Q: What is a birth center?
A true birth center is a community of people working together to provide you with the birthing experience you want: state of the art care married with the most positive, empowering natural childbirth. Experienced midwives, our caring staff, doulas and other parents-to-be, all come together to collaborate with you during the most miraculous time in your life – before, during and after childbirth.
A true birth center is solely focused on you, your family and your baby. Birth centers are not located in hospitals—they are designed solely from the ground up to provide the ideal natural birth environment, rather than inside a mini birth center, which is part of a busy doctor’s office.
A true birth center is a facility where you will receive family-centered pre-pregnancy, prenatal and postnatal personalized care from professional health care providers. We are designed to provide a low-intervention, serene and cost-effective alternative to hospital births. Instead of forceps, epidurals and c-sections, we offer months of mind and body classes and the experienced hands of midwives to help mothers through a natural birth.
Unlike hospitals or mini birth centers, Austin Area Birthing Center gives you continuing support from your first trimester through the second year of life. At our facility, one of the original true birthing centers in the country, you receive a complete network of maternity and women’s lifestyle services that are included at no extra cost:
- Lab draws, pain management and other diagnostic testing including prenatal and postnatal checkups & support
- Centering, a type of prenatal care that reduces complications by 50%
- Yoga classes three times a week
- Baby massage classes for a year
- Breastfeeding classes
- Postnatal Yoga for a year
- Toddler classes for year
Our care is covered by most major health insurance plans (but not all plans) and our friendly front office staff can help you with your financial questions.
Birth centers welcome your children, your parents, and your friends to be present for your birth if you so choose. We focus on healthy pregnancy diets, exercise and care to facilitate an optimal birth experience. Mother and baby usually remain at the center for approximately six to eight hours after a normal delivery before returning home.
Austin Area Birthing Center is a facility independently owned by an Austin midwife, and has a formal collaboration agreement with the Seton family of hospitals, St. David’s Hospital and Gynics Associates. We opened in 1987 and are one of the first free-standing birthing centers in the United States. http://www.austinabc.com/about/our-story/
Q: How safe are birthing centers?
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The New England Journal of Medicine released a study in 1989 which was then confirmed by a January 2013 study by the American Association of Birth Centers in which Austin ABC participated (http://www.birthcenters.org/research).
These studies concluded that birth centers are as safe as hospital environments for delivering babies to low-risk mothers. Birth centers also reduce many standard hospital interventions such as labor induction, electronic fetal monitoring, epidurals and routine IVs, so birth center cesarean statistics are less than half that of traditional hospitals.
If you have no more than one cesarean section, it is safe to have a birth center birth (VBAC). However, our AABC Midwives are required to review your past pregnancy and birth records before we can officially serve you for this very special experience.
Q: What is a midwife?
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At AABC, midwives are the very heart of what we do. They’re trained to assist in managing pregnancy, labor and birth. We also have European trained midwives who bring yet another perspective to the birthing experience.
Austin Area Birthing Center midwives are either Certified Nurse-Midwives (CNMs), who have been trained in both nursing and midwifery and are certified by the American College of Nurse-Midwives, or Certified Professional Midwives (CPMs), licensed by the State of Texas, who are trained in midwifery.
Midwives at AABC take extensive medical histories of our clients, order routine lab tests and provide thorough prenatal, labor and postpartum care.
Q: What about epidurals?
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Due to the risks involved, epidurals are not administered at freestanding birth centers such as Austin ABC. The rise in the routine use of epidural medication – anesthesia injected through a catheter threaded through a needle and inserted near the spinal cord – has been linked to the rise in cesarean births throughout the world.
Epidurals are often the first intervention in what is sometimes referred to as a “cascade affect,” or the first medical intervention leading to a multitude of subsequent interventions.
An epidural can slow a woman’s labor, and she is more likely to be given a Pitocin drip to speed up the labor process. Movement of the mother during labor is either eliminated completely or severely limited. Epidural administration necessitates fetal monitoring, to ensure the baby’s heart rate is not affected by the drug. The second stage of labor is often particularly slowed, sometimes leading to the use of forceps. All of these interventions can lead to unnecessary cesarean sections.
While epidurals can numb the sensations of pain associated with labor and delivery, they also numb the muscles that aid in pushing the baby out.
The International Cesarean Awareness Network, Inc. published a white paper written by Dr. Sarah Buckley outlining the risks for mother and baby of epidural use. The report concluded that “there is a noticeable lack of research and information about the effects of epidurals on babies. Drugs used in epidurals can reach levels at least as high as those in the mother (Fernando et al.), and because of the baby’s immature liver, these drugs take a long time–sometimes days–to be cleared from the baby’s body (Caldwell, Wakile et al.). Although findings are not consistent, possible problems, such as rapid breathing in the first few hours (Bratteby et al.) and vulnerability to low blood sugar (Swantstrom et al.) suggest that these drugs have measurable effects on the newborn baby.”
Q: Is any pain medication is available?
