Frequently Asked Questions
FAQ
What are the differences between giving birth at a hospital vs. a birth center?
A birth center is a healthcare facility dedicated to providing care for low-risk pregnancies and births. These centers are designed to create a home-like atmosphere, promoting natural birth practices and personalized care. They also encourage family participation, allowing loved ones to be actively involved in the birthing experience. The Birthing Inn, for example, is staffed by licensed midwives (LMs, CPMs) and certified nurse-midwives (CNMs) who work in close collaboration with obstetricians to ensure safety during low-risk pregnancies.
Birth centers are generally cheaper than hospitals because they focus on natural birth methods and minimize the use of the medical intervention, testing, and resource-intensive care that contribute to high costs at a hospital setting.
How far is The Birthing Inn from JBLM?
The travel time between JBLM and The Birthing Inn is approximately 18 to 20 minutes.
What insurance plans are accepted?
We accept most major insurance plans, including Medicaid. Please see our Financial Policies page for more information or contact our office to verify coverage and discuss billing questions.
Can I bring my partner or support person to my delivery?
Yes, partners and support persons are welcome to be with you throughout labor and delivery. There is only space in the delivery suites for one or two additional individuals, but there is space to wait in the main room, which includes access to the kitchen.
We do not recommend bringing other children to a birth as it can be an extended wait.
What amenities are available at The Birthing Inn?
Our facility includes three private birthing suites, a large tub in each and individual bathrooms, comfortable lounge areas, and a kitchen for family use. We offer snacks and beverages which are available in the kitchen.
Is water birth an available option?
Yes, we offer water birth as a natural and relaxing option for eligible women. The tub in each suite is large enough for two adults to comfortably use. We utilize the tubs for pain management, comfort and relaxation, and for the delivery itself, if desired.
What should I bring with me for labor?
Please bring comfortable clothing, slippers, toiletries, and any personal items you wish to have during your stay. We do not advise bringing any “pretty” pillows, blankets, or clothing – they will not stay clean.
How long will I need to stay after the birth?
Typically, stays range from 4 to 6 hours after a normal delivery, depending on your and your baby’s health.
Do you provide postpartum support?
Yes, we offer postpartum visits, breastfeeding support, and parenting classes.
What if I have a high-risk pregnancy?
Unfortunately, there are several circumstances wherein we are legally unable to provide birthing services at the Inn. There are certainly home birth options still available which several of our amazing midwives can provide.
Is childbirth education available?
We offer childbirth classes that you can register for during your prenatal visits and by contacting the office. There are other childbirth classes available in the nearby community, as well.
How do I contact The Birthing Inn in an emergency?
In case of an emergency, call 911 immediately. For non-urgent inquiries, please page the midwife on-call. You may also call our main office number listed on our website.
Is The Birthing Inn licensed and accredited?
The Birthing Inn is licensed by the Washington State Department of Health and has been nationally accredited by the Commission for the Accreditation of Birth Centers since 2016.
Do I need a doula?
You are welcome to have a doula accompany at your birth at The Birthing Inn. Doula’s are not Midwives or Physicians, they are birthing coaches who are specially trained and experienced in the process of birth and labor. This might include education, emotional support, or physical support before, during and after labor. Consider adding a Doula to your birth team!
The Birthing Inn recommends utilizing CalledtoBirth.com or DoulaMatch.net to find the right Doula(s) for you.
Is it safe to labor and give birth in a freestanding birth center?
Studies have shown that for healthy, low-risk pregnancies, giving birth at a freestanding birth center is as safe as giving birth in the hospital. The American College of Obstetricians and Gynecologists agrees. In November 2011, The Birthplace Cohort Study involving over 64,000 women in England found that “for planned births in freestanding midwifery units…there were no significant differences in adverse perinatal outcomes compared with planned birth in an obstetric unit”.
Healthy people giving birth in a birth center avoid the routine use of advanced technology and interventions that may not be most appropriate for normal physiologic birth. Women giving birth at The Birthing Inn receive skilled, continuous care and labor support from Certified Professional and Certified Nurse-Midwives. Research has shown that continuous labor support decreases the need for epidural anesthesia, medical interventions, and cesarean sections.
Who provides care at The Birthing Inn?
The Birthing Inn offers comprehensive prenatal care by Certified Professional Midwives (CPMs) and Certified Nurse-Midwives (CNMs). Our CPMs and CNMs are licensed as independent practitioners in Washington State. They have advanced training in midwifery and are experts in normal pregnancy and birth. The midwives’ scope of practice includes all prenatal, labor, and birth care, as well as immediate care of the newborn after birth and extended care of the postpartum mother. CNMs at The Birthing Inn also offer gynecologic health care throughout the lifecycle.
What conditions could prevent me from giving birth with The Birthing Inn?
