FAQs

Several studies have evaluated birth center safety, most recently the 2013 National Birth Center Study II, which evaluated outcomes for 15,574 birth center clients between 2007 and 2010. We are excited to have had our data included as part of this study! This study found birth centers have comparable safety outcomes to hospitals for low-risk mothers and infants. Importantly, the rate of c-section (6%) was significantly lower for clients who began labor at a birth center, even if they transferred to the hospital during labor.  

Austin Area Birthing Center is accredited by the Commission for the Accreditation of Birth Centers. This means that we adhere to a high standard of safety and risk assessment. Before you begin care at AABC, we establish that your pregnancy is low-risk and appropriate for midwifery care and out-of-hospital birth. Throughout prenatal, labor, birth, and postpartum care, we continue to closely monitor you and your newborn to ensure that you both are meeting this low-risk criteria. When risk factors are present, co-managed care with a physician and AABC midwives may be possible or transfer to a physician’s care may be necessary.

A midwife is a birth professional who is trained to care for low-risk clients and their newborns, from the beginning of pregnancy and until 6 weeks after birth. Austin Area Birthing Center is unique because our practice includes both certified professional midwives (CPM) and certified nurse-midwives (CNM), and our clients benefit from both perspectives. 

Certified professional midwives are also known as licensed midwives. They may attend university programs and/or train through apprenticeship programs. Regardless of their educational path, they are certified by the North American Registry of Midwives (NARM) and licensed in Texas by the Texas Department of Licensing and Regulation (TDLR). CPM training is specific to out-of-hospital birth with a focus on holistic family-centered care.  

Certified nurse-midwives are advanced practice registered nurses with an advanced degree in midwifery. They are certified by the American Midwifery Certification Board (AMCB) and licensed by the Texas Board of Nursing. In Texas, nurse midwives have prescriptive authority with physician supervision. While AABC nurse-midwives deliver only at the birth center, nurse-midwives can deliver babies at home, in birth centers and in hospitals. Nurse-midwives also provide annual exams and routine health screening to non-pregnant clients. 

Midwives and doulas both work to support physiologic labor and birth, and though our roles do overlap they are quite different. A midwife is a medical professional who provides care during pregnancy, labor, birth, and postpartum. Your midwife will be monitoring your vital signs, your baby’s heartrate, your cervical dilation and physically assisting with your birth. Your midwife will be the person who admits you to the birth center in labor, and she will stay to oversee your care until you and your baby are discharged home. 

A doula is a birth professional who is trained and often certified to provide labor support. Some doulas provide postpartum support as well. A doula may come to your home to assist with early labor comfort measures before you come to the birth center, and they usually stay with you at the birth center until after the birth of your baby. Your doula helps you find positions of comfort in labor, provides hands-on support to help cope with contractions and generally helps you to have an easier birth experience. 

Just as choosing to have your baby in a birth center lowers your chances for unnecessary interventions and c-section, choosing to have the support of a doula can help you to have a shorter labor, decrease the likelihood that you will need pain medication, and help you to feel more relaxed and calm during your birth. You don’t have to have both a midwife and a doula, but a doula can be a huge asset!

The short answer is that we don’t have them! Epidurals require an anesthesiologist or nurse anesthetist to administer them, and these providers work in hospitals. An essential aspect of birth center care is the ability to move freely during your labor and birth, and this is not usually possible with an epidural.  

Our goal is for our clients to be mentally and physically prepared for unmedicated childbirth. We offer childbirth classes to help you develop coping tools. Staying active during the process and using hydrotherapy for relaxation can be very beneficial. A doula can provide excellent support in labor and birth. 

Sometimes an epidural can be a very effective tool when a laboring person is physically exhausted or unable to relax with the measures we have available at the birth center. 

Most of our clients cope effectively with labor without need for medications, thanks to techniques learned from childbirth education classes, the freedom to be active in labor, hydrotherapy for relaxation, and support from loved ones, doulas, and midwives.  

