Experience with an alternative birth center in a university hospital.

Consumer interest has generated the widespread popularity of the alternative birth center (ABC) in recent years. The Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, recently incorporated such a center into a tertiary care educational facility. Intrapartum transfer of 39 (20%) ABC patients to a conventional delivery area demonstrated the need for careful clinical assessment of the patient. The cesarean section rate and forceps delivery rate of all ABC patients were less than half those of the overall obstetric population in the period studied. Serious fetal and maternal complications occurred infrequently but underscored the need for access to full hospital facilities. Low-risk, consumer-oriented obstetric service can be provided safely within the confines of a tertiary care referral service while providing the additional advantage of professional and patient education.