do it is we provide tours.  We have tours all through the week and a woman will call us and we’ll say, “We suggest you come and see the birth center, learn about the services we have, come and be here, walk through it, see how it feels to you.  If it feels like the right place to you, then, it’s probably a good thing.  And so then they can make an appointment for the first visit.  We would provide a typical first pre-natal visit where we do lab-work.  We give lots and lots of information and education about diet, exercise and kind of what the standard pre-natal care would look like.  And then a woman will come on a regular basis throughout the pregnancy, very similar to what the physicians do.  Once a month at the beginning of the pregnancy, every two weeks in the middle and every week at the end.

Sunny Gault: Okay. So I have to ask, because we did talk a little bit about insurance and what that covers, so are most women are paying out of pocket?

Misty Davies: That’s what I want to know.

Susan Melnikow: Yeah, no, not actually.  We are very lucky at Best Start.  Best Start has been around for almost 30 years and we have contracts with several different insurance companies.

Sunny Gault: Okay.

Susan Melnikow: We accept MediCal.  We find that there are a number of women on MediCal.  We have a contract with Tricare, so we have a lot of military families.  And then, some of the private insurances like Aetna, Blue Cross will pay for our care as well.

Sunny Gault: Okay.

Misty Davies: It’s a matter of us switching from the HMO.

Susan Melnikow: It’s PPO! It’s the HMOs that are the issue.

Stephanie Saalfeld: It is.

Sunny Gault: I’m in the same boat ladies.

Stephanie Saalfeld: Darn it!  Next time, next time.


Misty Davies: But just out of curiosity, out of pocket, if someone were to have to pay out of pocket, what…, what does that look like?

Susan Melnikow: For Comprehensive Care, I believe we are at 6,600 dollars right now and that would include all of the Pre-natal Care, the birth and up through six weeks post-partum.

Stephanie Saalfeld: And lab work?

Susan Melnikow: And I think lab work…., lab work may be separate which would be about another 200 dollars.  It may be included, I haven’t kept pace with that.

Misty Davies: Seven…, sevenish.

Susan Melnikow: Now, should transfer to the hospital become necessary, that’s separate.

Misty Davies: Yeah.

Sunny Gault: Okay.

Susan Melnikow: But if you are covered by your insurance, your insurance will always cover that.

Misty Davies: Right.

Sunny Gault: Alright, well, when we come back, we are going to find out exactly what kind of experience you can expect at a birthing center throughout your labor and delivery.  We’ll be right back.

[Theme Music]

Sunny Gault: Welcome back.  We are talking about birthing centers as a possible alternative to hospitals and joining us is Susan Melnikow.  She’s a Certified Nurse Midwife, right here in San Diego with Best Start Birth Center.  So, let’s talk about labor and delivery and what women can expect.  At what point do you recommend moms come in to the birth center to start laboring there?  Because I know in hospitals, you know, you have to be a certain amount of centimeters and whatever, but are you limited with space?  Like how does that work?

Susan Melnikow: We encourage moms to stay home as long as possible, just because I think it’s a comfort thing.  I think moms do well at home.  But like I said, we usually talk to people two or three times while they are in labor and we help guide them.  Now of course it depends on if it’s a first baby…

Sunny Gault: Yeah.

Susan Melnikow: …or a subsequent baby and what her previous experiences have been.  It also depends on how far away she lives, because we do have moms coming far distances and so, we really individualize what we decide to do at that time.  In general, we have people come in when we think they are in active labor and we try not to actually admit them to the birth center until they are about four centimeters.

Sunny Gault: Okay.

Susan Melnikow: So, sometimes, we are really lucky that we are close to Balboa Park.  Sometimes a mom will come down…

Sunny Gault: Go take a walk…

Susan Melnikow: Yes! Exactly.  And it’s a beautiful place to walk.  And then she’ll come back in an hour or two and we’ll see what’s going on.

Sunny Gault: I had to do that, but I had to walk the halls of the hospital!


Susan Melnikow: Right.

Sunny Gault: Not as pretty as a park, really.

Susan Melnikow: Right.

Sunny Gault: Okay. So when they first arrive, is there some sort of process to…, you obviously check them out to see how far dilated they are?

Susan Melnikow: We will check and see how far dilated they are, we’ll kind of check and see what their contractions are doing.  We check their blood pressure and their pulse and we listen to the baby’s heart beat.  We check the baby’s position to make sure that we haven’t made a mistake earlier that the baby’s in a good head down position and just assess everything so that we know that mom and baby are really healthy and appropriate to be at the birth center.

Sunny Gault: Okay. And then, how many rooms…, I know this will vary on a case by case basis, but how many birthing rooms do you guys have available at Best Start?

