Many families today are seeking a more natural, empowering, and low-intervention birth experience. A major benefit of choosing a birth center birth, is a significantly lower risk of cesarean section.
Cesarean section rates tend to be significantly higher in hospitals compared to birth centers. National data shows that cesarean rates in accredited birth centers are around 6%, compared to approximately 32.1% in hospitals (CDC). And research indicates that planning to give birth at a birth center is associated with a lower likelihood of cesarean delivery, even if a transfer to a hospital becomes necessary during labor (The American Association of Birth Centers’ National Birth Center Study II).
This difference highlights the contrasting philosophies of care between the two settings, with birth centers generally promoting less invasive approaches unless a medical necessity arises.
Why Avoid Cesarean?
Because c-sections are performed so regularly, many people are unaware of the risks involved in cesarean delivery. In the short term, cesarean sections are associated with increased risks of infection, blood loss, blood clots, and longer recovery times compared to vaginal births. Women may also experience more pain and limited mobility in the days and weeks following surgery. For babies, there is a slightly higher risk of respiratory issues, particularly if the cesarean is performed before labor begins.
In the long-term, women who have had a cesarean delivery may face complications in future pregnancies, such as placenta previa, placenta accreta, or uterine rupture, especially with multiple cesareans. Additionally, cesarean birth has been linked in some studies to altered gut microbiota in infants, which could potentially affect immune development. This is why we work hard to help women avoid the first cesarean and if she has had a c-section we provide her with education and options for future births including VBAC (vaginal birth after cesarean).
With the right support, most women can have a vaginal delivery with little to no intervention. Everything from the environment to the philosophy of care is designed to support natural birth.
In this article, we’ll explore exactly how birth center birth helps reduce the risk of cesarean delivery and why this approach can lead to safer, more satisfying outcomes for both mother and baby.
Safe, Private, and Unobserved Birthing
Doctor Sarah Buckley, has said that a woman needs to feel safe, private and unobserved to deliver vaginally without intervention.
Our Birthing Centers in Morristown and Guttenberg, right on the Hudson, naturally allow for these things. The atmosphere is quiet and peaceful, and we even offer outdoor areas to encourage labor progression. You don’t have to be stuck in a stressful hospital environment during one of the most important moments of your life.
Familiar Faces
In birth center settings, labor unfolds in the presence of people the mother knows and trusts. Unlike in many hospital settings, where care teams rotate frequently and unfamiliar nurses or doctors may enter the room, our clients are surrounded only by the Midwives, Nurses, and Midwife Assistants who have walked with them throughout their entire pregnancy. These are faces she’s seen at prenatal appointments, hands that have measured her belly and listened to her baby’s heartbeat, voices that have answered her questions and eased her worries. This consistency creates emotional safety, essential for labor to progress naturally.
Water Therapy Available
Water therapy is more than a comfort measure, it’s an integral part of our approach to supporting physiologic birth.
Waterbirth offers significant benefits, including:
- Reducing pain perception
- Lowering stress hormones
- Enhancing the release of endorphins and oxytocin, the body’s natural painkillers and labor hormones, for natural pain relief
The buoyancy of water alleviates the pressure of gravity, allowing for easier movement and position changes, which can facilitate labor progression. This environment helps the laboring woman access her “hind brain,” the instinctual part of the brain that governs the natural processes of childbirth, enabling her to stay in her “zone” and labor more effectively.
Since our first water baby in March 2000, we’ve delivered over 1,000 waterbirths without a single complication related to the water setting. Over 40% of our clients choose waterbirths, drawn by the comfort and autonomy it provides. The warm water not only eases labor pain but also creates a sacred space for birth, promoting a calm and empowering experience for the mother.
Additionally, waterbirths are associated with reduced perineal trauma, as the warm water allows the perineum to stretch more gently, and the buoyant environment enables mothers to assume positions that facilitate easier delivery.
No Electronic Fetal Monitoring for Mom and Baby
There is no fetal monitor in the birth center because continuous electronic fetal monitoring isn’t shown to improve birth outcomes in low-risk women. According to a study, continuous monitoring may increase the risk of cesarean birth. The baby is safely monitored by intermittent auscultation of its heart rate every 15-30 minutes in active labor and every 5 minutes in the 2nd stage. After the birth, the baby is assigned an Apgar score at 1 and 5 minutes of age. The respiratory rate, heart rate, temperature, color, feeding, and behavior are monitored every 30 minutes while the baby is in the birth center.
