COUNTYWIDE : Birthing Center Gives Midwifery New Look

Midwifery may conjure up images of rural grandmothers delivering babies by candlelight, but for a growing number of Orange County families, the centuries-old approach seems to be the most progressive birthing option around.

Replete with quiet, pastel-colored rooms, rocking chairs, therapeutic tubs and hallways devoid of typical hospital hubbub, the UCI Birthing Center offers a relaxed setting and a natural, less interventionist approach to childbirth than a hospital.

At the same time, said Dr. B.J. Snell, director of UCI nurse-midwifery services, the center’s close ties and quick access to nearby UCI Medical Center give the facility a level of medical care unmatched by other midwife programs. In fact, she said, the facility is the nation’s only free-standing birthing center affiliated with a hospital.

But while the Birthing Center shares UCI’s name, its unconventional methods occasionally raise eyebrows among Medical Center staff on duty there for the first time.

“We put the mother in a chair, or on her side, or tell her to squat, and (the new nurses) look at us and say: ‘You’re going to do what?’ ” Snell said.

Unusual positions, massages, delivery rooms crowded with loved ones or walks through a courtyard during labor are common practices at the Birthing Center, Snell said.

“We do it the way the mother feels best,” said Snell, who spent 10 years working in conventional obstetrics wards. “They don’t want to be treated like they’re abnormal, they want to be treated like this is a normal, natural event. They know what they need, and what they don’t need.”

UCI officials founded the Birthing Center four years ago to help relieve overcrowding at other facilities.

Months earlier, those same officials ignited a small furor when they warned expectant mothers that the obstetrics ward at the medical center was overcrowded, performing up to 600 deliveries a month instead of the 300 it was designed to handle, said Dr. Thomas Garite, chairman of UCI obstetrics and gynecology.

“It was a rather difficult situation to say the least, and the news media just gobbled it up,” Garite said. “The consultants we had come in suggested some ideas, and one of them was a free-standing birthing center. At first, I was one of the biggest skeptics.”

Garite said he changed his view after recognizing the comforts offered by the more personal environment of the Birthing Center, and the savings it could pass along. He predicts that nurse-midwife staffs at similar centers could be the wave of the future, making it “really critical that this project succeeds.”

The Birthing Center is staffed by eight certified nurse-midwives, all registered nurses who have completed a one- or two-year midwifery program and who have extensive practical experience in the delivery room, Snell said. They can prescribe non-narcotic medicines, and they have access to both a laboratory and a respiratory care room within the center.

Costs are kept low because risks are kept low. Careful prenatal exams detect pregnancies involving higher risks, such as twins or likely premature birth, and these cases can be referred to the medical center. At the same time, should an unforeseen problem arise, there is a hot line that rings directly to the medical center’s specialists and, just outside the door, an ambulance waits to hurry patients the two miles to the medical center.

The result is cheaper technology and staffing for the Birthing Center, Snell said. And for the lower-income women who make up the majority of the caseload, that often translates to more prenatal visits, which Snell called “extremely valuable” to baby and mother.

Care for the 30 to 40 women who deliver each month at the Birthing Center, most of whom are Medi-Cal patients, averages about $3,000, compared to more than $5,000 for a delivery at most conventional hospitals.