Low Risk

What is considered Low Risk?

Birth Center care is appropriate for women who are considered low risk and have had uncomplicated pregnancies. At each prenatal visit clients are assessed for their suitability to deliver at the birth center. Only patients who are determined to be low risk and able to undergo a normal delivery shall be admitted to Our Birthing Center.

Low Risk eligibility will be determined by your care provider based on criteria established by Our Birthing Center. The following are some examples which would disqualify patients from delivering at Our Birthing Center.

  • Blood pressure: Patients with hypertension (high blood pressure) are ineligible for delivery at the birthing center. That includes pre-pregnancy / chronic hypertension and preeclampsia which is pregnancy induced high blood pressure.

  • Breech position: A client who presents with breech position does not meet risk criteria for delivery at OBC.

  • Cardiovascular: patients with documented cardiovascular problems such as heart disease, pulmonary embolism, moderate to severe cardiac murmurs or symptomatic congenital heart defects.

  • Chromosomal abnormalities evidenced in amniotic fluid.

  • Diabetes- insulin controlled. Gestational diabetes which is diet controlled may be eligible if cleared by our Collaborating Physician.

  • Epilepsy

  • Fetal growth: If Estimated Fetal Weight is less than 2500 gm or greater than 4000gm.

  • Genital Herpes- Active within one week of delivery.

  • Infection: untreated vaginal, urinary, or skin infections.

  • Kidney issues- patients with moderate to severe renal disease; pyelonephritis.

  • Multiple gestation - Twins, triplets, etc.

  • Oligohydramnios- a condition in pregnancy characterized by a deficiency of amniotic fluid.

  • Known abnormalities of the Placenta

  • Premature labor - before 37 weeks

  • Post Term labor- past 42 weeks into the pregnancy

  • STD’s: Patients with active Sexually Transmitted Diseases such as HIV.

  • Substance abuse: women with a history of substance abuse

  • Tuberculosis

  • VBAC

Transfers

What are some examples of instances which would necessitate a transfer?

DURING LABOR

The following conditions discovered during labor would cause a transfer from the birthing center to the hospital.

  • Breech: if it is discovered during labor that the baby is in breech position, they would be transferred from the birthing center to the hospital.

  • Prolapsed cord

  • Fetal heart rate abnormalities

  • Particulate meconium in amniotic fluid unless birth is imminent

  • Placental Abruption

  • Prolonged labor. For example, a patient with ruptured membranes greater than 24 hours without active labor.

  • Uterine Rupture

 

POSTPARTUM

The following conditions discovered postpartum would necessitate a transfer from the birthing center to the hospital.

  • Soft tissue problems such as marked edema of cervix, severe hematoma or laceration requiring repair by physician including 4th degree laceration.

  • Blood loss estimated to be greater than 500cc.

  • Postpartum hemorrhage failing to respond to appropriate management.

  • Maternal seizures

  • Any condition requiring more than 12 hours of continuous postpartum observation.

 

NEWBORN

The following conditions discovered with the newborn would necessitate an infant transfer from the birthing center to the hospital.

  • Apgar score of less than 7 at 5 minutes.

  • Congenital anomaly requiring immediate acute care

  • Persistent hypothermia (less than 96o F after 2 hours of life) in spite of warming measures.

  • Immediate jaundice

  • Severe or worsening respiratory distress

  • Difficult resuscitation

  • Exaggerated tremors or any seizure activity

  • Any condition requiring more than 12 hours of continuous post-delivery observation.