Development and experience of a university-based, freestanding birthing center.
OBJECTIVE
To describe our experience with a freestanding birthing center established in conjunction with a university medical center, and to determine the safety and effectiveness of such a program.


METHODS
The University of California Irvine Medical Center opened a freestanding birthing center 2 miles from the hospital. The unit provides prenatal, labor, delivery, postpartum and well-baby care 24 hours/day. All direct patient care is provided by certified nurse-midwives. Data were collected prospectively to provide a descriptive account and to evaluate maternal and perinatal morbidity and mortality to determine the safety and efficacy of this approach.


RESULTS
During the first 20 months of operation, the University of California Irvine Birthing Center cared for 1830 patients. Approximately 90% were indigent, 85% were Hispanic, and 35% were nulliparas. Of the total patients, 12% were transferred antenatally for high-risk conditions and 19% were transferred intrapartum. The cesarean rate for all patients was 10% (6.5% for those whose intrapartum care began at the birthing center). The perinatal mortality rate was six per 1000. Neonatal morbidity rates, neonatal intensive care unit admissions, and maternal complications were not greater than expected.


CONCLUSIONS
The first 20 months of experience with a university-based, freestanding birthing center suggests that this alternative is safe for delivering obstetric and newborn care to low-risk patients.
Garite
T J
TJ
Department of Obstetrics and Gynecology, University of California Irvine Birthing Center, USA.
Snell
B J
BJ
Walker
D L
DL
Darrow
V C
VC
D000293:Adolescent; D000328:Adult; D016550:Birthing Centers / Q000458:organization & administration*; D002140:California; D017046:Cost Savings; D005260:Female; D017048:Health Care Costs; D006785:Hospitals, University; D006801:Humans; D009721:Nurse Midwives; D015403:Nursing Evaluation Research; D010360:Patient Transfer; D011247:Pregnancy; D011256:Pregnancy Outcome; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D000078329:Workforce