On December 31st of last year, my final client of 2018 gave birth to her newest family member at Mt. Sinai West. This birth was remarkable for a number of reasons: 1. #Doulabadge earned: it was the first time since starting my career as a doula that I got to share my birthday with the baby of a client. 2. It was the final day of the Birthing Center at Mt. Sinai West (formerly St. Luke’s Roosevelt)—it would close for good, the following day, on January 1, 2019. 3. This particular sweet baby was to be the last ever born at that birthing center.
Since 2009, when Bellevue’s Birthing Center closed, Mount Sinai West’s three room birthing center was the only in-hospital birth center in New York City. (Sidenote: plenty of hospitals call their labor & delivery floor a “birth center”—this is misleading and confusing for people trying to navigate options.) In 2016, pregnant people’s options increased slightly when New York Presbyterian Lower Manhattan Hospital (LOMA) opened a two room birth center. Unfortunately, because of hospital administration, LOMA’s birth center has been virtually defunct for over a year—now relegated primarily to storage space and overflow for regular labor and delivery patients.
The devastating reality for pregnant people in New York City is as of January 1, 2019, there are no reliably functioning in-hospital birthing centers serving our population.
As we settled into the birthing center, my client lurched forward, grabbing the bed as a contraction surged through her body. A few years earlier we had rushed into this same room with just minutes to spare before her first baby was born. This time around, we had come with plenty of time to enjoy the comforts of the birthing center and I quickly began filling the full-sized jacuzzi tub with warm water to help relieve her aching hips. As she submerged her full belly into the tub she sighed, “Oh this feels so good.”
Generally, birthing centers are distinguished from standard labor and delivery rooms by access to birth tubs; limited monitoring with a doppler; no routine IVs or hep-locks; large, cozy beds; the ability to move freely and eat; and access to nitrous oxide for pain management among other things.
On the labor and delivery floor, everything is made for managing potential risk. From the continuous beeping of monitors and machines to the oversized “Code Blue” button on the wall behind the bed, it is hard, as a laboring person, to not feel a quiet sense foreboding and uncertainty as you move through labor.
The births I have attended in hospital birthing centers are quiet and respectful. Lights and voices are kept low, nurses blend into the furniture and stealthily do their jobs in such a way that you may not ever realize they were there. The attending midwife or doctor takes a back seat to the birthing person and encourages them to listen to their body, trust its ability and relax into the process of birthing.
Birthing centers give the assurance that labor and birthing are normal, physiological realities. They give space for the laboring person to do exactly what they need to to get to the other side of pregnancy.
For many laboring people, the physical comforts of these in-hospital birthing center rooms are enhanced by the comfort of knowing that they also could access emergency obstetric care at a moments notice should it become necessary.
None of which is to say a quiet, respectful birth experience is impossible in labor and delivery—but it can be definitively harder.
So where does a pregnant person in NYC go for a birthing center experience now? If you wanted the true non-intervention, non-medicated, midwife supported birth experience—birthing at home with one of NYC’s licensed home birth midwives, might be your best option.
Research shows that for low risk pregnancies, birthing at home is just as safe as giving birth in a hospital. Of course, a discussion I insist on having with my clients that plan home births is the contingency plan: where do we go in case of an emergency and where do we go for a non-emergency hospital transfer? I encourage clients planning home births to tour and familiarize themselves with their options ahead of time so that it feels less traumatic if plans change or an emergency situation arises.
If home birth does not feel like the right choice, the Brooklyn Birthing Center is also an option. Midwives support births and provide prenatal care at this freestanding birth center in Midwood. The birthing center provides all the comforts of a hospital birthing center (birth tub, wireless monitoring, nitrous oxide). However, if you need to transfer care for obstetric management or emergency care, you are left to navigate your options on your own.
All things considered, Mount Sinai West is still a great option for birthing. Because the birth center ever existed there, low intervention, unmedicated births are part of the hospital culture and the nurses and staff understand the needs and wants of people who would choose a birthing center experience. My hope is that Mount Sinai West’s birthing center culture remains alive and well and the knowledge and skill to support patients who desire an unmedicated birth is not lost in the way that time and distance tends to dull competence and memory.