If you need additional help coping with labor, we usually begin with herbal tinctures and homeopathic remedies tailored to your specific circumstances. We also have nitrous oxide available and a synthetic opioid analgesic medication called Nubain to help with pain relief and relaxation when appropriate.  

Birth can be unpredictable, and our midwives and birth assistants work to provide care that is safe and supportive, while staying alert to potential complications. We do regular peer review of all transports and complications to ensure that we are adhering to our clinical practice guidelines and updating guidelines as needed to provide the safest care possible. 

Additionally, our clinical staff regularly participate in emergency drills covering situations that may arise in the birth center setting. These could include postpartum hemorrhage, difficult delivery of the newborn’s shoulders, or newborn resuscitation.  

Our center is equipped with emergency medications and supplies in case the mother or newborn needs additional support at birth, and our midwives have these ready at every delivery. 

The most common reason for transport during labor is slow progress and/or fatigue, with less than 2% of transports classified as urgent. Below are some reasons that clients may transfer to the hospital in labor or soon after birth: 

• Breech presentation (transferred prior to labor) 
• Maternal exhaustion 

• Stalled labor after trying all measures available at the birth center 
• Prolonged rupture of membranes and not in active labor 
• Maternal vital signs outside normal range 
• Fetal heart rate abnormality 
• Retained placenta 

• 3rd or 4th degree tear after birth 
• Newborn requires higher level of care, based on midwife’s assessment 

Our midwives support physiologic birth while closely monitoring both mother and baby during labor, birth, and postpartum. If the midwife determines that transport may be necessary, she will discuss this with you and your family and make the process as smooth as possible. 

During Pregnancy: 

Some conditions that arise during pregnancy could make it necessary to transfer care to a physician for hospital delivery. Some examples are gestational diabetes that requires medication, high blood pressure, or breech presentation. We have a collaborative relationship with Gynics Associates and can make a seamless transition to this all-female team of obstetricians when needed.
 

During Childbirth:
In addition to our collaborative relationship with Gynics Associates, Austin Area Birthing Center has a formal transfer agreement with St. David’s hospitals. St. David’s has locations in both North and South Austin, as well as a location in Central Austin. All three locations have 24/7 OB Hospitalists on staff, ready to accept our clients as needed. Two of these locations even have nurse-midwives on their Hospitalist staff! In the event that you need transport to a hospital, our midwives will arrange transfer to the closest St. David’s location or to another hospital of your preference if time allows. The midwife can accompany you to the hospital and assist with the admission process. 

All clients have an ultrasound at 20 weeks from our ultrasound technicians and we are able to perform these at AABC Duval and AABC South.

If a scan is abnormal or the mom has risk factors, we refer to one of the Perinatologists we work closely with.

Ultrasounds are useful in dating a pregnancy when the mother is not certain how far along she is. They are also used near 20 weeks gestation to examine the baby and placenta. Occasionally, ultrasounds are used when a pregnancy lasts past the due date. This provides your midwives with more information about the baby’s health.

Our north and south facilities have an ultrasound machine.

Absolutely! Each of our birth rooms has a deep tub appropriate for labor and waterbirth. We’ve worked hard in our 30 years of operation to find the most comfortable birthing tubs available. Our tubs are outfitted with strategically placed handles to allow you to brace yourself while finding your most comfortable birth position. Almost all of our clients use water for relaxation in labor, and about 20% of our clients choose to deliver their babies in the water.  

During the COVID pandemic, we ask that you have no more than three support people at your labor and birth. These three people will stay in the birth room with you throughout your stay at the birth center. 

Outside of the Covid pandemic, you may select anyone you wish to support you during your labor and birth. At AABC, we are committed to providing a warm, calm and nurturing environment for clients as they labor and in the important first moments of bonding with their newborns.  We encourage you to choose support people who understand what is important to you during this special time and are comfortable with out of hospital birth. 