Susan Melnikow: We have three birthing rooms.

Sunny Gault: Okay.

Susan Melnikow: And we…., and we birth an average of about 20 babies a month, and we find that most of the time, it’s not an issue.

Sunny Gault: Okay.

Susan Melnikow: Yeah.  We…, I’ve worked there two and a half years and this week, for the very first time [Laughs], we had four and we ended up using our Call Room.  The mid-wives have a call room with a bed and we ended up using that but it…, like I said, that’s the first time that’s happened.

Sunny Gault: That’s ever happened.  Okay.  Because that may be a concern of some women because you think hospital, they'd probably be able to accommodate you, but a smaller center, how does that work?

Susan Melnikow: But we were…, yeah, we were still able to accommodate and it worked beautifully.

Sunny Gault: Okay. And how involved are you with your clients, when they are in labor?  Because that was one of the things, when I had my first, I had an OB and it was situ…, it was in a hospital, but it was a situation where I didn’t know who was going to be on-call.  But with OBs, you know, you are primarily taken care of by your nurse, okay, and then they just kind of come in for the grand finale.  You know?

Susan Melnikow: It’s the opposite.  We practice opposite.  When a mom calls in labor, she talks directly to the mid-wife that’s on-call and usually, I talk to people two, three times before it’s time for them to come into the birth center.  When they…, when we decide it’s time for her to come in, I’m the one that meets her.  The mid-wife provides all the direct care.  We do all of what a nurse would do in a hospital and then, when she’s really active, you know, a couple of hours before we think she’s going to birth, we call an RN in.

Sunny Gault: Okay.  I see.  Okay.

Susan Melnikow: Or a birth assistant.  We have mid-wives and nurses who work in that role.

Sunny Gault: Okay, so how many people are usually there?  Another thing that I remember from giving birth is that, when the big finale comes, suddenly, there’s 10 people in the room and crotch is wide open!


Susan Melnikow: Usually, from our side of staff, we only have two people.

Sunny Gault: Only two people, that’s nice. It’s nice and intimate.  You know.

Susan Melnikow: Yes. And that’s a big reason that some people choose to come. It’s much more personalized and intimate than it would be in a hospital.

Misty Davies: Yeah, there’s not the random nurses and doctors and students and…..

Susan Melnikow: I know!


Susan Melnikow: That’s right.

Stephanie Saalfeld: So, what happens if something goes wrong and the mother or the baby needs….

Susan Melnikow: In labor?

Stephanie Saalfeld: Yeah.

Susan Melnikow: Okay. Well we are assessing very carefully.  You know we don’t use external fetal monitors during labor.  We are actually accredited, we are Nationally accredited by The American Association of Birth Centers and one of their criteria is that we are not to use external fetal monitors which are used extensively in the hospital and the reason for that is that, actually all the studies and research that’s been done, shows that they are useful for high-risk pregnancies but they’ve never been shown to actually make a difference in low-risk pregnancies.  So, rather than using that, we use intermittent oscillation, we call it.  We are listing to the baby’s heart rate every 20 minutes and then as the pregnancy…., as the labor progresses, we listen more frequently, up to every five minutes, when the mom is pushing.  But, through that, we are evaluating whether or not we think the baby is doing well.  So one of things that can happen is, if we are listening to the baby’s heart beat and we are concerned, we may say, “You know what?  We think we need to go to the hospital because that’s going to be a better place for your baby”.  Or if the mom’s blood pressure starts to go up, that’s another thing that can occur.  So then we would talk with the mom and her family and say, “You know what?  We really think that probably transferring to the hospital is a better scenario”.  Generally, our transfers are not emergency transfers, and we go in a car to the hospital.  We contact the hospital and the physician that we’ve decided to work with, make sure that they have room and that they are expecting us.  We make copies of everything that’s gone on and then we go over to the hospital.  Obviously, if we have an emergency situation, we call 911.  We do use the….  But then that’s seldom that we have a transfer like that.

Misty Davies: Okay.  I was going to say, how many times does that usually happen?


Susan Melnikow: We…, in all, overall, we have about a 15 percent Transfer Rate of moms who start labor and then end up going to the hospital and the bulk of that is the mom who actually looks at us and says, “I want an epidural.”

All: Oh!


Susan Melnikow: It’s not because there’s an issue.

Sunny Gault: Right.

Susan Melnikow: Yeah.

Sunny Gault: And what kind of numbers should we be looking for?  I mean, is that a pretty average number for birth centers?

Susan Melnikow: I think for a birth center that probably is, there may be birth centers that have a lower rate, but we are pretty busy.

Sunny Gault: Sure.

