Delivery Procedures in Out-of-Hospital Birth Centers and Hospital Birthing Rooms

Out-of-hospital birth centers and in-hospital birthing rooms offer a number of options to couples expecting an uncomplicated labor. Most birthing centers are run by certified nurse-midwives, with a physician as a backup in case a complication arises. They are usually located outside a hospital and accept only low-risk women as clients. In-hospital birthing rooms offer many of the same options as birthing centers do, but are located in the labor and delivery area of a hospital and utilize the hospital staff. If your caregiver is a physician, the nursing staff will monitor and care for you during labor. Your physician will arrive for the delivery. Occasionally, if your physician is in the hospital, He may visit several times during the labor. If you have chosen a nurse-midwife as your caregiver. she will often remain with you during labor to monitor your progress, as well as to perform the delivery.

Only a few hospitals still require women to labor in one room, transfer to a delivery room, move to a recovery and eroding room, and finally go to a postpartum room.

The majority of hospitals have birthing rooms, also known as LDRs (labor, delivery, recovery), where a woman stays until she is transferred to a postpartum room. The newest form of birthing room is the LDRP (labor, delivery, recovery, postpartum), in which a woman remains for her entire hospital stay. This type of birthing room is the closest in concept to the birth center.

In both birth centers and birthing rooms, attractive surroundings make foe room homelike, with the necessary radical equipment hidden within furniture. Restrictions on visitors are minimal or nonexistent. Siblings may even be present for the birth. A woman is free to move about foe room and halls, and to labor in a comfortable recliner or rocking chair. Many facilities offer showers or tubs in which women can relax during labor.

In out-of-hospital birth centers, few interventions are used and only if medically necessary—for example, IVs, fetal monitors, and draping are not routine.

Women are encouraged to eat and drink as they desire. Most birth centers have regular beds, which allow the woman to choose whatever position feels most comfortable to her. She may even deliver on a birthing chair or stool. At foe moment of birth, foe mother and father can reach down and lift their baby up onto the mother’s bare abdomen. The infant is never separated from the parents to go to a nursery; all exams are done in the same room. Several hours after birth, when the mother is ready to get washed, she may take her baby into the tub with her for his first bath. Birth center philosophy considers not only the mother’s physical needs, but also her emotional and spiritual concerns. Families play an integral part in planning the birth to provide a safe delivery in a loving, caring atmosphere. The woman and the baby usually go home within 6 hours after the birth and are followed closely by the nurse-midwife via telephone conversations and an office or home visit during the first days.

Most in-hospital birthing rooms have birthing beds that can be maneuvered into various positions. A common delivery position elevates the woman’s back and places her feet in footrests or stirrups. The lithotomy position should be avoided. Many doctors are willing to try alternate positions that are more comfortable for the woman. At the time of delivery, the bottom of the bed is removed, an antiseptic solution is poured over the woman’s perineum, and her legs are draped. Not all doctors require stirrups or leg drapes to be used. Others do not use abdominal drapes, recognizing the importance of the skin-to-skin contact that is obtained when the newborn is placed on the mother’s bare abdomen following delivery. Many supportive doctors hand the newborn right to the mother to touch and caress as the family begins the bonding process immediately after birth. If you choose to deliver in a hospital, discuss these and all options with your caregiver to ensure an optimum birth experience.