The mother has her vital signs and labor progress assessed on arrival to the birth center and then at regular intervals until the baby is born. After the birth, the Midwife and Nurse will monitor the mother’s bleeding, vital signs, and intake and output at least every 30 minutes until discharge.
After discharge home, the partner will document the baby’s temperature, intake and output, and respiratory rate, and the mother’s bleeding, intake, and output every 4 hours until the home visit. The Midwives or their nurses see the client and her baby after the baby is 24 hours old to check in on Mom and Baby and do the state-mandated Metabolic screening test and the Oxygen saturation test.
Freedom of Movement
One of the most important ways birth centers support a vaginal birth is by allowing freedom of movement. No one is telling a woman to “stay in bed” or “don’t walk around.” Movement isn’t just tolerated; it’s encouraged!
In hospitals, women are often confined to bed due to routine IVs, continuous fetal monitoring, or simply the hospital’s standard policies. Unfortunately, lying on one’s back is one of the least helpful positions for labor progress. In contrast, being upright and active can shorten labor, reduce pain, and help the baby descend, which in turn decreases the likelihood of interventions that often cascade into a cesarean.
No Routine Interventions
Nothing is done “just because.” Each decision is made thoughtfully, with the mother’s input and evidence-based guidelines in mind. Unlike in a hospital setting, where interventions like cervical checks, IV fluids, Pitocin, or artificial rupture of membranes may be routine, we let labor unfold on its own whenever possible.
Why does this matter? Because every intervention has a potential consequence. Induction and augmentation with Pitocin, for example, are linked to increased cesarean rates. Artificially breaking the water (AROM) can also raise the risk of infection or lead to more painful contractions that are harder to manage. By avoiding unnecessary interventions, we reduce the chances of the labor veering off course.
Personalized Care From Midwives
Midwives are experts in normal birth. At our practice, every client is under the care of a trained Midwife who trusts in the natural process and knows how to support it while also recognizing when medical help is needed. This combination of deep physiological understanding and clinical skill is powerful and translates into the highest level of care.
Midwives’ low risk patients have fewer cesareans than obstetricians’ low risk patients. This is not because we take risks, but because we manage labor differently. We wait, watch, and support. We encourage rest when it’s time to rest, movement when it’s time to move, nourishment when energy is low, and emotional reassurance at every step. And it’s evident in our birth statistics – our average cesarean rate is around 13% while the national average is around 32%.
You aren’t left alone to labor behind a curtain. We are present, attentive, and available. Having continuous labor support is one of the best ways to reduce the risk of undergoing a cesarean procedure.
A Foundation of Trust
Perhaps the most subtle but powerful way that birth center birth reduces cesarean risk is by cultivating trust during the birth process.
Hospitals can feel clinical, even when the staff is kind and caring. There’s a risk of the process being treated like a crisis waiting to happen. That atmosphere can lead to fear, which increases adrenaline, which can stall labor. At Midwives of NJ, the message is: You were made to do this. We’re here to support you, not to control you.
That kind of trust creates a feedback loop. When a woman feels safe and supported, she can relax. When she relaxes, her body releases oxytocin, the hormone that powers labor. When oxytocin flows, labor progresses. That progress reinforces her confidence. And the cycle continues.
Patience, Not a Running Clock
In the hospital, there’s often a “clock” running. You’re strictly monitored by how long you’ve been in labor, how long your water’s been broken, and how long you’ve been pushing. These time frames can result in pressure to move things along artificially, sometimes before it’s necessary. That pressure can increase anxiety and lead to interventions like Pitocin or cesarean when the labor may have been progressing just fine on its own.
The Midwives of NJ are patient. We trust that labor unfolds differently for every woman. As long as the mother and baby are doing well, there’s no rush. This patience often makes the difference between a vaginal birth and a cesarean.
We don’t just reduce cesarean rates by accident; it’s built into every part of our care model. From the calm environment, the trust in the body to the personalized support, everything works together to support safe, satisfying, and spontaneous birth.
How Safe is Waterbirth?
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