Susan Melnikow: You know, we take care of a lot of women.  So…

Sunny Gault: Sure, sure.  Okay.  Now assuming that a mother is able to give birth at the birth center and isn’t transferred, what happens after the baby’s born?  How long do they stay there and what kind of care do they receive?

Susan Melnikow: That’s another thing that’s very, very different because it’s a much shorter stay than it would be at the hospital.  We take care of the birth.  We are prepared if the mom has had little tears, you know, we are prepared to stitch it.  We are checking the mom’s blood pressure and pulse, the amount of bleeding she’s having and we are doing that very frequently, for the first hours after birth.  The mid-wives are trained to do physical exams on the new-borns, so we do a full physical exam on the new-born, we are doing the vital signs to see what the heart rate is and the respirations of the baby and in general we have a policy that the minimal stay is four hours.  But our average stay seems to be about six to eight hours.  And then about that point, moms really kind of want to go home and get in their own bed.

Sunny Gault: I see.

Misty Davies: Well it sure is better than several days at the hospital.

All: Yeah!

Susan Melnikow: So our criteria, you know, are that mom and baby are both stable, baby has nursed well.  We want to know baby can nurse before we send them home.  Mom has been able to get up and urinate, take a shower, feels good, has had a meal, and then we know that everybody is good.  We do provide a home visit the following day and we contract with Whole Life Home Care which Vicky Wolfrum who is a Nurse, Mid-wife and a Lactation Consultant.  And she goes and visits all of our moms in the first two days after.

Sunny Gault: Well, you don’t get that in a hospital, do you?


Stephanie Saalfeld: Do you have a Lactation Consultant visit you while you are in the center?  Or…,

Susan Melnikow: Not a Lactation Consultant.  All of the mid-wives have experience…, a lot of experience and training with breastfeeding.  So that is one of our really big things.  We…., we…, when the baby is born, we lift the baby right on to the mom’s chest and the baby isn’t taken any place else.  And I firmly believe that, that makes a huge difference on how the baby gets going with the breastfeeding.  If there isn’t a lot of disruption.  We usually don’t even weigh the baby for the first several hours.  It’s one of the last things we do, because we want…, when baby settles in on mom’s chest, they really get ready to nurse and we usually get them nursing within about 20 to 30 minutes and we don’t disrupt them until we know there’s been really good nursing experience going on.

Stephanie Saalfeld: That’s great.

Sunny Gault: What are some of the questions that we should be asking birthing centers in our area to determine if it’s a good fit?  Obviously, we want to go in and we want to explore that, but I know a lot of women are concerned about like what their stats are for different things.

Susan Melnikow: Yeah, no.  I think it’s important to know how long a center has been around and what the experiences of the mid-wives who staff it.  You know, how much experience and what their training is.  And then, what the Transfer Rate is.

Sunny Gault: To a hospital, if they have to go to a hospital.  Okay.

Susan Melnikow: To a hospital, right. And what the reasons are for the transfer rate and…, what the affiliations are; are they affiliated with a hospital, so that it will be an easy, you know, transfer?  Are they affiliated with physicians?  And …., you know, just to explore those kinds of things, so that you know that it’s all covered.

Sunny Gault: Alright.  Well, thank you Susan…

Susan Melnikow: Okay!

Sunny Gault: …for sharing your wisdom, your knowledge with us today, we really appreciate it.  Of course we’d love to learn about your experience giving birth at a birthing center or if you have additional questions for us about today’s topic, let us know and we’ll contact Susan and see if she can answer those questions for you.  You can also share your experience on our Facebook page or leave a message in the comment section for this episode on our website.

[Theme Music]

[Featured Segments:  From Our Listeners - Never Considered Surrogacy Before!]

Sunny Gault: We’ve a message from one of our listeners.  This comes from Christen of Fort Collins, Colorado.  Christen writes:  “Hi Sunny, loved, loved, loved the episode on Surrogacy.  I’ve actually never thought about it as an option for me, but listening to your show has made me re-think the possibilities.  My husband and I had some difficulty getting pregnant the first time and for a while, we weren’t even sure if we could have our own children.  If that had been the case, we may have needed a Surrogate of our own.”  Christen, thank you so much for writing in, we love sharing all this information with our listeners.  That wraps up our show for today.  Coming up next week, we are exploring The Benefits of Professional Birth Photography.  Thanks for listening to Preggie Pals, your pregnancy, your way.


This has been a New Mommy Media Production. The information material contained in this episode are presented for educational purposes only.  Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts.  Though such information materials are believed to be accurate, it is not intended to replace or substitute for professional medical advice or care and should not be used for diagnosing or treating health care problems or disease or prescribing any medication.  If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.

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