What is Best Start Birth Center?
Best Start is the only state-licensed, nationally
accredited, free-standing birth center in Southern California. That means we are not part of a hospital or HMO. We are a private
practice owned and operated by midwives. We have physicians associated with the practice whom we consult with and refer clients to
as needed, but they are not here for deliveries -- it is the midwives who do the deliveries. Best Start is also the only facility
in San Diego offering Water-birth.
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What do you do here?
Best Start provides prenatal care, delivery,
recovery, post-partum care, well-woman care, and contraceptives for our clients. Our birth center has comfortably decorated
private birth suites with private attached bathrooms. Our birth center features tubs for water births, birthing balls, birthing
stools, and many other items that allow the laboring woman to find a position that is most suitable for her during her labor and
delivery.
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How
do we pick our midwife / How do we know which midwife will be at our delivery?
During your prenatal care, you will meet all of our
midwives. You are not assigned to a specific midwife, so when you go into labor, you just call the midwife on call. You both
discuss when it is time to come to the birth center. When you arrive in labor, the midwife will meet you at the birth center and
remain with you for your entire labor. As you approach delivery she will call the nurse on call to assist with delivery. About two
hours after delivery, if all is well, the midwife signs out and the nurse stays with you for the rest of your recovery.
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How long will I stay after
delivery?
Most of our ladies are ready to go home about six
hours after delivery. The next day your nurse will visit you in your home. She makes sure you are healing properly, that the
breastfeeding is going well, and addresses any questions or concerns you may have at that time. Then you have a one week, two
week, and six week post-partum visit at the birth center.
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If
you do not have epidurals here, how do you help with the pain?
To promote your comfort in labor, we do not use
fetal monitors which strap to your tummy. We want you to walk around and change position freely, and we check the baby's heartbeat
periodically with a Doppler, that gives us the information we need.
We strongly encourage you to take a childbirth
class. Any method you prefer is fine, and you are not required to take a class in order to deliver at the birth center.
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We want you to eat and drink while in labor.
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We can use IV's, but do not use them routinely.
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You are encouraged to bring any items you need for
your comfort, candles, music and incense are very popular.
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We do not have an epidural service, but we use natural methods stemming from
complimentary therapies, such as massage, healing touch therapy, acupressure, and aromatherapy.
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Laboring in the tub is also an option.
You may deliver in any position you choose,
side-lying, standing, squatting, hands and knees, or in the water. You may have Dad deliver the baby, or you may deliver the baby
yourself, and in any event, the midwife will be there to assist.
Immediately after birth, the baby goes to the
breast, and Dad cuts the cord when it stops pulsing. Then the midwife delivers the placenta and checks for any repairs. We do not
do episiotomies routinely, and our midwives are very good at helping you to stretch naturally, so any repairs they must make are
usually superficial.
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What is a Certified Nurse-Midwife?
All our midwives are Certified Nurse-Midwives,
which is the highest credentialing a midwife can receive. That means they were nurses first, continued their education into
advanced practice, and have been licensed by the State of California to practice Midwifery.
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What do you do if something
goes wrong?
At every prenatal visit our clients are assessed
for their suitability to deliver at the birth center. If for any reason it is not appropriate for a client to deliver at the birth
center, her care is transferred to a physician, or she is transferred to a hospital. We have two OB/GYN physicians to refer our
clients to as needed, and we have 3 consultants.
Midwives adhere to the same standards of care as
physicians, so the care you receive is the same, just with a more personal approach.
Midwives are limited to caring for ladies with
low-risk pregnancies. That means that Mom is healthy, and has only one healthy baby coming head first. If Mom and baby come into
labor healthy, the odds are stacked in their favor that they will deliver safely.
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How
often do women have to be transferred to the hospital in labor?
In labor, about 7% (updated Jan. '08) of our ladies are transferred
to the hospital. The number one reason is labor has stalled and is no longer progressing. A stalled labor is very disappointing
but is NOT an emergency. In any non-emergency the woman is transferred to the hospital of her choice.
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We have three nearby hospitals for emergency and non-emergency transfers: UCSD
which is a tertiary level hospital, Scripps Mercy, and Sharp Mary Birch.
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For emergencies, we call an ambulance and transfer
to UCSD.
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Of our ladies who are transferred to the hospital,
only a few are delivered by cesarean, for an overall rate of 3% for the birth center. (C-section rate for the US is 31.1%, according to the CDC Report, Dec.2007)
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At 28 weeks or sooner, Best Start recommends that all patients take a hospital tour. In the unlikely event of a hospital transfer, we want you to rest assured that the care you receive will be in
you and your baby’s best interest. Our local hospital physicians and nurses are an extended arm of our team. We couldn’t be here without their support. They are always available and provide the expert care our transferred mothers and babies need. They are an integral part of why we have the good outcomes we are so proud of, and grateful for. When you visit them for a tour, please keep in mind that their services address special circumstances and their high technical units are what a transferred mom or baby needs.
This network of support allows Best Start Birth Center to provide natural child birth services to our clientele. Amongst the physicians and hospitals that accept interfacility transfers for the birth center, are the Resident and Attending Physicians at UCSD Medical Center and our Perinatal Consultant, Gary Blake MD who accepts our transfers at Sharp Mary Birch Hospital for Women. Together, these physicians and hospitals have accepted patient transfers for over 20 years. While we understand that a transfer may be disappointing, our excellent outcomes for mothers and babies are the result of the expert care provided by our local hospital physicians and nurses. Please remember that while the atmosphere and procedures in the hospital are quite different from those at Best Start, like us, they are dedicated to the health and wellbeing of mothers and babies and deserve the support and respect of all of us.
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What can Best Start
offer that hospitals can't?
Some of the things Best Start Birth Center can
offer that hospitals cannot are:
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Continuity of care: The people you see during your
prenatal appointments are the people who will be at your delivery.
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We have an experienced staff dedicated to providing
sensitive individualized care that honors the miracle of birth.
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All of our nurses and midwives are experienced in
their field.
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In labor you will receive one-on-one care and
support from your Midwife and/or nurse.
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Options - You choose how you deliver, whom will be
present and in what atmosphere. More importantly, you always have the option to change your mind.
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If
you only have three birthing rooms, what do you do if there several ladies in labor at once?
With our commitment to provide the best in
family-centered care, we are introducing a "Family Birth Suite" which enables us space for 3 laboring women. We seldom
have more than one lady in labor at a time. If we do have more than one lady in labor, we call in more staff. We have never been
so busy that we have to turn our clients away.
