If there’s one thing many birthing women need, it’s the empowerment to control their bodies during labor and delivery.
“Our goal is to give women the tools to be active participants in their pregnancy and birth experience,” says Mary-Signe Kelly, lead certified nurse midwife at the Minnesota Birth Center in Saint Paul.
The new birth center, open since April, offers medical care for women, puberty through menopause, including family planning, pre-conception counseling, annual exams, prenatal care, and labor and delivery.
Longtime perinatologist Dr. Steve Calvin opened the Minnesota Birth Center in Minneapolis in 2012 after recognizing the need to offer women with low-risk pregnancies a place to labor and deliver with limited medical intervention and continuity in care. Calvin says 40 percent of American women never meet their birth attendant in advance. “The way we do pregnancy care in the U.S. is designed to almost treat it like a disease or a disaster waiting to happen,” he says.
After being open only two years, the Minneapolis birth center was unable to meet the demand, so Calvin opened the Saint Paul location. Serving a broad population of women is a priority. For women who speak little or no English, staff will offer providers who speak the patient’s native language or have interpreters.
The Saint Paul facility features three birthing rooms, each with private bathrooms with showers, birthing tubs and queen-size beds. A small kitchen and common area are available for family and visitors. In addition to Kelly, staff includes four to five fulltime certified nurse midwives and two to four registered nurses, who assist with up to 40 births a month.
Megan Goodoien and her husband, David, knew they wanted their baby to be born in a birth center, but Megan was concerned about transferring from the Minneapolis birth center to a hospital should the need arise. Her fears were allayed when she learned that the Minneapolis staff has privileges at Abbott Northwestern Hospital, located across the street. (Both staffs have privileges at United Hospital in Saint Paul as well.) In those cases, the nurse midwife accompanies the patient to the hospital and continues to provide care along with a dedicated group of collaborating physicians. About 14 percent of clients make the transfer, according to Kelly.
Kelly explains that women receive parallel care, similar to what they would in a hospital setting, with some exceptions. “One of our goals is to give women a vaginal birth,” she says, adding that the national hospital Cesarean delivery rate is 33 percent, whereas the Minneapolis birth center has a 4 percent rate for patients admitted during labor.
Natural childbirth is encouraged, but women are given the option of self-administered nitrous oxide (commonly known as laughing gas), hydrotherapy and unrestricted mobility during labor.
Goodoien was apprehensive about her pain tolerance. A midwife honestly told her, “birth is painful, but there is a difference between pain and suffering.” If Goodoien felt her labor was tipping into the latter, she could transfer to the hospital. “It felt like a really nonjudgmental philosophy,” she says. “It gave me peace of mind that the decision would be mine, and they’d be supportive of that.”
Goodoien spent part of her 17-hour labor in the birthing tub, easing back labor, and she had a water delivery of son Hudson. “The place that felt best for me was in the tub,” she says. “Having a little bit of buoyancy made the difference.”
After Hudson was born, the Goodoiens found welcome respite in the room’s queen-size bed. “That was a special moment,” she says. “We just napped for a couple of hours. It was a nice way to end our birth.”
Goodoien was discharged a mere six hours after delivery. “It was nice to recuperate at home,” she says. Some mothers might blanch at the notion of going home four to six hours after giving birth, but Kelly says most welcome the chance to return to the comfort of home.
Care continues after families are discharged. A registered nurse makes home visits between 24 and 36 hours after the birth to perform metabolic and heart defect screenings, hearing and weight checks, and breastfeeding assessment. The center requires that a pediatric health care provider assess the baby three to five days after delivery. Mothers visit the birth center for two- and six-week appointments.
