Global Birth Home/Center Definition
A birth home is a physical facility reflecting a local woman’s home-like environment, that is separate from CEmONC facility and, when in a low resource area, meets BEmONC standards of care.
Providers are skilled birth attendants, usually midwives, as defined by WHO/ICM,,.
The philosophy of care provided is the midwifery wellness model of care for healthy women with normal labor, birth and support. Continuous risk assessment is done throughout her care to assure appropriate level of care is provided. The midwifery model of care specializes in low medical intervention and high comfort, “a high touch, low tech approach”, reinforced by care dependent on relationships and community, involving time, education, personal attention and trust.
The “program of care” required to do this is a relationship driven care model, often including such things as childbirth education, support groups, breastfeeding education and support, nutrition and health education, community outreach, centering pregnancy, family planning and GYN care to meet a particular community’s needs.
A birth center is committed to a woman’s health safety, personal safety of staff and woman, cultural safety and community safety as demonstrated through standards of care.
The birth center is rooted in a woman’s local community, working with local health care providers, and is part of the larger health care system, working with the community’s CEmONC through drills, education and communication to facilitate high quality of care, collaboration and transfers of women as needed, directly and easily.
“a skilled attendant is an accredited health professional — such as a midwife, doctor or nurse — who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns. Core midwifery skills have been defined by the International Confer deration of Midwives in a document entitled Essential Competencies for Basic Midwifery Practice, available at http://www.internationalmidwives.org”1
“Types of skilled attendants and the mix of skills and abilities While it is up to each country to decide on how maternity care should be organized, much depends on the availability of skilled attendants, the composite set of skills and abilities they possess and the resources available to recruit, train and retain these staff. The principal categories of skilled attendants found in many countries include:
Midwives (including nurse-midwives): Persons who, having been regularly admitted to an educational program duly recognized in the country in which it is located, have successfully completed the prescribed course of studies in midwifery and acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery.
Nurses with midwifery skills: Nurses who have acquired midwifery knowledge and skills either as a result of midwifery being part of their nursing curricula or through special post basic training in midwifery.
Doctors with midwifery skills: Medical doctors who have acquired competency in midwifery skills through specialist education and training, either during their pre-service education or as part of a post-basic program of studies.
Obstetricians: Medical doctors who have specialized in the medical management and care of pregnancy and childbirth and in pregnancy-related complications, but not usually complications of the newly born infant. They have usually undergone additional education and clinical training to acquire these additional skills and have been certified or accredited in obstetrics.”2
 BEmONC provides: parenteral antibiotic, oxytocin and anticonvulsant drugs, manual removal of the placenta, removal of retained products of conception and assisted vaginal delivery (vacuum delivery) as well as basic newborn resuscitation and care. CEmONC provides: BEmONC level care and cesarean section and blood transfusion. http://pdf.usaid.gov/pdf_docs/PA00JX4F.pdf