- Nicole Villalpando American-Statesman Staff
Dr. Christina Sebestyen of OBGYN North envisioned a place where her patients could come and have a natural labor under the care of a midwife. A place that would feel more like a luxurious hotel room with large jetted tubs, comfortable queen beds and spacious bathrooms. It would have the comforts of home for the family: a living room with comfortable couches, a large-screen TV and a kitchenette.
It also would be a place where, if a patient had complications, the attending midwife could accompany her across the street to a hospital and continue to attend to her needs as well as have access to Sebestyen or her fellow doctors in the practice.
That place became a reality on Labor Day. OBGYN North opened the Natural Beginning Birth Center, connected to its new offices. Five certified nurse midwives will staff the center, working 24-hour on-call shifts, as well as nurses. The center has three birthing rooms. It’s designed for about 30 births a month.
This isn’t the first time OBGYN North has opened a facility for birth. The practice began in 1982 under Dr. Margaret Thompson, who coincidentally delivered my children, and was part of a group that had the adjoining Renaissance Women’s Center hospital from 1997 to 2001. Sebestyen bought the practice in 2008.
Most of the pregnant women in the practice won’t be candidates for Natural Beginning Birth Center. In fact, Jamie Cousins, the director of the center, estimates that about 10 percent of the practice’s patients will choose it. They have to agree to do a natural birth. There’s no going across the street for an epidural and going back to the birth center to deliver.
“It’s a commitment,” Sebestyen says. “It’s a real effort, and it’s a different experience.”
Even if a patient plans on having a natural birth, if she is high risk because of things like high blood pressure or having a vaginal birth after Cesarean, she’s not a candidate for the center. And her baby can’t be high risk, either. High-risk patients still can have a natural birth with a midwife, but they have to do it across the street at the Women’s Center of Texas at St. David’s North Austin Medical Center.
A mom will come into the birthing center when she is in active labor — about 4 centimeters dilated with regular contractions. She can walk around the center to help her labor or get into the jetted tub that is hospital-grade and sanitized. The center is designed to emulate a home birth but with a hospital across the street in case of emergency.
The practice already has tested out how quickly it can get a mom from the birthing center to the hospital. Recently Sebestyen had a woman pregnant with twins come into her office bleeding from the placenta abrupting from the uterine wall. They rolled the mom across the street in a wheelchair, which was faster than EMS. The time from when the woman walked into the office to the time her babies were delivered by Cesarean was 10 minutes.
During labor, while the mom can’t get an epidural, she can use nitrous oxide or laughing gas, which is a popular practice in Europe. She will have a mask she’ll have to fit to her face, and only then will it release the gas. No one else in the room is allowed to give her the gas. That’s a safety precaution to make sure that she doesn’t get too much, Sebestyen says, because if she is getting too much, she won’t physically be able to hold it to her mouth. A valve in the room will take away any errant gas.
The gas, Sebestyen says, is nice during transition, a time when many women will give up on natural childbirth. It keeps them relaxed yet doesn’t affect blood pressure or blood flow to the placenta. Plus it doesn’t cause the muscle weakness that an epidural does and allows the mom to still push effectively.
There’s no stirrups on the bed when it’s time to push, and the mom can chose to have a water birth in the tub if she wants. Fathers are encouraged to be involved and even help catch the baby if they want.
Once the baby is born, the family stays four to six hours before heading home. They see their pediatrician the next day.
“Birth is about family,” certified nurse midwife Siobhan Kubesh says. “What happened over time is it became medical and about the other people in the room.”
With the birth center, it becomes about the family again, she says.
The center will work with the mother’s insurance, but each mother will be charged a $4,500 facility fee they pay in advance and then get reimbursed by their insurance if the insurance will cover a birthing center.
Christy Connelly and her husband, Leon, are planning to use the center for the birth of their first child, Taylor Christienne Connelly, who is due in November.
“When we heard about OBGYN’s new birthing center, we were very excited because we feel like we’re getting the best of both worlds,” she says. “We love that it will be comfortable, like a home setting, with the support of the midwives, but that we have the security of St. David’s North right across the street and the added support of the doctors that we already have a relationship with, should we need them.”