The Birthing Inn specializes in normal physiologic birth. Please review below TBI’s list of Risk Factors for more information. While the list is not exhaustive, the mentioned conditions are generally incompatible with care at The Birthing Inn. Please note that TBI does not consider age or IVF/ART to be risk factors.
- A previous cesarean section (the state won’t allow VBACs in birth centers)
- Clotting or bleeding disorder, or are severely anemic
- Preeclampsia or high blood pressure requiring medication
- Plurality gestation: twins, triplets, etc.
- Unmanaged diabetes prior to pregnancy or starting in pregnancy
- Preterm labor leading to birth before 37 weeks of pregnancy – TBI can do prenatal and postnatal care but early delivery may need to be performed at a hospital.
- BMI greater than 40
- Certain active infections
- Certain untreated or active sexually transmitted infections, please reach out for a personal discussion if you have concerns in this area.
- Certain blood disorders, heart conditions, and other medical problems
- Disorders of fetal development requiring hospital intervention at birth
- Emergency situations in labor, such as cord prolapse or difficulties with newborn resuscitation will require immediate transfer to a hospital.
- Inadequate prenatal care (While we can usually help make up for “missed” prenatal visits, state law prohibits The Birthing Inn from providing late transfer services when we can anticipate the individual will have had less than 7 prenatal visits total in pregnancy before delivery)
- Incomplete legal paperwork when families plan adoption or surrogacy may complicate hopes for a birth center birth. Please work out all details during a consultation with The Birthing Inn Director prior to 36 weeks gestation.
- Inability/unwillingness of pregnant person or family members to forgo smoking/vaping tobacco, marijuana, or other products during labor & postpartum within TBI care.
- Factors usually addressed during pregnancy but if discovered on admission would prevent discharge after the TBI postpartum stay: no home, no corset, no helping adult, teen, or supportive assistance, no transportation, cellphone, or other means of calling for help.
Are lab and ultrasound services available at The Birthing Inn?
Routine prenatal labs are drawn at The Birthing Inn and are usually processed by Quest Laboratory. The Birthing Inn will refer to a third party for early pregnancy scans.
Genetic testing and perinatal consultation are available to our families with a referral from one of our midwives.
What is The Birthing Inn’s approach to ultrasound?
TBI’s midwives are committed to practicing evidenced-based, financially responsible care and will only assess, test, and treat when medically indicated.
If indicated, an early ultrasound will be performed or referred to an outside facility depending upon provider availability.
Who will attend my birth?
Continuous labor and delivery support is provided by a Certified Professional-Midwife (CPM) or a Certified-Nurse Midwife (CNM) aided by a Birth Assistant. Midwifery students may also assist at births. Doulas, friends, family members, and other support persons chosen by the laboring mother are welcome to attend births at The Birthing Inn.
Is medication available at The Birthing Inn?
Emergency medication and equipment such as IVs and oxygen useful during normal birth are available at The Birthing Inn. We do not offer epidurals for pain relief, as this is an advanced anesthetic procedure requiring a hospital environment for appropriate monitoring and safety.
What comfort measures are available during labor and delivery?
The Birthing Inn specializes in natural birth. We offer a wide variety of comfort measures including:
- Nitrous Oxide for pain relief
- Water birth in our large labor pools
- Use of birth balls and birthing stool
- Freedom of movement
- Bluetooth speaker for soothing music
- Aromatherapy & essential oils
- Ability to eat and drink as desired
- Continuous labor support from your midwifery team (and doula, if you have one)
What happens after my baby is born?
After birth your baby will be placed in your arms for immediate skin-to-skin contact. Your midwife team will assist you with breastfeeding while continually monitoring your and your baby’s health during the immediate postpartum period. Families stay at the birth center an average of four to six hours after birth.
How does TBI approach the end of pregnancy?
The Birthing Inn’s approach to the end of pregnancy is guided by recommendations from American obstetric and maternal health organizations and client preference. Many pregnancies progress past 40 weeks, especially first time pregnancies.
If your pregnancy reaches 41 weeks you can expect to have a discussion with your midwife about possible next steps, which will include the option of induction in the hospital. If you prefer to let your pregnancy continue and all other health indicators are normal, your midwife will provide or arrange testing to confirm that your baby is doing just fine where they are. This testing will include an ultrasound to confirm that you have a normal amount of amniotic fluid around your baby, and a non-stress test (NST), which involves placing monitors on your belly to assess your baby’s heart rate over the course of 20-40 minutes. She will discuss natural methods for encouraging labor.
If you are still gestating at 42 weeks, we will recommend induction of labor at a local hospital. Washington State and our birth center accrediting body dictate that we attend births only between 37 and 42 weeks in the birth center. Outside of those times we will refer you to our associated in-hospital obstetricians and CNMs.
