Comparing local hospitals in Southwest Michigan

By Jessica English, LCCE, FACCE, AdvCD/PCD/BDT(DONA)

One of the questions we're asked most often by clients and students is, "What do you think of my midwife/doctor/hospital?" That's a complicated question and there's no one perfect place to give birth in Southwest Michigan.

How will your birth unfold? If we take a "control the controllables" approach, choosing a provider and a birth place are important in stacking your deck for the best possible experience.

We never want you to come out the other side of your birth saying, "I wish I'd known."

As doulas and childbirth educators, we have a unique vantage point to see births across a variety of settings and with many different providers. We're always happy to share individual insights and experiences once we are officially working together. As a community service, we also want to share the facts on your options.

We created this chart to help you figure out what's available at our area hospitals. If you decide you're in the wrong place, it's never too late to change. Your doula can help you make the shift! Changes are easier earlier in your pregnancy, though, so if you're seeing a mismatch between what you want and what's offered, we suggest calling other practices as soon as you can.

Be sure to read the details below the chart so you can fully understand each option and how it might impact your birth.

Unfortunately, we don't have any birth centers in the Kalamazoo area. This chart compares local hospital options within a 30-minute drive. If you're interested in home birth, see our list of local home birth midwives.

SW Michigan hospital comparison
  • Midwife at your birth or in the office.

    Around the world, midwives are the standard of care for low-risk births. OB/GYNs are surgeons, and in many other countries they often don't get involved unless there are complicated factors at play. In the U.S., physicians still attend the majority of births but births attended by midwives (and people who have midwifery care during their pregnancy) actually have better outcomes. (See our blog post on changes at Ascension Borgess for more information on the benefits of midwifery care.)  We are lucky to have several options for midwifery care in our area! 

    In the hospital, your midwife will have a bachelor's degree in nursing and a master's degree in nurse-midwifery. Many nurse-midwives also have a PhD degree. They are specialists in normal birth, and they can also collaborate with physicians in higher-risk situations. You can expect longer visits, a more physiologic approach to pregnancy and birth, fewer inductions, and overall fewer interventions with a nurse-midwife.

    If you prefer midwifery care, pay close attention to whether a midwife is likely to attend your birth at each practice. Sometimes people are seeing a midwife in the office but they don't realize that they will have a doctor for the actual birth. That's the case at the Bronson physician practices (11th Street and Centre Street) — you may see a midwife in your office but only physicians and residents attend births. At the time of this publication, at Ascension Borgess there is a midwife on call at the hospital only one or two days each week. The rest of the time, you will have a physician at your birth. 

  • Membrane sweeps.

    A membrane sweep is where a provider inserts a gloved finger through the cervix during a vaginal exam and sweeps back and forth as a way to encourage the onset of labor. There are pros and cons (the Evidence Based Birth podcast has a helpful episode), but some practices in our area won't even offer the option. There are benefits to letting labor begin on its own, but sometimes you might want to try having your membranes swept a time or two before a medically necessary induction (for example, if an induction is scheduled for Friday, you could try having your membranes swept on Tuesday and Thursday). We've seen this help many clients go into labor on their own and avoid the other (bigger) interventions that come along with induction. It may also help to improve the Bishop score, which is a measure of whether an induction is likely to end in a vaginal birth. If your practice doesn't offer membrane sweeps, the option is automatically off the table for you. 

  • Tub in labor.

    Unfortunately, the University of Michigan is the nearest hospital that offers water birth. However, most hospitals in our area do offer the option to labor in the tub. The physician trade group ACOG affirms research that shows it's safe to labor in the water at any stage of labor, even if your water has broken. Bronson Battle Creek does not allow patients to labor in the bathtub. 

  • Residents involved.

    Residents are medical school graduates who are completing the final phase of their education by practicing hands-on. They are often eager to practice interventions to complete the required number to finish their residency. At Bronson (Kalamazoo), if you are with one of the physician practices (Centre Street or 11th Street) the residents will be heavily involved with leading your care at the hospital.

    If you are with the Bronson midwifery group (you attend your office visits downtown on John Street), the residents may come into midwifery births as observers, especially to get exposure to the midwifery model of care. That's a great way for physicians to learn skills like catching babies in a variety of positions! You can always say yes or no to a resident observer if you are a midwife patient (downtown), but if you are with one of the physician practices it may not be possible to opt out of having a resident involved. If you ever feel uncomfortable with resident care, you can ask to see the attending physician.

    At Ascension Borgess, residents are sometimes present for daytime births but not usually overnight. There are few residents at Bronson Battle Creek or Three Rivers.

  • Nitrous Oxide.

    Nitrous oxide is a medication used for pain relief and anxiety reduction on labor. It carries very little risk to the parent, the baby or the labor. In Great Britain, it's even used at home births. This is an option to "take the edge off" the intensity of contractions, not total pain relief like you'd experience with an epidural. Nitrous is available for labor at all local hospitals except Three Rivers.

  • External cephalic version for a breech baby.

    Your doula can help you with ideas to encourage your baby head down if they are breech at 34 weeks (chiropractic care, acupuncture and moxibustion, positions, the Spinning Babies parent handbook). If your baby is still breech by 36-37 weeks, external cephalic version is an evidence-based intervention where a physician feels the outside of your belly and tries to encourage the baby with pressure to move head down. If successful, this can help people avoid a hospital cesarean for a breech baby. External version is not an option at Three Rivers and in our experience very unlikely at Bronson Battle Creek.

  • VBAC and VBA2C.

    A cesarean in the past doesn't necessarily mean you need a cesarean birth for all future babies too. Vaginal birth after cesarean (VBAC) or after two cesarean (VBA2C) are reasonable options for many people, according to medical groups. All of our local hospitals offer VBAC, except Three Rivers. VBA2C is also an option with the Bronson downtown group (you'll need to co-manage care with a midwife and a physician) and with the Borgess physicians. 

  • High-volume hospital.

    Bronson is a high-volume hospital. Occasionally all of the beds are full and people have to labor for hours or even give birth in triage (a small space separated by curtains from other laboring families), or there can also be perceived pressure to speed up a birth and "turn over" a room where someone is laboring because others are waiting.

If you find any information in this chart is inaccurate or if you have suggestions on items to add, please email to let us know! We're dedicated to keeping this as an up-to-date reference for Southwest Michigan families.

And if you want even more of an insider scoop on the energy, atmosphere, induction rates, and general "feel" at each hospital, reach out to your doula. Whether you're a Birth Kalamazoo doula client or not, you can also book a one-hour birth options consult with Jessica to talk through all of your hopes for your birth and receive recommendations on locations that might be a good fit.

We hope you'll feel empowered by this information, and ready to make changes if you find you're not with the right practice for you. It's truly one of the most important decisions you can make about your birth.