Birthing at our Birth Center

When you choose to give birth at our birth center, you are choosing to give birth in a home-away-from-home.

Since 2002 The Birth Cottage has offered a comfortable, peaceful, and safe place to labor and birth on your own terms.  Our midwives believe in your innate self-knowledge and strive to help you give birth with confidence and strength. Hundreds of babies have been born here over the years, and The Birth Cottage midwives combine a warm and welcoming style of practice with the convenience of a centrally located birth center.

What is a Birth Center?

A birth center is a health care facility for childbirth where care is provided in the midwifery and wellness model. The birth center is freestanding and not a hospital.A birth center serves healthy women with low-risk pregnancies in an atmosphere that is more relaxed than a hospital setting. Birth centers are more cost effective, and reduce overall healthcare costs due to their low intervention care.

Our Facilities

The Birth Cottage has freestanding birth centers in downtown Milford and Salem, New Hampshire. Please call us to schedule a tour! The front office includes a child-friendly waiting room, our lending library, the prenatal and well body rooms, and the midwives’ offices. The birth centers each include two birthing suites with private bathrooms and a shared kitchenette with home-cooked food available to everyone.

Your Stay at the Birth Center

When you choose to give birth at our birth center, you and your friends, family, or doula complete early labor in the comfort of your own home.  In active labor and when you are ready for more support, you and your chosen companions arrive at the birth center and settle into one of our comfortable birthing suites.

Once you arrive, our midwives care for you, offering labor support and monitoring you and your baby’s well-being.  We encourage those laboring to listen to what is best for their body, from positioning and pain management to nourishment and rest.  We offer comfort measures in labor and help facilitate a peaceful and safe birth for you and your baby.

Once your baby is born, we continue to monitor you and your baby closely while helping establish breast feeding and bonding.  Routine and emergency procedures, tests, and medications are available for both of you, if needed.  After you are stable and you have enjoyed one of our freshly prepared home-made meals, you can be released to rest and recover in the comfort of your own home, typically 2-12 hours after birth. We will come to your home during the initial postpartum period to continue care, so you do not have to leave your home with your new baby.

Prenatal and Postpartum Care

Whether you plan to birth at the birth center or at home, we offer high quality prenatal and postpartum care in our offices in Milford and Salem. 

During your prenatal care, we will review carefully the many discomforts as well as risk factors that may impact your pregnancy and offer sound advice for nutrition, self-care, and holistic health.  We offer standard laboratory testing in the office, genetic testing, ultrasounds both in the center and at other facilities, and integrated maternal fetal medicine consultation should further care be necessary.  Prenatal visits with the midwives include 30 minutes of face to face time, giving you plenty of time for questions and discussion. Postpartum care includes a visit to your home between one and two days and then office visits until 6 weeks.

What sets us aside is our focus on informed consent and shared decision making.  There are no routine interventions or procedures during our care.  Every step of the process involves intense education, careful conversation, and thorough review of evidence surrounding your choices.  Culturally sensitive and individualized care includes plenty of time to ask questions, discuss your wishes and desires, and get to know the care team that will be with you during your birth. 

“The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care, and advice during pregnancy, labor and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant.  This care includes preventive measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical or other appropriate assistance and the carrying out of emergency measures.”

From the International Definition of a Midwife, adopted by the International Confederation of Midwives 2002


The Birth Cottage is happy to offer the option of water birth to clients in both the birth center and for home births! Spacious birthing tubs are available in each of our birthing rooms. For our homebirth clients, we have portable AquaDoula birth pools available to rent.


Laboring in water can promote relaxation and provide significant pain relief for many people. Some people labor in the water, and many stay in through pushing and birth their babies underwater. We observe that babies born in water are often quiet and alert immediately following the birth.

The effect of buoyancy lessens body weight, allowing free movement and new positioning. Buoyancy promotes more efficient uterine contractions and improved blood circulation resulting in better oxygenation of the uterine muscles, less pain for the laboring person, and more oxygen for the baby.

