PCC Community Wellness Center (PCC), a federally Qualified Community Health Center, operates the Birth Center at PCC within the premises of PCC South Family Health Center in Berwyn, IL. The Birth Center at PCC is available to pregnant women who are patients at PCC clinic sites and who meet medical inclusion criteria. Currently PCC provides Maternal and Child Health Services at seven clinics; pregnant women deliver with midwives and physicians at West Suburban Medical Center and Westlake Hospital. The Birth Center offers women who are low-risk an alternative, out-of-hospital site for birth. The Birth Center at PCC offers birthing women a safe, supportive, and family-friendly environment that minimizes use of technology while remaining cost effective.
The Birth Center at PCC is a substantive project because it offers a new service that is not available in either the Illinois Health Planning Area (A-06) or PCC’s service area. PCC clinics serve Chicago’s Westside communities and nearby western suburbs. The Birth Center serves a population that is primarily low-income, medically underserved, and who have not previously had access to a freestanding birth center. PCC patient data indicate that 65% of patients are covered by Medicaid or Medicare while 19% are uninsured. Approximately 80% of PCC patients live at or below 200% of the Federal Poverty Level. In addition to serving a population who do not have access to professionally staffed out-of-hospital delivery services, the Birth Center provides these services at costs significantly lower than a hospital, while offering appropriate levels of service and safety precautions. A typical vaginal birth, with no complications, on average costs $3,438 at a birth center, compared to $8,920 for an uncomplicated vaginal birth in a hospital.
Women coming to the Birth Center at PCC for prenatal care may choose the birth center for their deliveries if they meet low obstetrical risk requirements. Prenatal care for birth center patients is provided along the same timeline as PCC patients who deliver in the hospital, becoming more frequent in the last trimester of pregnancy. Care is focused on prevention of complications and vigilant monitoring of risk factors to allow for appropriate referrals when indicated. The Birth Center's patients receive prenatal care from providers at the same PCC clinic sites as pregnant patients who will deliver in the hospital and follow screening protocols at the same intervals. PCC practices an integrated care model, enabling Birth Center patients to access primary care, behavioral health care services, oral health care, and financial counseling during their pregnancies.
Women who choose to deliver in the Birth Center travel to the center in labor rather than to the hospital. Two birth rooms with private baths are available to patients. Proper staffing ensures that women are attended to in a timely manner both by a primary midwife and a birth assistant. Select mothers have the support of a labor support doula as well. Women in labor receive attentive care from staff in the comfort of a home-like setting without sacrificing health or safety standards. Patients have access to birthing tubs for hydrotherapy as well various tools that may be used for pain management. Mother and baby receive appropriate monitoring throughout labor in order to ensure labor is progressing well and without developing complications.
A mother’s support persons are welcome to remain at the center throughout labor, either in the patient’s room or in the family waiting area. Care is given to ensure the Birth Center space remains a safe and comfortable environment for the laboring mom. Upon delivery, the birth team provides appropriate postpartum care for the mother and provides all immediate newborn care. Mother and baby remain together at all times after the birth to enable breastfeeding initiation; each is monitored closely. After the dyad rests and each are confirmed to be in good health, the family may leave the Center to complete postpartum recovery at home. A birth assistant or Community Health Nurse provides a home visit between 24-48 hours after birth to monitor mother’s and baby’s health and to address any feeding or care concerns. Mother and baby follow-up with a midwife at a PCC clinic three to four days after delivery.
PCC anticipates that the Birth Center will serve up to 200 patients during its first year of operation and expects to serve a maximum of 290 birthing women annually when capacity is reached within three years. An administrative team, Certified Nurse-Midwives (CNMs), birth assistants, and doulas operate the Birth Center with the support of lactation consultants and PCC administrative staff.
The medical providers for the Birth Center at PCC are CNMs employed by PCC. CNMs are licensed and certified independent health care providers who care for women across the lifespan and specialize in reproductive health and perinatal care. PCC providers provide well woman care, perinatal care, including deliveries, and postpartum care to birth center patients. PCC also employs Family Practice Physicians who practice Level One or Level Two obstetrics, as well as Obstetricians, who are available for consultation and transfer of care when required. Collaboration between providers ensures continuity of care for patients who may need the support of additional clinicians. Pregnant patients who develop risks that prevent delivery at the birth center continue to be served by PCC providers throughout the perinatal period, including delivery in the hospital. Patients who require hospital transfer during or after birth are accompanied by the attending midwife to the closest hospital, West Suburban Medical Center. Transfer of care is given to a physician for high risk deliveries or Cesarean births. West Suburban Medical Center transfers neonates requiring Level III care to Northwestern Memorial Hospital in Chicago, their regional Level III Perinatal Center Partner.
The Birth Center at PCC meets National Standards for Birth Centers developed by the American Association of Birth Centers (AABC) and seeks accreditation by the Commission for Accreditation of Birth Centers within the first year of operation. PCC Community Wellness Center is Joint Commission Accredited, demonstrating an ongoing commitment to high level attention to patient safety and patient care. Monitoring of equipment and evaluation of proper housekeeping and maintenance procedures is reviewed routinely. In addition to meeting practice standards required by the Illinois Department of Health (IDPH), PCC follows an organization-wide commitment to continuous performance improvement by measuring success of program objectives and goals. The Birth Center Steering Committee regularly holds team meetings, assesses objectives, and identifies areas for improvement. Birth Center staff engage in ongoing clinical education, emergency drills, and quarterly peer-review evaluations to ensure best practices.