What can I expect in my postpartum time?
24-48 hours after the birth of your baby at the birth center, you will return to your midwife’s office for newborn testing and to evaluate your postpartum progress. The midwife will assess your health and emotional well-being and discuss any concerns you might have. The midwife will also assess your newborn and complete recommended assessments (see “What pediatric services does TBI provide?” below). For babies born in the hospital, these assessments will be provided by the great nurses at Tacoma General or St. Joseph’s. See “What can I expect during the later postpartum weeks,” below for more information.
What pediatric services are provided by The Birthing Inn?
Before leaving the birth center a TBI midwife will perform your baby’s first newborn exam and administer any of the medications recommended at the time of birth that you would like your infant to receive. These medications include Vitamin K and erythromycin eye ointment.
At your first postpartum visit, which occurs at 24-48 hours after your baby’s birth, a midwife will complete several recommended newborn assessments. These include a Metabolic Screen, CCHD (Critical Cardiac Defect) screen, and jaundice screening. Additionally, the TBI midwife will assess your baby’s feeding at this visit and help you troubleshoot any early difficulties. You will be referred to a nearby hospital to complete newborn hearing screening within a 1-2 week timeframe.
The Birthing Inn requires clients to have a permanent pediatric provider chosen prior to birth and recommend you take your newborn to see that provider within 3-5 days post-birth.
How late in my pregnancy can I transfer my care to The Birthing Inn?
We are happy to accept very late transfers in pregnancy, at the discretion of our individual midwives.
Please contact The Birthing Inn for more specific details. We do require adequate medical records in order to facilitate care, so the sooner those can be provided, the better.
What is the Process of transferring my care into The Birthing Inn?
The Birthing Inn values the relationship that is forged over the length of a pregnancy. We also understand that sometimes a pregnant person finds that their preferred philosophy of birth changes over the course of a pregnancy. With that in mind, we welcome transfers of care at all stages of pregnancy.
Transferring clients must review the “What Conditions Could Prevent Me From Giving Birth with the The Birthing Inn?” section of the Frequently Asked Questions above.
Transfer clients who have not given birth previously are encouraged to pursue childbirth education and/or doula services.
Transfer clients will be conditionally accepted for care until their complete medical records are reviewed at the Intake appointment.
“Transfer” means that clients must have their complete prenatal records sent to the The Birthing Inn and have an appointment scheduled with a midwife.
All transferring clients must have complete records from their current pregnancy sent to our offices prior to their first visit (their “intake” appointment). If you have not done so, please call our office at (253)761-8939 and make an intake appointment for transfer of care. Medical records can be transferred using the Release of Information form and faxed to (253)761-7492.
I have paperwork to fill out for Short Term Disability/FMLA. How can I get that completed?
Many companies require specific paperwork to be submitted to initiate Short Term Disability and/or FMLA leave related to the birth of a child. If you will be utilizing benefits through your employer, we highly recommend speaking with your benefits administrator prior to your birth to confirm the necessary paperwork and timeline for submission.
The Birthing Inn midwives are happy to assist you in completion of the medical portion of the necessary paperwork.
How do I obtain my baby’s birth certificate if I give birth at The Birthing Inn?
We will help you fill out Washington State’s Birth Certificate Worksheet. The Birthing Inn will file your completed information with the Washington State Department of Health, and you will be able to order official copies of your baby’s birth certificate within a few weeks after birth.
Can you help me get a Social Security Number for my baby?
We provide and complete the Washington State Birth Filing Form. Within that form is a box to check off YES or NO if you’d like a social security number for the baby.
The parent or caregiver will then need to order the Birth Certificate and social security card through the Department of Health or the Office of Vital Statistics.
What can I expect during the later postpartum weeks?
Care during the weeks postpartum can be scheduled, or it can be quite fluid, depending on your needs. The midwives who helped you give birth expect to schedule at least two appointments after you and baby have had your 48-hour check-up. The first might be as early as a week later if feeding issues need attention. If not, 2-3 weeks is the norm, and can easily be accomplished virtually if all we need to do is discuss future family planning. The second is usually in-person at around 6 weeks, but can be adjusted earlier or later, according to your needs. Six to 8 weeks postpartum is when your midwife is likely to offer a gentle physical exam, investigate and help you understand and plan for future care and screening exams.
Can I get my general health care at The Birthing Inn?
The Birthing Inn recommends everyone have their own primary care provider (PCP). This can be a physician or nurse practitioner available through private practice or a larger health system who can treat (or refer) anyone in your family for just about anything: a broken finger, exposure to mono, or a recurring sinus infection.
People who need family planning and women’s health care get to choose specialists in that care. So, YES! You can choose a midwife who’s also a nurse practitioner for healthcare from birth through menopause at The Birthing Inn. Ask at the front desk about our services!
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