Birth Center and Hospital Choices

At Special Beginnings, we understand that:

  • You are giving birth and it is our job to support you in doing that.
  • A woman’s stress or anxiety affects the labor and birth.
  • You may intuitively know where you want or need to be.

For these reasons, we support you fully in choosing to give birth in whichever place has the least stress for you: the birth center OR at AAMC hospital.

Best of all, while you can decide the location in advance, you do not need to decide before you go into labor. We encourage you to start at the birth center because there is plenty of time to transfer to the hospital if necessary.

Explore your choices throughout labor and birth
with Special Beginnings:

  1. Facility
  2. Safety
  3. Freedom
  4. Pain Management during Labor
  5. Interaction with Staff
  6. Family Interaction
  7. Necessary Interruptions During Active Labor
  8. After the Birth
Facility
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Rooms Birth Center rooms are intimate, like a bedroom, also with natural light. The bed is large enough for you and your family to sleep upon. There is also a couch in the kitchen for family members to take a nap. Hospital rooms are quite large and comfortable, with lots of natural light. There is also a pullout couch that the father or other family members may use.
Showers, Jacuzzis & Tubs Full-size private shower + 2 Jacuzzi’s and birth pool available. Full-size private shower
Beds Double bed. People support your body if you need to rest on something in a particular position. Single bed. The head can go up and foot can go down, and can be like a lazy boy chair. There is also a squat bar on the bed and foot and leg rests if you want them.
Many pillows are available and if you have particular pillows you want from home, you are welcome to bring them. YES YES
Birthing Support Tools YES. Birth balls and birth stools, which are excellent for a supported squat. YES. Birth balls and a squat bar on the bed.

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Safety
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Oxygen and suction equipment available YES. The emergency equipment is readily available in cabinets in the birth rooms. YES. The emergency equipment is readily available.
Staff trained in emergency procedures for moms and babies, including neonatal resuscitation YES YES
Adequate time to get to emergency care if needed YES. We are vigilant in paying attention to you and your baby. We are trained to support normal birth while screening for the abnormal situations, which tells us whether or not we need to go to the hospital. We do not wait until the situation is urgent. An emergency cesarean section is extremely rare. YES

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Freedom
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
To labor/birth as you desire YES YES
To share the birth with children, family, and friends YES YES
To wear your own clothing YES. Your wear whatever you wish. No special gown provided by the birth center. The staff typically wear everyday clothes. NO. You wear a hospital gown and the staff typically wear cheery hospital scrubs.
To eat whatever food works for you YES. You can eat the food that works for you. The birth center staff will advise you regarding good choices for keeping your energy up during labor. NO. You may ingest clear fluids only – no solid foods, due to hospital-wide anesthesia policies. 

Your family may get whatever is available from the hospital cafeteria or bring their own. There is an assortment of local restaurants nearby.
To go outdoors if you want to during labor YES. We have a small private lawn area behind the birth center with lovely landscaping. NO. There are lovely views of the atrium or the outdoors from the birth rooms.
To have peace, privacy and dignity during labor and birth YES. Usually you are one of two families giving birth at the birth center, so it can feel like it is your own home. There is a nurse and a midwife in addition to your support team. We minimize interruptions to the best of our abilities. YES. It sometimes requires more effort on the part of your support team to ensure this for you, due to the length of the labor, other events going on in the hospital, and change-over in staff during that time. The staff are very respectful of your wishes.
To have a Vaginal Birth After Cesarean (VBAC) NO. Even if you have already had a successful VBAC, we can only support your VBAC at the hospital. YES. AAMC is wonderfully accepting of mothers who prefer to have a VBAC.
To switch to this facility with Special Beginnings, even late in your pregnancy YES YES

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Pain Management during Labor
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Pain medication available YES. Tylenol to synthetic narcotics. YES. Tylenol, narcotic analgesia and epidural anesthesia are readily available.
Labor Tubs YES. Warm water is a primary tool for pain management in labor for many women. NO
Movement & Breathing YES YES

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Interaction with Staff
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Nurse-Midwife support during labor and birth YES YES
Tech at the birth: records birth time and infant weights as it happens NO. The birth center staff take care of these tasks without adding another person in the room at your birth. YES. This staff person is only called into the room when the birth is near, and is sensitive to your experience. Sometimes they have even volunteered to take pictures for families.
Nurse support during labor
(most of the time the nurse-midwife is with you)		 YES. It is likely you will be with the same nurse as your birth attendant for the whole birth. YES. At the hospital, it is likely that more than one nurse will care for you during labor and birth.
Doctor presence during labor or birth Transfer to hospital if needed. Your nurse-midwife is still your primary care provider. Only if needed. Your nurse-midwife is still your primary care provider.

