Why a Birth Center? 20 years as a labor nurse taught me we deserve more choices.

I’ve worked as a labor nurse for over 20 years, most of it (over 17 years before I became a manager) at the bedside supporting moms through their labor and birth experiences. I’ve been lucky to work in many different environments. My first job out of nursing school was working with midwives in a small community hospital where moms were allowed to labor and birth without a lot of hands-on interventions, tub laboring was promoted, and OBs and CNMs worked collaboratively. I even worked with a physician in this setting who required that the lights be turned all the way down after a delivery when the baby was on mom’s chest, required silence in the room from any staff that was helping put things back together, while he sat in the corner serenading the family on his guitar so that mom and baby could bond. These were some of the most beautiful experiences I could’ve ever imagined — so incredibly empowering that they filled my heart and kept me going.

I’ve also worked in high-risk Level 3 and Level 4 centers with families dealing with extreme prematurity, the most severe forms of preeclampsia, so so many hemorrhages, & high C-section and intervention rates. I’ve seen how interventions are incredibly necessary to provide safety for some — and how those who don’t need the interventions get caught up in that same model and wind up with outcomes that were truly preventable if all of those interventions hadn’t taken place. I’ve seen what it looks like when care is explained well and time is taken for women and their partners and families to have choices explained, where their perspectives and autonomy are respected. And I’ve seen systems that systematically dismiss personal choice, ignore symptoms, over and over — where providers and staff feel like they know better. I have witnessed obstetric violence. I have even seen one of the forced cesarean-by-court-decision situations in person. It has been heartbreaking at times to try to advocate, educate, and push for change while watching some of these circumstances occur.

Listening to so many moms, I’ve heard over and over again that they felt pressured into care they did not want or did not understand — and the results from that. I’ve heard so often how people have not been listened to.

Birth in America is multifaceted, more complicated than it sometimes needs to be, over-medicalized in its infrastructure, and frequently disempowering. We know this — and yet we continue to push forward, trying more often to find ways to work within the systems than creating ways to restructure, like so many other countries have done. The midwifery model is used extensively around the world, country after country, with overflowing evidence that we can achieve better outcomes if we don’t intervene where we don’t need to. Here, midwives are undervalued, and the lobbies for physicians-only are rigid. Interventions are high, inductions for convenience are the norm, and risk management rules. I realized I’m done trying to change it from inside hospitals. 

Rather, I want to work alongside. To hold space in a different sector of the ecosystem. I believe women deserve more choices. Choices to birth at home if they so choose, without innumerable access barriers. To birth in a birth center — in a home-like environment where you can feel comfortable because it is built to respect your choices, your viewpoint, your bodily autonomy. Where the standard allows for the time in prenatal and postpartum visits to talk about the things that you really need to know — so you’re not leaving your rushed 10–15 minute appointments with more questions and wishing you had more answers, because frankly, pregnancy and birth bring up a lot. A place where you can easily access therapy to work through past trauma, or feel comfortable talking about anxiety that comes up in pregnancy, or access treatment in real time for depression.

We deserve systems that support us. Systems in which we are held — that create community and battle isolation. Systems that do not regard the postpartum period as only six weeks. Birth centers have incredible outcomes, and yet we undervalue them — which removes our options. There are no freestanding birth centers currently in Missouri. There is one amazing birth center attached to a hospital that I have heard incredible things about, and I love that that choice exists — but it deserves not to be rare. We deserve to have birth centers that are rooted in community, freestanding, and midwife-led. While birth centers are not for everyone, the majority of women are actually low-risk enough to be able to take advantage of the option if they so choose.

So that’s why this is my journey. And I’m grateful to continue finding community that feels the same — like my incredible and courageous partners in this birth center journey, and many others who are working to create something different in this country so that we all have more choices - like Birth Center Equity, whose goal is that 50% of the births in this country will be attended by midwives by 2050. 

I’m often told I’m crazy, that this is an incredible hill to climb in Missouri. But we all have our own ways of being the change that we want to see, and all the work and time is worth it to me to help women and families in Missouri access the options they deserve to have.

Because choice is everything.

Does this resonate with you? Follow us on our journey to build the birth center.