Frequently Asked Questions
What Is Best Start Birth Center?
Best Start is the longest established state-licensed, nationally accredited, free-standing birth center in Southern California. That means we are not part of a hospital or HMO. It is a private practice operated by midwives. We refer clients for physician if needed, but the physicians do not practice in the birth center. Midwives attend all of the births in the birth center.
What Does Best Start Birth Center Do?
Best Start provides prenatal care, birth, recovery, post-partum care, well-woman care, and contraceptives for our clients. Our birth center has comfortably decorated private birth suites with private attached bathrooms. Best Start features large tubs for water births, essential oils- diffused into the air, or massaged onto the skin. (Best Start offers a variety of oils for use for a minimal charge), birthing balls, birthing stools, and other items that provide comfort and allow the laboring woman to find a position that is most suitable for her during her labor and delivery. We also work with our moms to find doula support, (for those who seek this), and other therapeutic resources which aid relaxation and emotional balance, relieve stress, and promote effective labor.
Do I Qualify to Birth at the Birth Center?
No underlying medical conditions and no previous cesareans. (Under certain circumstances, women with a previous cesarean section who are planning to deliver in the hospital may get prenatal care at the birth center).
A positive drug screening test would result in disqualification to give birth at the Birth Center.
BMI (Body Mass Index) should be below 40. Calculate your BMI.
One baby, Head down by the time labor begins. We handle only single pregnancies; multiples require more monitoring. Most babies turn and stay head down around 32-34 weeks, but some take their time. As long as baby is head down by the time labor begins, you are still qualified to birth at Best Start
* If you have a concern about whether or not you are low risk, please speak to our clinical director.
How Do We Pick Our Midwife / How Do We Know Which Midwife Will Be at Our Birth?
During your prenatal care, you will meet all of our midwives. You are not assigned to a specific midwife, so when you go into labor, you just call the midwife on call. You both discuss when it is time to come to the birth center. When you arrive in labor, the midwife will meet you at the birth center and remain with you for your entire labor. As your labor progresses she will call the nurse on call to assist with birth. About two hours after birth, if all is well, the midwife signs out and the nurse stays with you for the rest of your recovery in the birth center.
How Long Will I Stay After Birth?
Most of our ladies are ready to go home about six hours after baby is born. Shortly after the birth of your baby, a nurse or midwife will visit you in your home or at the birth center. She makes sure you are healing properly, that the breastfeeding is going well, and addresses any questions or concerns you may have at that time. Then you have a one week, two week, and six week post-partum visit at the birth center.
If You Do Not Have Epidurals Here, How Do You Help With the Pain?
To promote your comfort in labor, we do not use fetal monitors that strap to your tummy. We want you to walk around and change position freely, and we check the baby’s heartbeat periodically with a Doppler, that gives us the information we need. We strongly encourage you to take a childbirth class. We want you to eat and drink while in labor. • We can use IV’s, but do not use them routinely. • You are encouraged to bring any items you need for your comfort, candles, music and incense are very popular. • We do not have an epidural service, but we use natural methods stemming from complimentary therapies, such as massage, healing touch therapy, acupressure, and aromatherapy. • Laboring in the tub is also an option. You may give birth in any position you choose, side-lying, standing, squatting, hands and knees, or in the water. You may have Dad receive the baby himself, or you may receive the baby into your own hands if you desire. In any event, the midwife will be there to assist. Immediately after birth, the baby goes to the breast, and Dad cuts the cord when it stops pulsing. Then the midwife delivers the placenta and checks for any repairs. We do not do episiotomies routinely, and our midwives are very good at helping you to stretch naturally, so any repairs they must make are usually superficial.
What Is a Midwife?
A midwife is a professional provider of services for women who are essentially healthy. In California there are two pathways to becoming licensed as a midwife. Certified Nurse-midwives are licensed by the Board of Registered Nursing. They are registered nurses with Masters level education in midwifery care. Certified Nurse-midwives practice in various settings: hospitals, clinics, offices, birth centers, and in the home.
Licensed Midwives, (also called Certified Professional Midwives), are licensed by the California Medical Board and usually are not nurses. Their preparation is specifically for practice in the home or a birthing center.
Best Start midwives, both LMs and CNMs, follow the same high standards that are renowned for providing excellent outcomes. Evidence has repeatedly demonstrated that the midwife-led model of care produces great outcomes at reduced cost to payers and the public, and increased satisfaction by the consumer. These high quality outcomes improve the quality of life for mothers and babies, improving the health of our communities.
How Often Do Women Have to Be Transferred to the Hospital in Labor?
In labor, about 13% of our ladies are transferred to the hospital. The number one reason is labor has stalled and is no longer progressing. A stalled labor is very disappointing but is NOT an emergency. In any non-emergency the woman is transferred to the hospital of her choice. • We have three nearby hospitals for emergency and non-emergency transfers: Scripps Mercy which is a tertiary level hospital, Sharp Grossmont, and Sharp Mary Birch. • For emergencies, we call an ambulance and transfer to Scripps Mercy. • Of our ladies who are transferred to the hospital, only a few are delivered by cesarean, for an overall rate of less than 4% for the birth center. (C-section rate for the US is 32.8%, according to the National Center for Health Statistics Report, (Oct.2012) • At 28 weeks or sooner, Best Start recommends that all patients take a hospital tour. In the unlikely event of a hospital transfer, we want you to rest assured that the care you receive will be in you and your baby’s best interest. Our local hospital physicians and nurses are an extended arm of our team. We couldn’t be here without their support. They are always available and provide the expert care our transferred mothers and babies need. They are an integral part of why we have the good outcomes we are so proud of, and grateful for. When you visit them for a tour, please keep in mind that their services address special circumstances and their high technical units are what a transferred mom or baby needs. This network of support allows Best Start Birth Center to provide natural childbirth services to our clientele. Amongst the physicians and hospitals that accept inter-facility transfers for the birth center, are the Resident and Attending Physicians at Scripps Mercy and our Consultant, Dr. Lac Vu, MD who accepts our transfers at Sharp Grossmont Hospital. Together, these physicians and hospitals have accepted patient transfers for over 25 years. While we understand that a transfer may be disappointing, our excellent outcomes for mothers and babies are the result of the expert care provided by our local hospital physicians and nurses. Please remember that while the atmosphere and procedures in the hospital are quite different from those at Best Start, like us, they are dedicated to the health and well-being of mothers and babies and deserve the support and respect of all of us.
What Can Best Start Offer That Hospitals Can’t?
Some of the things Best Start Birth Center can offer that hospitals cannot are: • Continuity of care: The people you see during your prenatal appointments are the people who will be at your birth. • We have an experienced staff dedicated to providing sensitive individualized care that honors the miracle of birth. • All of our nurses and midwives are experienced in their field. • In labor you will receive one-on-one care and support from your Midwife and/or nurse. • Options – You choose how you birth, who will be present and in what atmosphere. More importantly, you always have the option to change your mind.
If You Only Have Three Birthing Rooms, What Do You Do if There Several Ladies in Labor at Once?
We seldom have more than one lady in labor at a time. If we do have more than one lady in labor, we call in more staff. We have never been so busy that we have to turn our clients away.