The Art of Admittance to the Birth Center

During labor, one of the most stressful questions for many birthing parents is, “When should I go to the birth center?” While the question is direct and self-explanatory, the answer is more complex. The reason? Simply put, there is not one across-the-board answer.

Each birthing person’s experience is different. Even the same parent’s experience is different with every labor and birth. To determine whether to admit you to the birth center, our midwives take a holistic approach, considering many factors before making a decision or putting a plan into place.

In this blog, we’re sharing some of the most common questions related to labor progression and if “it’s time” to go!

What Role Do Contractions Play?

When it comes to contractions during labor, their timing plays a role in whether you’re admitted to the birth center, but that’s not the only important element we look at. For first-time parents, we like to reference the 3-1-1 formula. This is when contractions are three minutes apart, last for one minute, and continue for one hour consistently. Generally, 3-1-1 is a good guideline to put your bags in the car, contact the midwife-on-call, and discuss heading to the birth center.

For parents who are expecting a subsequent baby, our advice is to contact us at 5-1-1. The reason is because, after our bodies have done something once, the muscle memory of that experience might make things progress more quickly. (But not always. There are no guarantees with birth!)

It’s important to note that neither of these formulas alone ensure you’ll stay at the birth center. For example, if you arrive with contractions that have lasted an hour but are not less than 3-5 minutes apart and they are not nearing one minute long, we may send you home. Braxton Hicks contractions, especially in late pregnancy, can become a little more intense than they were early on. Upon assessment, we determine if true labor is imminent or if your body is just making natural progress in preparing for the real labor that is soon to come.

Does My Dilation Matter?

Some people think the answer is clear cut in terms of dilation, and in some ways, it is. If you’re five centimeters dilated or greater, you will be admitted. However, if you are less than 5 centimeters dilated, we don’t automatically send you home either.

Deciding if you should stay at the birth center or go back home is more like an art, not a science. We assess each client thoroughly to make sure we are adhering to our commitment to a positive birth experience with positive outcomes. For example, if you arrive at 3 centimeters dilated and the baby is very low, we will assess you. During an assessment, we ask questions, such as:

• How often are your contractions?

• How intense are the contractions?

• How well are you coping with the contractions?

• Is the birth center the most comfortable place for you?

We will also refer to your medical history and any pertinent information from previous birth experiences, if applicable. This type of labor check helps us not only get a holistic view of your experience at the moment, but it also allows us to determine the best plan for you and your baby. An assessment usually takes 30-90 minutes, and the outcome will determine the next steps and plan of care.

What Other Factors Help the Midwives Decide?

When you’re in labor — and always — we want you to know we are listening. We support you and take you and your concerns seriously. In addition to the physical and emotional aspects we already discussed, we also consider logistics, including:

• How far away do you live from the birth center? (Trust us when we say, we don’t want you to have your baby in the car!)

• Are your support people, like your partner and/or doula, available to help you at home?

• Has your water broken? We need to know if your water has broken no matter what because if your membranes rupture and you are not experiencing contractions, we are in a different scenario that puts you on a timeline to deliver.

What About Timing?

Your baby’s gestational age is always an estimate based on when your last menstrual cycle started. There is no magic week or day during pregnancy when, at the same time, babies are fully ready for the outside world. We understand as you near the 40th week, you may feel anxiety, apprehension, and excitement. Sometimes these emotions and feelings can emulate changes that may be interpreted as signs of labor.

Since Florida law allows you to deliver at a birth center until 42 weeks, we are careful to let your body and your baby take the time they need to do what they know how to do naturally. We will follow the assessment plans discussed above to determine what’s best at any given time. Please do not feel discouraged if even at the gestational mark of 40 weeks, you are not admitted just yet. The time will come, and it will be soon.

Takeaways About Being Admitted to the Birth Center

It’s common, especially for first-time parents, to be cautious and arrive at the birth center thinking they should be admitted. Sometimes this cautiousness is justified and accurate; other times it may be a bit too soon for admission, and we will suggest going back home.

If you go home, please do not feel bad or like you are a burden. Your perception is important! No matter what the results of your visit, we want you to know it is always valid. Getting clarification can help ease both the mind and the body. Sometimes doing a physical check or assessment when things feel like they are changing is exactly what you need. We support you and want you to feel that care throughout your entire journey with us.

At Magnolia, we strive to take away the uncertainties that can come with pregnancy and childbirth in a variety of ways. If you are interested in learning more about prenatal care and birthing services, call us at 786-953-6534 or fill out our form to set up a free consultation.