Frequently Asked Questions

1. What is a "freestanding" birth center?

A freestanding birth center is a home-like maternity center that is often in proximity to a hospital. Many hospitals call their labor and delivery wards "birth centers"; however, they are not the same. A freestanding birth center is designed specifically for healthy people choosing an out-of-hospital birth experience. Typically, a freestanding birth center utilizes a midwifery philosophy of care that is rooted in the understanding that with support and education, a pregnant person is the one most equipped to make the best decisions regarding their own health and the health of their children.

Unlike hospitals, birth centers never employ the following interventions:

• Induction and augmentation of labor with oxytocin

• Continuous electronic fetal monitoring

• Epidural anesthesia

• Cesarean section

Birth Centers do:

• Support physiologic birth

• Encourage labor using non-pharmaceutical methods

• Provide intermittent fetal monitoring

• Offer continuous labor support and use natural techniques to work with the intensity of labor

• Have lower rates of transfers leading to cesarean birth.
  

2. What is a midwife?

A midwife is an expert in normal pregnancy, birth, postpartum, and newborn care.

Midwifery philosophy is rooted in the understanding that:

• Pregnancy and birth are normal, healthy life events

• Pregnancy and birth can be very empowering experiences

• Midwifery care usually begins in pregnancy but often continues throughout the lifespan

• Midwifery care emphasizes evidence-based, personalized care with informed and shared decision-making. We understand that people will make the best decisions for themselves and their families. It is our job to ensure that adequate information and unbiased support are available for the decision-making process.

• Families benefit from midwifery care
  

3. Is it safe to have my baby at a birth center?

Giving birth is safe. Despite what is depicted in the media, people can give birth safely and physiologically. There are large, well-designed studies that have examined the safety of out-of-hospital birth. The results are conclusive; for low-risk pregnant people, out-of-hospital birth attended by a skilled provider and hospital birth of similar groups have equivalent safety outcomes. There are inherent risks regardless of where a person is giving birth, and having trained providers with medical intervention available, if needed, increases safety. Pacifica Family Maternity Center has a great relationship with Alta Bates and nearby Kaiser Hospitals. We prioritize safety in the out-of-hospital birth setting and will transfer to a hospital if a higher level of care is needed at any time during care. Please see our Evidence section for more information on this topic.

4. Can I choose the midwife who will attend my birth?

The midwives at Pacifica have on-call days during which they attend births, days they are in the clinic, and days off. Our appointments are much longer than typical OB appointments to ensure you get to know and become comfortable with each member of our team. We will encourage you to join our prenatal groups, which will provide you with more opportunities for learning, sharing, and creating community. Our midwives are committed to helping you have the safest and smoothest birth possible by providing care that is personalized to you and your baby. Our midwives have a shared philosophy and practice under the same guidelines, so you can be assured that you will receive consistent care.

5. Can I have a water birth at Pacifica?

Pacifica is equipped with tubs in each of our birthing suites, and many women choose to labor and even give birth in the water. You will be encouraged to find your own path and what is right for you and your baby. You can read more about the safety of water birth in our resources section.

6. What are my pain management options for labor and birth?

The experience and intensity of giving birth are unique for each person. As such, our approach to working with each person in labor is unique. During your prenatal care with the midwives, the topic of managing labor sensations is discussed extensively.

Some tools to manage pain include:

• Continuous physical and emotional support and guidance

• Water therapy, including a luxurious tub and shower

• Labor and birth sling

• Nitrous oxide

• TENS unit

• Hot packs

• Freedom of movement

• Massage

• Freedom to eat and drink as you please

• A private, peaceful environment that you can make your own

• A small number of our clients will require pharmacologic pain management. In the event that medical pain relief is requested, we will support your decision and accompany you to the hospital.

7. Can I see the birth center and meet the staff before deciding?

Yes! We strongly encourage you to come to one of our orientations to see the birth center, ask questions, and meet the midwives. You are welcome to bring your family or support people to an orientation. Please sign up for an orientation session.

8. What if there is an emergency during my birth?

In the rare case that a complication does occur, we are prepared with the equipment, medications, and skills to handle emergencies. In addition to having oxygen and suction equipment on hand, the midwives can provide intravenous infusion (IV) and have emergency medications readily available if they become necessary. At least two skilled and licensed attendants will be present at your birth, and our midwives are all trained in infant resuscitation. An ambulance transfer is rare, and most problems can be resolved without leaving the birth center. Most transfers to the hospital occur simply because the birth is taking very long and the client needs medical assistance to augment their labor.

Pacifica is an accredited freestanding birth center. We follow the standards set by the [American Association of Birth Centers][3]. We are located in proximity (4 blocks) to Alta Bates Hospital and will transfer your medical care to the skilled physicians at Alta Bates if needed. To ensure that you are always supported, one of our staff will remain with you in the hospital for the remainder of your birth and during the immediate postpartum period.

9. Do I need an OB/GYN or MD as well as a midwife for my prenatal care?

The midwives can provide all of your prenatal labor/birth and postpartum care, including referrals for ultrasounds and all standard lab work. You do not need a physician involved in your care, unless a complication arises, in which case we can refer you to an OB/GYN for consultation, concurrent, or a transfer of care. You are welcome to have concurrent care with an OB/GYN if you'd like.

9. Can anyone give birth at a freestanding birth center?

The birth center is open to families who received their prenatal care with the midwives at Pacifica. At the initiation of care, all people will be screened for risk factors that are outside of the scope of midwifery care. Risk assessment is an ongoing process throughout pregnancy, labor, and post-partum. We are committed to prioritizing our clients’ safety.

10. Can I use my insurance plan to cover midwifery care at the birth center?

We partner with EarthSide Billing, Inc., an independent service which specializes in billing insurance companies for midwifery care and community birth. EarthSide can submit claims to most PPOs. They may be able to assist you in obtaining a gap exception for some HMOs, but there is no guarantee requests will be approved. We cannot guarantee that your insurance company will pay claims, or how much they will reimburse. 

11. What if I don't have insurance or need financial assistance?

We make care more accessible by offering a sliding scale as well as alternative payment plans. Sliding scale eligibility is based on household income, family size and financial need. Email us at midwives@pacificamaternity.com if you wish to apply.