Several hospitals, including St. Luke’s – Roosevelt and NY Methodist Hospital, have birthing centers connected to the hospital – which gives a woman immediate access to hospital-level care should she require it – but there are few options for freestanding birthing centers as many have recently closed due to funding issues, according to Jaffe.
The Brooklyn Birthing Center is still operating, however, and is well regarded by parents and healthcare professionals alike.
In order to deliver safely in a birthing center, Silverstein cautioned that expectant mothers should be in good health. “If someone were obese or diabetic, I wouldn’t want them in a birthing center, or if they have a history of high blood pressure or another kind of medical history. Usually people who decide to give birth in a birthing center know they have to be in good health.”
Women should also be confident in their pain management, as she said there are usually no epidurals available in birthing centers, though there may be other pain management options.
Even more women are opting for home births, which Silverstein asserts is the safest way to deliver in New York. She estimates that her neighborhood in Crown Heights has one of the highest rates of home birth in the country – “not because people are hippy and alternative, but because it’s really the safest place to give birth in New York.” It’s also one of the least expensive methods for insurers, and NY State law requires all insurers to cover at least one midwife care option. Medicaid also covers home births.
Silverstein also encouraged people to discard their outdated stereotypes of unhygienic home births. “Home birth midwives are all RN licensed midwives; they can resuscitate babies; they bring oxygen and they bring IVs,” she said.
Maimonides Medical Center Number One in New York State
Maimonides Medical Center in Brooklyn boasts the biggest baby business in New York State, delivering nearly 8,000 babies each year. It also has one of the lowest rates of delivery by cesarean section, 23.1% as of 2011. This may be partially due to their openness to midwives; nearly 20% of women at Maimonides delivered with a midwife in 2011, while in 2007, 13% of women delivered with a midwife, suggesting that this number is on the rise. Maimonides is also the only hospital in New York City that provides volunteer doulas on a nearly round-the-clock basis. Operated by N’shei C.A.R.E.S. (Community Awareness Responsibility Education & Support), a division of Agudah Women of America, these doulas provide parents with non-medical services such as advice during labor on breathing, positioning, relaxation techniques, as well as massage and other natural pain management. Maimonides has a strong commitment to encouraging breastfeeding; 90% of babies born there in 2011 were fed at least some breast milk.
The birthing center at Maimonides includes 11 labor and delivery suites, as well as four additional rooms for the care of high-risk women. New moms can choose from 24-hour a day rooming-in as well as daytime-only rooming-in with their babies.
Thanks to their state of the art NICU, quality support services and top-notch doctors, surgeons and specialists, the New York State Department of Health gave Maimonides the status of Regional Perinatal Center, making them the referral center for the South Brooklyn community.
The Heavy Hitters – Hospitals in New York with the Most Live Births in 2011
Maimonides (Brooklyn): 7,968 live births; 6,094 natural, 1,828 cesarean (23.1%)
St. Luke’s Roosevelt Hospital Center: 6,637 live births; 4,735 natural, 1,746 cesarean (26.9%)
Mount Sinai: 6,232 live births; 4,030 natural, 2,049 cesarean (33.7%)
NY Presbyterian – Cornell: 5,698 live births; 3,537 natural, 1,994 cesarean (36.1%)
NY Methodist Hospital: 5,422 live births; 3,385 natural, 2,006 cesarean (37.2%)
NYU: 4,654 live births; 3,289 natural, 1,260 cesarean (27.7%)
Columbia Presbyterian: 4,508 live births; 2,681 natural, 1,698 cesarean (38.8%)
Lenox Hill: 4,183 live births; 2,510 natural, 1,571 cesarean (38.5%)
Beth Israel: 3,956 live births; 2,820 natural, 953 cesarean (25.3%)
Data collected by the NY State Department of Health, available online at http://hospitals.nyhealth.gov/maternity.php.