Portland is great, for a number of reasons, right? It is a great place to bike, be close to nature, shop at farmer’s markets, go paddling, take the bus, run into your friends at the grocery store, AND give birth! We have a lot of different options in the Portland area, which means all families get to chose what works best for them.
Portland is home to numerous hospitals, a couple free standing birth centers, and many midwives. So, what is the difference between all these options and what does each options look like for your birth?
Well, the first option is the standard one that most Americans still go to for giving birth, and the majority of Portlanders do too- the hospital. We have some great hospitals and each one has its own flair. You could go down the standard American route and see an OB doctor for all your prenatal appointments. This is a good option for someone who has some high risk factors, like diabetes needing insulin treatment, among other risk factors. Often the doctor works in a group practice and takes turns being on-call for deliveries. Some doctors have multiple hospitals they deliver at while other doctors only work at specific hospitals. Make sure to get to know the doctors in your group practice as well as taking a tour at the hospital that they deliver at.
Another option in the hospital is to work with Certified Nurse-Midwives (CNMs). Like an OB practice, CNMs work in a group and you get to see different CNMs in that practice during your pregnancy. Whoever is on-call during your delivery is the one you’ll get! CNMs practicing in the hospital setting work under different protocols than homebirth midwives, as they are under the direct supervision of the hospital OBs and their protocols. Hospital based CNMs are perfect for low risk clients who are most comfortable delivering in a hospital but want a natural birth and/or trying for a lower intervention birth. The Portland hospitals currently that have CNMs on staff are Providence Portland, OHSU and Legacy Emanuel. Some of the hospitals allow for laboring in the birthing tubs with the midwives and provide telemetry units that allow movement while still being monitored. Providence Portland also has a doula program that works with the families that are under the CNM care.
For families that are unsure where they want to give birth, but leaning towards out of hospital, a free standing birth center could be an option. In Portland there are now 4 birth centers that are not in the hospitals and are staffed by a combination of midwives. Most of the birth centers are staffed by midwives on rotation, like the hospital CNMs, so you don’t have continuity of care (like with home birth midwives), but many practice differently than the stricter protocols from the hospital. There are CPMs/LDMs, CNMS, and ND midwives at the area birth centers. The birth centers are made to resemble more of a home like setting than a sterile hospital environment. All of them have birthing tubs that you can labor in and at least two of the centers you can stay and birth in them. This middle ground is great for families that want a natural birth (no epidurals here!) but aren’t ready to commit to a home birth.
And then there are homebirths! We, of course, love homebirths but completely acknowledge that it’s not the place for all families. And that is OK! It’s important to give birth where you are comfortable and where is the safest for your pregnancy, birth, baby, and set of risks. Homebirths are not for women who are high risk. But, if a woman is low risk and wanting a natural birth with her loved ones, pets, candles, pillows, and kids around her then this is her best option! A home birth is nice because you don’t have to leave your house in labor or get in the car with a tiny, new human being. You have all your own things and can eat out of your own refrigerator (yes, we want you to eat in labor!). There aren’t strangers coming into your room while you are in labor. It also provides the best option for continuity of care and individualized care with midwives. We bring all the emergency equipment to homebirths along with a whole bag of other supplies. You also have the option to have an inflatable birthing tub which some women use just for laboring in and others give birth in it. You have more options in your movement and birthing positions if you are at home. We also come back to you three times in the first week postpartum, another great reason for a homebirth! There are a lot of homebirth midwives in Portland so go ahead and interview a couple to find the right fit for you and your family if this is the option that best suits you.
It is important to know there are multiple birthing options and find the best match for you. Just because your best friend had a homebirth doesn’t mean that’s right for you if you are worried to be out of the hospital. Or just because your mother in law thinks all babies are born in the hospital doesn’t mean you shouldn’t look into a birth center or homebirth like you’ve been wanting to. Go ahead, do some research, visit a couple places and talk to a couple providers and the right choice will present itself.