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Pain medication is available at Austin ABC in the form of an injectable, synthetic analgesic called Nubain. Nubain (nalbuphine hydrochloride) like Demerol, mimics the effects of naturally occurring pain-reducing chemicals (endorphins). Nubain seems to have the least affect on the newborn of all the injectable-type medications.
We also offer our laboring moms nitrous oxide to assist in pain management. Nitrous oxide, also known as laughing gas, will not harm your baby and helps clients calm themselves without slowing down the childbirth process. AABC is one of the few birthing centers in Texas to offer nitrous oxide.
However, most clients do not ask for or need pain medication. Good childbirth education, addressing fear of birth, is beneficial in preparing for a natural childbirth. Warm water therapy available in AABC’s deep birthing tubs, also cuts down on the need for medication. Freedom of movement for the laboring mother (who is not confined to a narrow hospital bed) along with being able to choose various laboring and birth positions, aids in lessening pain and also helps to speed deliveries.
Q: What experience does Austin ABC have with challenging births?
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Our knowledgeable staff has experience with the following birth challenges:
• Infant resuscitation
• Shoulder dystocia
• Maternal hemorrhage
• Prenatal Down’s Syndrome diagnosis
• Prolonged rupture of membranes
• Maternal dehydration
• External version
• Meconium aspiration syndrome
• Dysfunctional labor (hypertonic, hypotonic)
• Under water births
• Uterine infections
• Beta strep infection
• Fetal distress
• Gestational diabetes
• Placental abruption
• Transient tachypnea
• Difficulty delivering placenta
• Placenta previa
Q: What birth circumstances require transfer to a hospital?
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The most common reason for transport during labor is slow progress and/or fatigue. Our midwives are extremely experienced at using age-old techniques to promote progress and support the mother. Since they are also modern nurses or midwives, they use emergency drugs, IVs, oxygen and other supplies to assist with difficult deliveries. However, if hospital support is required, Austin ABC is prepared to transport. We never compromise the health and safety of the mother.
Q: What if something goes wrong?
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AABC has a collaborative agreement with Gynics Associates and Austin Maternal Fetal Medicine. If you develop a condition in pregnancy which requires a physician consultation, AABC can refer you to the appropriate provider who will discuss your situation with you. Together, we can decide what is best for you and your baby.
Austin Area Birthing Center has a formal agreement with Seton and St. Davids hospitals as well as Gynics Physician Group. This means that in the unlikely event you need transport to a hospital, our midwives can accompany you to your preferred facility where you will receive care. The AABC midwife will confer with the doctors and reach a decision about the best method of treatment for you and your baby.
Sometimes a transport to St. Davids Hospital is the best plan due to proximity or client preference and Austin Area Birthing Center participates in the St. David Hospital “ONE CALL SYSTEM”. This gives our facility top priority when a transfer to the hospital becomes necessary. The midwife activates the system by phoning a special hotline. An ambulance is dispensed and the closest hospital is notified that a AABC mother is on her way with her attending midwife. This system triggers a chain reaction: an ambulance is immediately dispatched and a room is made available for our mother.
AABC is the only midwifery practice in Austin invited to participate in the ONE CALL SYSTEM. The rationale, according to our St. Davids Hospital representative, relates to our longevity and our reputation in the community.
Q: Will I have an ultrasound during my prenatal care?
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All clients have an ultrasound at 20 weeks from our ultrasound technicians and we are able to perform these at AABC Duval and AABC South.
If a scan is abnormal or the mom has risk factors, we refer to one of the Perinatologists we work closely with.
Ultrasounds are useful in dating a pregnancy when the mother is not certain how far along she is. They are also used near 20 weeks gestation to examine the baby and placenta. Occasionally, ultrasounds are used when a pregnancy lasts past the due date. This provides your midwives with more information about the baby’s health.
Our north and south facilities have an ultrasound machine.
Q: Is water birth an option at Austin ABC?
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Each birthing room has a deep bathtub appropriate for laboring and/or delivering the baby in the water, several of which are SaniJet tubs. We have the best, tasteful, and largest tubs of any birthing center in Austin or the State of Texas.
Approximately 30% of Austin ABC moms choose to deliver in the water. Those mothers who do not actually give birth in the tub speak highly of the relaxing benefits of having a tub nearby for labor. If you’ve ever had menstrual cramps and then gotten into a warm tub, then you already know the benefits of water therapy.
Austin ABC’s birthing tubs can be filled and refilled quickly to ensure sanitation and are supplied by large industrial hot water heaters. Running out of hot water is never an issue at AABC. Inflatable tubs, typically used in home birth settings, are filled with a hose, then heated, and can’t be drained and refilled during labor and delivery, posing sanitation risks.
Our tubs are outfitted with strategically placed handles that allow mothers to brace themselves while finding their most comfortable birth position.
We’ve had 30 years to perfect our water birthing technique at AABC. It is a specialty that not all midwives are adequately experienced in. Water deliveries require extreme calm, clear, and quick thinking by midwives. No other medical practice, particularly obstetrics, trains care providers for the complexity and beauty of a water birth.
Q: Who can attend my birth?
