Birth

Hospitals operate as bustling, crisis-oriented places. Such institutions are for sick people, and pregnancy is not considered an illness by supporters of a new kind of environment for giving birth—the alternate birth center. Alternate birth centers were developed because many parents objected to what they felt to be the impersonal, needlessly technological, and increasingly expensive childbirth procedures available in the conventional hospital setting. As a growing number of women chose to give birth at home, the risks involved became a concern. Alternate birth centers, then, are a response to both the dissatisfaction with hospitals and the hazards of home births.

These centers were all but unheard of in 1969. Within a few decades, at least 1,000 had been established, and the trend continued into the early twentyfirst century. In 1978 the medical establishment officially endorsed many elements of this alternate care, recommending that it be included in conventional maternity services. Out-of-hospital facilities for the management of low-risk deliveries were also established.

Alternate birth centers provide a relaxed, homelike atmosphere for the pregnant woman, her family, and the newborn. The most dramatic aspect of an alternate birth center compared with a conventional hospital is the room where the deliveries take place. Unlike the operating-room atmosphere to which laboring women are generally sent at the most uncomfortable, critical moment, the birthing room—the location of the woman's predelivery hours—is a cheerfully decorated suite resembling a bedroom. Women in labor move about freely. They rest as they choose and may be accompanied by their husbands, families, and friends. An attending nurse, midwife, or doctor delivers the baby into this low-key, family-oriented environment. It is dimly lit, quiet, and peaceful.

The new mothers, and those with them, report a sense of control and contentment in contrast to the anxiety and isolation experienced by many in the traditional delivery room. Many of these centers also encourage the participation of other siblings in various stages of the pregnancy and birth.

Following the birth, the new family remains in the birthing room, in close physical contact. The newborn is placed on the mother's bare skin (which can act almost like a "natural incubator") and has the first opportunity to suckle and enjoy eye contact. A soothing warm bath may be administered. In these first hours, bonding between the parents and child has a unique quality. In some birthing rooms, siblings may also share these special experiences. The entire family leaves the alternate birth center together, usually earlier than from the traditional setting.

For safety, birthing-room facilities keep a significant amount of emergency equipment hidden within the suite itself and deliver only low-risk births. Nonetheless, of these births, approximately 10 percent develop problems best handled in a more conventional setting. When located in a hospital, birthing rooms are usually adjacent to traditional delivery and operating rooms.