Birth in a birth center: procedure and costs

Why in the birth center?

About two percent of pregnant women now decide against the classic hospital birth. They find the stay too medical and sterile and a home birthactually too private. So the compromise remains: the birth house. Here you can give birth to your child in a personal atmosphere and under the guidance of professionally trained midwives. However, the birthing center does not offer the same medical standards as a clinic, because the midwives are not allowed to administer painkillers such as epidurals or perform a caesarean section. A doctor is not present. A home birth is therefore more comparable to the medical care of a home birth. They often offer many alternative methods of birth assistance and pain management. You can find more advantages and disadvantages of a birth center compared to a hospital birth or home birth in our article “ Clinic, birth center, home birth? “.

Offer of birth houses

Most birthing centers offer an “all-round” offer:

• You look after pregnant women as part of prenatal care,
• usually offer a lot of birth preparation courses (general course, weekend courses, acupuncture, baby care and much more),
• Extensive equipment in the birthing rooms (beds, couches, wall bars, ropes, balls, birthing stools, sometimes also birthing tubs),
• individual care by their midwives ,
• a more comfortable and pleasant atmosphere and
• take care of the aftercare during the postpartum period ,
• offer postnatal courses, breastfeeding advice and breastfeeding meetings.

Birth process in the birth center

The birth process is comparable to that of a home birth. You are very self-determined and are much more the center of attention than in a clinic. Unlike a home birth, however, you are more dependent on your assigned room. If you want to move, you can meet many other people. So it’s not the same intimacy as at home. Of course, a birth center offers much more equipment than a birth at home. So you often have tools such as a birthing stool or ropes available in your room. Some birthing centers have their own postpartum wards. So you can stay a few days after the birth, rest and be cared for. As a rule, the partner can also stay. If the birthing center does not have a station or you do not want to stay longer, you will normally be released after about 6 hours. The midwife will give you some good advice for the first few days and will visit you regularly at home for follow-up care in the following days.

Birth center reimbursement

A birth in a birth center is usually paid for by health insurance. This means that the care before the birth, the delivery itself and the aftercare are taken over. In exceptional cases, you have to pay for the use of the birth center yourself, which would be around 500 euros. You also have to dig into your own pocket for special services such as acupuncture treatment. You should clarify in advance how this is handled by your health insurance company. In general, however, giving birth in a birthing center is far cheaper for the health insurers than giving birth in a hospital.

Birth center only for uncomplicated pregnancies

The prerequisite for a birth center is that your pregnancy has been free of complications and that no other complications are to be expected during the birth. The following events exclude a birth in the birthing center:

• Disease such as diabetes mellitus, high blood pressure, preeclampsia , HELLP syndrome or coagulation disorders.
• Misplacement of the placenta ( placenta praevia )
• Malposition of the child ( breech position, transverse position )
• preterm labour
• Previous cesarean section
• Complications from a previous birth
• multiple pregnancies
• Multiparous women from the fourth child
• diseases or malformations of the child

Statistics prove the quality of the birth center

So if you and your child are healthy, there is nothing wrong with giving birth in a birth center. The risks are then no higher than with a birth in the hospital. Statistical surveys over more than ten years document the high quality of out-of-hospital care. Only in about 10 to 20 percent of cases does a woman have to be transferred to a clinic. However, this usually happens in peace and without hectic. Midwives prefer to transfer a woman early rather than wait too long. In less than 1 percent of cases, there is an emergency that requires a quick transfer. To make transfer as easy as possible, most birthing centers are located near, and in some cases directly attached to, maternity clinics.

When does the birth have to be terminated and transferred to the hospital?

• Transfer occurs when labor stops progressing and mother and child appear exhausted. In some cases, too strong or too weak contractions or bleeding can be the reason.
• If the health of the child is no longer assured because, for example, the heart sounds change, it must be transferred.
• After the birth, a transfer to the clinic may still be necessary if, for example, the birth injuries are too large or the placenta does not detach completely or promptly.
• In rare cases, it may also be necessary to take the child to a clinic with a children’s ward. This is particularly necessary if the child shows signs of illness, respiratory disorders or malformations.

find birthplace

There are now around 200 birth centers in Germany, so almost every pregnant woman should have one nearby. It is best to attend an information event at the birth center in question early in the pregnancy. So you can decide for yourself whether the equipment, atmosphere and the midwives working there appeal to you. You will also find many birthplaces in our local section .