Alternative Birth Center Research Articles

The Experience of Pregnancy: A Hermeneutical/Phenomenological Study

The aim of this study was to describe women's experience of pregnancy. The setting was the Alternative Birth Center at Sahlgrenska University Hospital in Göteborg, Sweden, from 1996 to 1997. Anonymous diaries were written by 12 women and analyzed using a hermeneutical/phenomenological approach. The essential structure and interpretation of women's experience of pregnancy can be expressed as "transition to the unknown," which includes three themes: (1) meeting one's life situation, (2) meeting something inevitable, and (3) preparing for the unknown.The essential structure and interpretation of women's experience of pregnancy can be expressed as "transition to the unknown" …

Reproductive Rights and the Medical Care System: A Plea for Rational Health Policy

Recently, there have been many challenges to women's reproductive rights and freedoms: court-ordered cesarean sections; criminal cases against women for prenatal child abuse; and attempts to limit the practice of mid-wifery, home birth, and the operation of alternative birth centers. In these cases, medicine has been complicit or proactive in attempts to control the behavior or health care options of pregnant women. We discuss medicine's role as an agent of social control, the medical reconstruction of problems that are social in nature, and the need for a more coherent policy framework to guide physician practices.

The need for pain relief in uncomplicated deliveries in an alternative birth center compared to an obstetric delivery ward

The need for pain relief during uncomplicated labour and delivery was studied in 125 women attending an Alternative Birth Center (ABC) and 170 women attending an obstetrical ward. The ABC was staffed only with midwives and assistant nurses who took care of all deliveries. In case of complications the doctor on duty at the obstetrical ward could come in a few minutes and the patient was transferred to the obstetrical ward. At the ABC the delivery room was next to the sleeping rooms and the living room and the woman in labour could have a chat with the women, who had given birth. At the obstetrical ward this was not possible. The delivery rooms were on one floor, and after giving birth the woman was moved to another floor. Women at the ABC were older and had a higher social status than women at the obstetrical ward. Twenty four of the 170 women had initially planned to give birth at the ABC but gave birth at the obstetrical ward due to accommodation restrictions at the ABC. Women refused by the ABC resembled women giving birth at the ABC but their need for pain relief was identical with the other women giving birth at the obstetrical ward. Pain relief with pethidine was 4 times more frequent among women giving birth at the obstetrical ward (18%) than at the ABC (4.8%). Pethidine was predominantly administered to young women and primiparas at the obstetrical ward and to women with prolonged labour at both birthplaces.

The Alternative Birth Movement in the United States: History and Current Status

The alternative birth movement is a consumer reaction to paternalistic and mechanistic medical obstetrical practices which developed in the United States early in this century. Alternative birth settings developed as single labor-delivery-recovery rooms in the hospital or as free-standing birth centers. Both alternatives offer family-centered, home-like, low technological maternity care. In order to overcome physician resistance to non-traditional maternity care, alternative birth center policies eliminate all women who are expected to have a complicated pregnancy or delivery. Physician resistance to alternative birthing is publicly based on the issue of maternal and infant safety. Additional issues, however, are that physicians fear economic competition and resist loss of control over obstetric practice. This paper (1) traces the historical antecedents and social factors leading to the alternative birth movement, (2) describes the types of alternative birthing methods, and (3) describes ways in which the obstetrical community has maintained and rationalized dominance over the birthing process.

Breast-feeding in a Danish alternative birth center compared with the obstetrical ward

In 1984 an Alternative Birth Clinic (ABC) was opened at the Copenhagen County Hospital in Glostrup. The ABC was opened on a trial basis to evaluate the demand for a different and more peaceful birth and nursing environment. The study was performed to illustrate how the place of birth can influence the delivery and the duration of breast-feeding. During the observation period of seven months there were 125 uncomplicated births at the ABC, and 170 uncomplicated births at the obstetrical ward. It was not possible to perform this study as a randomized one as delivering at the ABC was on offer to all women in this part of Copenhagen County. The newborn children at the ABC were nursed during the first 30 min after birth by 73.1% of the mothers compared to only 48.1% of the mothers at the obstetrical ward. On the fifth day after delivery 79.7% of the mothers at the ABC breast-fed without supplementary infant formula, while 95.1% of the mothers at the obstetrical ward breast-fed without supplement. Fourteen weeks after delivery 68.4% of the mothers who delivered at the ABC were breast-feeding without supplement, compared to 51.8% of the mothers who delivered at the obstetrical ward. The success of breast-feeding was found to have a positive correlation to higher social groups, delivering at the ABC, the number of antenatal care visits and increasing maternal age. The significance of these factors was tested in a regression analysis which revealed that birthplace and social group were the two factors that could explain the differences in the course of breast-feeding. Women referred to the obstetrical ward because there were no vacancies at the ABC (ABC-refused) followed in all aspects the mothers at the obstetrical ward. In spite of the groups not being randomized we feel that we can conclude, especially taking into consideration the results from the ABC-refused group, that the differences in the success of breast-feeding can be

