Birthing Centers

Thesis Statement

Birthing Centers remain a controversial issue but it is an option for mothers in country. This paper helps in understanding the main concept of birthing centers and issues and problems regaring it for the women and people who seek information about birthing centers.

Introduction

The news about woman's pregnancy brings happiness to many families at the same time. Nevertheless, this happiness is connected with number of possible difficulties and questions. One of the most important is right choice of birthing. Today most families prefer one of the three possible variants; hospital, birthing centers or home facilities. Each variant has its both advantages and disadvantages. But majority of doctors recommend birthing centers as best choice. This topic will provide a brief history of the development of birth centers in the United States.

Birthing Centers Concept

A birthing center is a healthcare facility, staffed by nurse-midwives and/or obstetricians, solely for laboring mothers, who are aided by doulas and coaches. By attending the laboring mother, the coaches and doulas can extend the span of the nurse-midwives. The nurse-midwives serve to assess the stages of labor, and to monitor the well-being of the mother and fetus during birthing to determine whether hospital-based backup due to complications, is needed (Rooks et al, 321-324).

History

For most of the 20th century, out-of-hospital birth took place in maternity homes, clinics, a birth room in a doctor's office, or the home of the mother. During the first half of this century, such sites served women who did not have access to, could not afford, or did not want, the services of physicians and acute care hospitals. During this era, the first nurse-midwifery services were established to provide care for the poor. Some examples are Kentucky's Frontier Nursing Service, New York City's Maternity Center Association, and Santa Fe's La Casita, which was operated by the Medical Mission Sisters (Jackson et al, pp 93-99). However, most midwifery care during the period from 1925 to 1945 was provided by a mix of "lay midwives" serving poor women, well-trained midwives who had immigrated from European countries with developed midwifery professions, graduates of a few short-lived American midwifery training programs, and self- or apprentice-trained midwives who filled in to meet needs.

The proportion of births occurring in hospitals rose from 37 percent in 1935 to 97 percent in 1960, and reached 99 percent by the 1970s. Several developments after World War II led to this change: (1) The GI Bill broadened opportunities for medical education, which resulted in doubling of the number of medical schools and new physicians; (2) the Hill Burton Act promoted the construction of community hospitals, which improved access to hospital care; (3) hospitals offered methods of pain relief in labor not available in the home; and (4) the expansion of employer-based health insurance and the creation of Medicaid provided insurance coverage for most pregnant women, but only paid for maternity services provided by doctors and hospitals, not out-of-hospital births (Fullerton, pp 33-37).

As a result, birth moved from mostly in homes to ...