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Family Interaction
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Fathers/significant others can participate fully YES YES
Photography allowed YES YES
Video allowed YES NO
Visitor Policies As many as you have invited and can fit in the room while the midwife is moving around and meet the fire code. During Labor: Limit 5 visitors in the room. If not in the room, visitors are asked to leave the unit and go to the waiting area.

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Necessary Interruptions During Active Labor
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Take vital signs During labor: every 4 hours unless a reason to do it more often

After birth: every 30 min. for 2 hours. At the birth center we use a manual BP cuff so you are more comfortable.

 During labor: every 15 min of every hour.

After the birth: every 15-30 min for 2 hrs. using an automatic BP cuff, which is left on your arm continually for couple hours. If you have an epidural, this can make it so you have to have your blood pressure monitored more.
Monitoring your baby during labor YES – At the birth center, we use a doptone, which is not considered as invasive by some mothers because it is momentarily on the belly. It is a handheld electronic instrument with a speaker on it that allows everyone to hear the baby’s heartbeat. This is also used at prenatal visits at the birth center. We also have doptones that can be used underwater as well. YES – At the hospital, the fetal monitor is used 20 minutes out of every hour. It can be worn while you are out of bed or moving, just not out walking the hall. This kind of monitor is held on the belly with belts. It is standard care to have continuous monitoring when you have an epidural or Pitocin during labor.
IV placed in your arm This is not done at the birth center unless it is necessary. At the hospital, we need to start an IV, saline lock, and draw blood right away as part of the protocol. The IV can be disconnected to allow you to move around as needed.
General amount of interruption of your labor process for monitoring The birth center has less traffic and more focus on your birth, without interrupting you.

We’re paying attention to contractions and can see and hear your breathing because we’re in the room with you. Amount of attention you receive  depends on what you want/need. Can be quiet and have time alone if you need it. We do what we need to do, without unnecessarily interrupting or interfering with you. Can also be giving lots of care, rubbing backs and feet.

 Facilities are more spread out at the hospital, with no lingering in the halls. This encourages the nurse-midwife and nurse to be in the room with you quite a lot. Some mothers find this comforting and others find it interrupting or invasive. We will be attentive to your desires.

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After the Birth
Features & Services At the birth center
with Special Beginnings		 At AAMC hospital
with Special Beginnings
Immediately after the birth: Let you hold your baby as long as you want after the birth. This bonding time is well-documented as crucial in the life-long development of your child. Your baby rarely leaves your arms for the first two hours after the birth. Your baby is examined on your belly as much as possible, maximizing your skin-to-skin time. This bonding time is supported by most nurses at AAMC. The hospital policy is to examine your baby within first 20-30 minutes after the birth on an infant warming bed in your room.
Lactation support available: Breastfeeding care and teaching and available at the birth. No matter where your birth occurs, there is follow-up available at the birth center with our lactation consultants, classes and breastfeeding boutique. YES – Experienced Nurses at the birth help with initial breastfeeding. YES – Lactation consultants see you before you leave.
Typical length of stay after the birth The minimum stay after the birth at the birth center is 4 hours. You can stay longer if needed and are discharged by the nurse-midwife. It is most common to stay at the hospital at least 24 hours after the birth. Your baby is discharged by a pediatrician. You will be discharged by the nurse-midwife or doctor responsible for your care.
Pediatrician You need to have baby seen within 72 hours by your own pediatrician. The birth center does not require your pediatrician to come to the birth. If your pediatrician does not have privileges at this hospital, the staff pediatrician will do your baby’s first exam and discharge from the hospital.
Circumcision (if desired) The birth center staff can help you make arrangements for circumcision within first 2 weeks of life. Circumcision can be done in the hospital the day after the baby is born, often before discharge.
Next Day Check-in YES. Your nurse-midwife will call you at home the next day to check in. YES. Your nurse-midwife makes rounds and visits you the next day.
Scheduled follow-up within first 2 weeks after the birth YES. 

  • If you live within an hour’s drive from the birth center, a nurse  will do a home visit the third day after the birth.
  • You will receive a follow-up phone call 2 weeks after the birth.
 NO. You are welcome to contact us with questions at any time.

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