Home away from home: The alternative birth center

Hospital alternative birth centers (ABCs) were established in response to consumer demands for ‘family-centered maternity care’. This paper considers the controversy among advocates of different childbirth alternatives, including ABCs, homebirth and conventional hospital birth. The expectations and evaluations of a sample of women who chose ABC births are compared to attitudes towards the ABC of women who selected homebirths or conventional hospital births. Women who choose the ABC and those who select homebirth share some critical views of conventional labor and delivery, but not the same overall ideology of childbirth. Women who choose the ABC and women who choose conventional labor and delivery share beliefs in the authority of hospital obstetrics and the expertise of physicians.

Characteristics associated with perineal condition in an alternative birth center

This retrospective study examines whether parturient preference to deliver without a routine episiotomy is viable. One hundred sixty-two women who delivered in an alternative birth center with the aid of nurse-midwives were studied. The incidence of episiotomies was 38%; 33% of the population delivered over intact perineums. First-degree lacerations were experienced by 21% of the population and second-degree lacerations by 8% of the women. Primiparous women with second stages lasting longer than 50 min who required anesthesia most often required an episiotomy. Neither the women who delivered without an episiotomy nor their infants appeared to suffer from the experience.

In-hospital alternative birth centers: where do we go from here?

In-hospital alternative birth centers: where do we go from here?

Nurse-midwifery prototypes: Clinical practice and education: The alternative birth center in jacksonville, florida: the first two years

Alternative birth centers (ABC) offer pregnant women a non-hospital, non-home environment in which to have uncomplicated childbirth. The experience at an ABC in Jacksonville, Florida, involving all patients laboring at the center from 9/11/80 through 4/14/82, was reviewed. One hundred and eleven patients were accepted into the center during the two-year period from April 1980 to April 1982; of these, 22 (20%) were transferred antepartum, 18 (16%) were transferred intrapartum, and 71 (64%) labored and delivered at the center. The Apgar scores of the 71 patients delivering at the center were greater than or equal to 8 at 1 min and 9 at 5 min. There were no fetal or maternal losses during this period, nor was there any significant fetal or maternal morbidity in this group.

Image and reality: An evaluation of hospital alternative birth centers

A survey of West-Coast hospital alternative birth centers showed that, although they are intended for that majority of women who expect to have normal, uncomplicated births, only a fraction of eligible women expressed an interest in using the ABC for their birth. Most hospital-alternative birth centers were used by 10% or less of the obstetric caseload. Moreover, the “alternative” aspects of alternative birth centers have been attenuated in many instances, so that they function more like regular labor and delivery units than like alternative-birth centers. It is suggested that these developments are the result of a lack of commitment to the concept of alternatives in childbirth, as well as to lack of promotion and publicity about the availability of alternative birth centers. Few hospitals allocate adequate staff or space to the alternative birth center. Finally, among obstetricians who are willing to. assist in an alternative birth center, some maintain traditional birth practices rather than offering alternative birth opportunities.

A faculty fellowship at maternity center association: An innovative approach in nurse-midwifery continuing education

The alternate birthing movement has burgeoned since the Maternity Center Association, in 1975, initiated the first demonstration project for family-centered care in a homelike out-of-hospital setting. Concomitant to this growth, consumers and future providers of health care, especially nurse-midwifery students, have demanded that maternity care educators include orientation to alternative birth center management in their curricula. The author discusses her participation in the Maternity Center Association's “faculty fellowship,” an innovation devised to meet these needs of students as well as her own needs for continuing professional growth.