As the laboring person relaxes physically, they are able to relax mentally with a greater ability to focus on the birth process. The water seems to reduce stress-related hormones, allowing the body to produce endorphins which serve as pain-inhibitors. Immersion in water often helps lower high blood pressure caused by anxiety. In the later stages of labor, the water has been shown to increase energy levels. Since the water provides a greater sense of privacy, it can reduce inhibitions, anxiety, and fears.

For more information on research and safety of waterbirth please explore the following links:

Nitrous Oxide for Labor and Birth

The Birth Cottage now offers Nitrous Oxide for Labor, Birth and Office Procedures! Safe and effective pain relief that is cost effective.

Quick Effect

Nitrous oxide takes effect in seconds and offers immediate relief of pain and anxiety without any needles or long lasting effects. You control when to use it and for how long to use it. It allows you to recognize and respond to your pain and discomfort on your own terms.

Will it Harm My Baby?

There are no known documented effects to the baby. Nitrous oxide use during labor has been demonstrated in several studies to have no negative effect on either Apgar scores or neonatal behavioral scores. Since it is an inhaled gas, no medication reaches the baby as you labor. Ask us for more information!

Quick Recovery

Unlike an epidural, there are no lasting effects and you can be up and moving around to actively participate in your labor. With nitrous oxide, you breathe into the mask, which you hold and control, when you need it for the pain. When the labor pain subsides, pull the mask away from your face, take a couple of breaths and the Nitrous Oxide is out of your system quickly.

Well Body Care

The Birth Cottage provides full scope well-body care and services, including:

  • Annual Gynecological exam
  • Review of health history
  • Review of life-style habits
  • Review and discussion of any specific concerns
  • Head-to-toe physical exam
  • Laboratory testing, including PAP testing

Assistance with family planning decisions

  • Natural family planning
  • Oral contraception
  • Emergency contraception
  • IUD insertion and removal
  • Nexplanon
  • Depo-Provera

Supplement and prescription needs
Additional specialty testing as indicated
Referrals to specialists as indicated
Education and counseling as indicated
Preconception care
Menopausal management
Health maintenance and disease prevention for annual exams

Home Birth Care

When you choose home birth with our midwives, you are choosing to birth in your own space, on your own terms, supported by your loved ones and embracing one of the most intimate and life-changing experiences a family can have. Giving birth at home, you can seamlessly transition from early labor to active labor and birth, without the interruption of a car ride. The midwives arrive at your home when you are in active labor and offer labor support and monitor your well-being.

We attend home births within a 20-mile radius of the birth center, whenever available, across most of southern NH. Currently, we do not attend home births in Massachusetts due to licensing and insurance coverage restrictions. We welcome those families to come to the birth centers instead. We encourage you to review your insurance benefits for exclusions for home birth to ensure coverage. In order to adequately serve all of our clients, we limit the number of home births per month and encourage you to register early in your pregnancy should you desire one. You can always change your mind and come to our cozy birth center!

Breastfeeding Support

The Birth Cottage midwives are committed to supporting a close and healthy nursing relationship for every person who plans to breastfeed.

Midwives are available 24 hours per day in the early postpartum to help with nursing issues. We will help you access community resources for breastfeeding support as needed. Our breastfeeding rates at The Birth Cottage are over 99%, with the majority of people choosing to nurse throughout (and often beyond) the first year!  Our in-house IBCLC will assist with nursing difficulties and problem-solving should the need arise.


The La Leche League of Milford meets at the birth center every second Thursday of the month. Contact La Leche League International or La Leche League of Maine and New Hampshire for more information.

La Leche League's mission is to help people worldwide to breastfeed through person-to-person support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and person.


The Birth Cottage midwives are committed to preserving the art and science of midwifery for future generations of people.

Students at our birth center have completed the didactic portion of their education. At this time, we accept students from MEAC-accredited programs.

Applicants for student placement should already possess a solid foundation of knowledge in the areas of midwifery and people health, and be prepared to work in a busy, broad-scope practice. Placements last between 3-12 months.


We also offer limited observation hours for student nurses. Midwifery and nursing students enrolled in graduate-level programs have used the center as a research site, or for project-based work in people health and community health.

Student inquiries should be directed to:

Inquiries must include a resume of birth and/or healthcare related experience and letter of introduction.