Birth Centers: A Guide for Expectant Families in North Carolina

Written By Mariam Lam

When preparing for your journey through pregnancy, birth, and postpartum, one of the most important decisions you’ll make is choosing the care model and provider that aligns with your health needs, values, and desires. In recent years, there has been a growing shift toward physiological and unmedicated birth, with many North Carolina families seeking alternatives to the traditional hospital-based obstetric model of care.

One option that’s gaining popularity is the Freestanding Birth Center, and North Carolina is now home to six accredited birth centers as of September 2025. This provides families across the state with greater access to personalized, holistic, and evidence-based maternity care. Anyone going through the profound journey of pregnancy and childbirth deserves to have options, since not one single option is right for everyone.

What Is a Birth Center?

Birth Centers are freestanding healthcare facilities that provide client-centered, evidence-based care in a comfortable, home-like environment guided by the values of the midwifery model of care. Unlike traditional hospital maternity units, birth centers are independent facilities not attached to hospitals.

A major goal of birth centers is to minimize clinical aesthetics and, instead, create a calm and welcoming atmosphere where clients feel safe, supported, and empowered. For example, the North Carolina Birth Center (NCBC) in Chapel Hill focuses its care around inclusivity, education, and respect while honoring each family's uniqueness and structure.

The Midwifery Model of Care

The midwifery model of care is the practice of providing an evidence-based approach to reproductive care that emphasizes the physiological nature of pregnancy and childbirth. It focuses on providing individualized, client-centered support and care throughout the pregnancy, birth, and postpartum period. Birth Centers in North Carolina operate under the midwifery model of care, led by Certified Nurse Midwives (CNMs) and supported by nurses, birth assistants, and administrative staff.

CNMs are advanced practice registered nurses with specialized training in midwifery. They care for individuals throughout pregnancy, labor, birth, postpartum, and beyond, including general reproductive health. Their focus is on:

  • Supporting low-risk pregnancies

  • Providing holistic and personalized care

  • Emphasizing informed-choice and education

  • Empowering patients to make decisions about their bodies and births

While birth centers operate independently, they maintain collaborative relationships with local hospitals and OB/GYNs to ensure a seamless transfer in case of complications. Safety remains a top priority.

In most developed countries, Midwives serve as the primary maternity care providers, especially for low-risk pregnancies. The United States is an exception, with OB/GYNs overseeing the majority of births. However, research and guidance from the World Health Organization (WHO) support the Midwifery Model as a cost-effective and safe approach to improving maternal and newborn outcomes.

Pain Management & Interventions

While birth centers do not offer epidurals or IV narcotics, they provide a wide array of evidence-based comfort measures:

  • Freedom of movement and choice in birth positions

  • Access to hydrotherapy (birth tubs and showers)

  • Water birth

  • Longer prenatal visits (30–60 minutes) focused on education and emotional support

  • Childbirth education classes centered on unmedicated & physiological birth

  • Encouragement to work with Birth Doulas

  • Minimization of unnecessary monitoring and testing

Research shows that limiting elective interventions reduces complications and the need for further interventions, which can lead to safer, more empowering birth experiences.

Postpartum Care at a Birth Center

One of the standout differences in Birth Center care is the comprehensive postpartum support:

  • Immediate skin-to-skin bonding

  • Delayed cord clamping

  • Lactation support and education

  • Newborn exams conducted at appropriate, family-centered times

  • Multiple postpartum check-ins before the 6-week mark

For instance, at NCBC, families receive four postpartum visits, starting around 24–36 hours after birth, compared to just one 6-week appointment in traditional hospital care.

Emergency Protocols: What Happens if an Emergency Occurs?

A common concern with out-of-hospital birth is: What if there’s an emergency?

Birth centers like NCBC have extensive safety protocols in place. Staff undergo regular emergency drills and work directly with EMS teams to ensure fast, efficient transfers if needed. Equipment and life-saving medications are on-site and ready for immediate use.

Data shows an average of 12% transfer rate to hospitals during labor (mostly non-emergency reasons like pain management or labor augmentation). While only 2% of transfers are considered emergencies.

Who Can Give Birth at a Birth Center?

Birth centers are best suited for individuals experiencing low-risk pregnancies. Each center sets its own risk criteria, but general exclusion factors may include:

  • Twin (or more) pregnancies

  • Breech presentation at term

  • Prior uterine surgery or cesarean (some centers may allow Vaginal Birth After Cesarean [VBAC])

  • Pre-existing medical conditions (pre-pregnancy diabetes, hypertension, seizure disorders, etc.).

  • Certain chronic health issues

  • Ongoing substance or alcohol use during pregnancy

  • Pre-pregnancy BMI over 45

Even if you begin care at a birth center, your risk factors and determination as to whether or not birth center care is appropriate are monitored throughout the pregnancy to ensure safety and appropriateness.

Choosing the Right Birth Center in North Carolina

When considering your options, here are some key questions to ask during your Birth Center tour:

1. Are You Accredited by the Commission for the Accreditation of Birth Centers (CABC)?

  • Accreditation is required for licensure in North Carolina under the Birth Center Licensure Act.

2. Are You a Member of the American Association of Birth Centers (AABC)?

  • AABC membership signals a commitment to high standards, continuing education, and involvement in national advocacy and research.

3. What Are Your Emergency Transfer Protocols?

  • Birth centers should have thorough protocols and drills to ensure emergencies are handled efficiently. You should always feel informed, and respected when asking about safety measures.

4. Does Their Philosophy Align with Yours?

  • Every birth center has its own personality and values. Make sure you feel welcomed, respected, and supported.

Accredited Birth Centers in North Carolina (as of September 2025)

Having options when choosing the right Birth Center for you is such an empowering experience. It can provide you with the autonomy to make your own choices during this powerful life event. Each of these centers has its own unique offerings. Explore to find the best fit for your needs:

  • North Carolina Birth Center – Chapel Hill, NC

  • Aya Birth and Community Wellness – Durham, NC

  • Haven Women’s Health and Birth Center – Cary, NC

  • Natural Beginnings – Statesville, NC

  • Bella Donna Birth and Women’s Health – Jacksonville, NC

  • Lilac Health: Asheville Birth Center – Asheville, NC

Final Thoughts

Choosing where and how to give birth is one of the most personal and impactful decisions you’ll make. Birth centers offer an empowering alternative that supports informed-choice, holistic care, and a more connected birth experience, especially for those seeking low-intervention, unmedicated birth.

By understanding the Birth Center model and asking the right questions, you can make the best decision for you and your growing family.

Mariam Lam