Modifying Practices to Promote Family‐Centered Care in the Neonatal Intensive Care Nursery

ABSTRACT: The Alternative Birth Center (ABC) practice and outcomes at Mount Zion Hospital are described and compared to those in the regular labor and delivery area. In the ABC there were fewer cesareans, better Apgar scores at 1 and 5 minutes, less use of analgesia and anesthesia, but no significant difference in admissions of babies to the newborn intensive care nursery. The ABC has helped to make more flexible some of the newborn procedures. Several case histories are presented which illustrate ways that such care can be provided while responding appropriately to parents’concerns.

The Economics of Intensive Care for the Full‐Term Newborn

ABSTRACT: The nursery and labor/delivery unit have long been loss leaders in hospital accounting. However, Medicaid, Crippled (or Handicapped) Children's Services, Blue Cross and Blue Shield will make very high payments for intensive fetal and neonatal care. As a result, there was an increase of 18% in the number of neonatal intensive care units (NICUs) between 1977 and 1978, and a concomitant reduction in newborn nursery space. Because a large number of NICU beds, and a 75% occupancy rate, are required by local and professional standards, in order to fill NICU beds normal or very mildly sick full‐term newborns are being admitted. The number of tests and treatments were found to be lowest after rotation of residents in August, and to increase monthly until they rotated out in June. Of full‐term newborns, 18% were treated for jaundice and/or given septic work‐ups at one Level II hospital. At another, the same percent of babies was admitted to the NICU from the alternative birth center (ABC) as from the labor/delivery unit, despite figures indicating that the ABC babies had better outcomes on all parameters.

Out-of-hospital delivery in Washington State, 1975 to 1977

The annual rate of out-of-hospital deliveries in Washington State increased from 1.6% in 1975, to 2.4% in 1977. Birth certificates, linked birth and death certificate files, and log books from tertiary referral hospitals were used to investigate this trend. As parity increased, rates of home delivery (HD) also increased (p < 0.001). However, alternative birth center delivery (BCD) rates did not change with parity (p > 0.1). HD rates and BCD rates increased with birth weight (p < 0.001). Obstetric professionals attended 91% of BCD as compared to 65% of HD. Fifty-four percent of the women in the BCD group had 10 or more prenatal visits compared to 40% in the HD group. Infant mortality rates were lower with BCD than with HD. However, our analysis of mortality was limited by countervailing biases inherent in the data. We concluded that out-of-hospital deliveries were a heterogeneous group that in future studies should be stratified into groups of birth center deliveries and home deliveries.

The alternative birth center movement in the San Francisco and Bay area

Alternative Birth Centers particular to the San Francisco area are discussed. Information of general interest regarding the issues that have brought about the advent of this birthing alternative is presented. Also provided is information concerning the specific services provided which should be of interest to maternity units considering the development of an alternative birth center within their hospitals.

Preliminary Observations on the Behavior of Children Present at the Birth of a Sibling

In an effort to shift the focus of hospital birth toward a more family-centered, natural process, an Alternative Birth Center (ABC) was opened in May 1976, at Mount Zion Hospital and Medical Center, San Francisco. Its purpose is to provide a safe, comfortable environment in which women can labor and deliver their infants.1 In order to also bring in families who would have had home births, the setting has been made as much like home as possible. Pregnant women may choose whom to have present at birth. In the ABC, as in other alternative birth settings, many parents are insisting on having their other children present at the birth of a sibling (New York Times, July 12, 1977, p 34; March 17, 1978, section 2, p 4).

The development and future of the hospital-based alternative birth center

The development and future of the hospital-based alternative birth center

An alternative birth center in a community teaching hospital.

The hospital-based alternative birth center answers the needs of many low-risk patients. At the same time, it provides safety factors that cannot be approached by home delivery. A home-like environment facilitates labor, simplifies delivery, and strengthens the family unit.

Nurse‐Midwifery in an Alternative Birth Center

Nurse‐Midwifery in an Alternative Birth Center

The Alternative Birth Center At Mount Zion Hospital

BirthVolume 3, Issue 3 p. 127-128 The Alternative Birth Center At Mount Zion Hospital Carolyn Ferris R.N., Carolyn Ferris R.N.Search for more papers by this author Carolyn Ferris R.N., Carolyn Ferris R.N.Search for more papers by this author First published: September 1976 https://doi.org/10.1111/j.1523-536X.1976.tb01176.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume3, Issue3September 1976Pages 127-128 RelatedInformation