Austin Area Birthing Center is an outpatient facility, so you typically stay at the birth center for 6-8 hours after the birth. During that time, the birth assistant looks after you and your baby and provides detailed instruction and support. We will assist with breastfeeding and perform an initial examination for your newborn. Families may remain at the birth center for up to 12 hours after delivery if a longer recovery is needed.   

Following discharge, a midwife will see you and your baby at the birth center at 2-3 days after birth, at 2 weeks after the birth, and at 6 weeks. These visits include both postpartum care for you and newborn care for your baby. 

Austin Area Birthing Center is significantly less expensive than a hospital delivery. Our cost is similar to that of a home birth, and we are in-network with most major insurance companies. We offer a prompt–pay discount for self-pay clients, and a financial hardship discount for those that qualify. Our flexible payment plans strive to make care affordable for most budgets.  

It is important to understand when shopping for a birth provider what your quote includes. At Austin Area Birthing Center your care quote will include all routine prenatal care, labor and birth, postpartum and newborn care to 6 weeks, newborn hearing screen as well as the facility fee for you and baby. It does not include ultrasounds, non-routine visits and lab processing fees. If you are comparing quotes from other providers, be sure they are including costs for baby and the facility.  

We work with the following insurance plans:  

• Aetna PPO/EPO
• BCBS PPO
• BCBS HealthSelect
• BCBS Blue Advantage HMO
• BCBS Federal Plans
• Cigna PPO
• Great West
• Humana PPO
• Medishare
• Oscar
• Sana Benefits
• Tricare (**providers only at this time, facility is self-pay)
• TriWest
• United Healthcare/UMR (Providers are in-network, facility is out of network)
• WebTPA/Whole Foods
• Some Healthshares we can bill directly, others we can provide a list of care with CPT and ICD-10 codes after delivery to aid with reimbursement.  

Don’t see your insurance listed? Ask us!

Unfortunately at this time, we cannot accept Medicaid, however, most clients that qualify for Medicaid will also qualify for our reduced hardship rate.

Financial questions are best answered by our Billing Team or Front Office Team.  If your insurance has specific requirements for birth center coverage, we can provide personalized guidance for appropriate steps you should take. If you’re unsure about your benefits, please contact our front office staff and we can verify your benefits for a small fee. We are happy to research and determine what your out-of-pocket costs will be when using your medical insurance. 

You can begin care at AABC until the last several weeks of pregnancy as long as you have a low–risk pregnancy and have been getting regular prenatal care. Please contact our office as soon as possible to discuss this option if you are later in your pregnancy and interested in a birth center birth. If you have had any other prenatal care during your current pregnancy, please be prepared to provide those records.  

Certain medical conditions are not appropriate to manage outside of the hospital for pregnancy, labor, and birth. This does not occur frequently, but in order to ensure the highest safety standards for an out of hospital birth, AABC has developed a list of conditions that are not approved for delivery at the birth center. Some examples include: 

• Any hypertensive (high blood pressure) disorder prior to or during pregnancy 
• Pre-eclampsia in current pregnancy 

• Blood clotting disorders 
• Placenta Previa (placenta is over the cervix) 
• Uncontrolled chronic medical diseases 
• HIV, Hepatitis B or C, or Syphilis 
• Pre-existing diabetes or gestational diabetes requiring medication 

• History of two or more cesarean section deliveries or one cesarean delivery with a vertical incision. 
• Twins or greater multiples this pregnancy 
• Breech presentation (baby not head-down) at term 

At AABC, we offer VBAC if you have a history of one prior c-section with a low transverse incision and have an otherwise low risk pregnancy. We will request records of your previous c-section delivery to confirm that a VBAC is a good option for you. At the beginning of your care, we will review the risks and benefits of this option so that you can make the best choice for your family. Your chance of a successful VBAC is higher in a low-intervention environment such as a birth center.  

To understand more about a VBAC at AustinABC please click here to watch a video.