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In addition to your midwife and her assistant, you can select anyone you wish to support you during your labor and birth. At Austin ABC, we are committed to providing a warm, calm and nurturing environment for mothers as they labor and in the important first moments of bonding with their newborns. We encourage you to choose support persons who understand what is important to you during this special time and are comfortable with out of hospital birth.
Our waiting area is available for family and friends to relax outside of your birthing suite, allowing them to share the experience. They are free to use the kitchen, watch movies on Netflix, or simply surf the web on their laptops using the center’s WIFI. There are games and different puzzles for entertainment and All three of our centers offer large, comfortable furniture to relax on while your loved one is is labor.
Our goal is that every member of your family be as comfortable as possible during your birth experience.
Q: How long will we stay at the birthing center afterwards?
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The birthing center is an outpatient facility, so unlike a hospital, mothers stay for 6-8 hours after the birth. If a mother does not meet our criteria for discharge, she is encouraged to stay longer until she has made a full recovery.
During that time, the birth assistant looks after the mother and baby and provides detailed instruction and support.
Postpartum checkups at Austin ABC are more frequent than at the hospital, as you and your baby are seen somewhere between 2 and 3 days after birth at the center, 2 weeks at the center and 6 weeks at the center for your final checkup. All checkups are for both the mother and infant.
Q: How much does it cost?
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Austin ABC is significantly less expensive than a hospital delivery. Our cost is similar to that of a home birth and we offer an affordable, flexible self-pay discount plan for those without insurance. We also are in-network with most major insurance companies.
We then include baby/mommy and toddler classes for the first two years of your baby’s life. You even get a personalized calligraphy baby birth certificate with your baby’s footprints as a commemorative gift from us.
Our goal is that you become part of a community of informed, loving Austin families for the price of a home birth. We know that isolation can affect the well-being of new families and we want to avoid that at all costs.
We work with PPO/POS insurance plans such as BCBS UTSelect, Blue Cross/Blue Shield, Cigna, United Health Care, Aetna, Humana, as well as Aetna EPO plans.
Financial questions are best answered by Katy Crutchfield, our Billing Manager. Her email is: firstname.lastname@example.org . She will personally guide you through any questions or actions you need to do in order to get top reimbursement from your insurance. You may also contact Stacey Jamail, our Senior Office Manager, to also help with financial questions.
If you’re unsure about your benefits, You can also go to Larsen Billing at http://larsenbilling.com/parents/vob/. They are experts at researching and determining what your out of pocket costs will be when using your medical insurance.
Q: Are there any restrictions on how late in my pregnancy I can use Austin ABC’s services?
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Austin ABC welcomes healthy women at all stages of pregnancy who do not have serious, chronic health problems. Late transfers will be reviewed on a case-by-case basis.
First-time moms or those who have only experienced epidurals in the past must have had some type of quality birth preparation class in order to be accepted at the last minute.
We ask that late transfers provide us with all prenatal care medical records prior to an initial tour. Our midwives look forward to reviewing these records not only to prepare for your tour, but to insure that we can properly care for you and your baby and that we are a good match for your pregnancy. Additionally, you will need to complete our secure online electronic charting program, Maternity Neighborhood, medical history questionnaire.
As previously stated, if you want to transfer your care to Austin ABC, and you are late in your pregnancy, you are welcome to set up a free tour.
However, prior to scheduling the tour, we need to review your records and the questionnaire. We devote at least one hour to your tour and if AABC is not a match for your needs, we don’t want to waste your valuable time.
Q: Are there conditions that would preclude me from being a patient at AABC?
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On occasion, an expectant mom has a medical condition that will deem her incompatible with delivery at a birthing center. This does not occur frequently, but in order to ensure the highest safety standards for an out of hospital birth, AABC has developed a list of conditions that are not approved for delivery at the birth center:
- Any hypertensive (high blood pressure) disorder prior to pregnancy
- Blood clotting disorders
- Placenta Previa (placenta is over the cervix)
- Uncontrolled Chronic Medical diseases
- HIV or Hepatitis B or C positive or Syphilis
- Medication dependent Diabetes
- History of two or more Cesarean Section Deliveries or one cesarean delivery with a vertical incision.
- Twins or greater multiples this pregnancy.
- Incompetent cervix which includes someone needing or having a cerclage (a stitch in the cervix to avoid miscarriage).
- Obesity to include: greater than 30 BMI (body mass index) for first time mother or attempted vaginal birth after cesarean section, and greater than 35 BMI for women who have given birth previously vaginally. (BMI is a proportion of height/wt)
Other conditions will be considered on a case by case basis. We do a full risk assessment based on our practice guidelines when you submit your application for a tour.
Does AABC perform vaginal birth after A Cesearan Delivery, known as VBAC?
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Yes, we have over 30 years of experience with VBACs. You will need to bring your previous birth records to your initial consultation visit. We have an 88% success rate, meaning that only 12% of our mothers with prior C- Sections need the hospitals help to complete their birth.
To understand more about a VBAC at AustinABC please click here to watch a video.