Choosing Where to Give Birth

Where you have your baby will have a big impact on your birth experience.

You have several choices and each one will offer your baby a different view of the world.

Most babies in modern times make their arrivals in cold, bright hospital rooms. There are other options, however.

More and more birth centers (some attached to hospitals and some freestanding) are being built around the country. Home birth is also an option that you can explore.

Choosing a Home Birth

Home birth used to be the standard of care and generations of families began with baby being born right at home. Home birth in modern times is a safe and intimate experience. There are many reasons to choose home birth, and I've listed several of them below.

A home birth can happen in your own home, apartment, or even in the home of a family member. My midwife had a client who lived across state lines from her practice. The client decided to lease a small apartment in my midwife's state for a month so that she could have a midwife attended "home birth!" As you can see, there are many options.

Your home is your safety zone. You can be completely comfortable to do what you need to do in your own home. You are in control. You can walk when you want to, eat when you want to, and go to the bathroom when you want to. The list could go on and on. You are free to do what you want and need to do during labor and birth.
You are able to determine the atmosphere. In your home you can pick the lighting, sounds, and smells. You can wear what you want to wear and you can choose the sheets and pillows that you want around! You can also arrange for a birth tub. Again, you are in control.
At home you do not have to worry about common hospital procedures such as an IV line, hospital gowns, fetal monitoring, or limit on what you can eat or drink.
You are also free from worry about episiotomy, forceps, and vacuum extraction in your home. Your chances of having an unnecessary cesarean section are much less.
You will most likely be able to give birth in any position you want to and where in your home you want to.
Many believe that your and your baby's chances of getting an infection are much less at home, where you are used to the environment and are not introduced to strange new germs, as you would be in another setting.
You can have an unassisted childbirth (UC) at home.

Reasons you may not choose a home birth:

You have a pre-exisiting condition and your midwife has advised you that a hospital birth would be best. For example: diabetes, epilepsy, anemia, or high blood pressure.
Pre-term labor (though if it stops and you are fine you can plan to have a home birth when you reach term)
Consistent prenatal warning signs such as protein or sugar in your urine.
If you are having twins (though some midwives may attend your twin home birth).
You had a cesarean before - though many midwives will attend an HBAC (home birth after cesarean). Some areas of the world are very hostile towards VBAC (vaginal birth after cesarean) in general and that carries over to HBAC. Research your area and talk with your midwife.
You are in poor health, feel very insecure about pregnancy and birth, or cannot find a place you would like to give birth. These are valid issues to plan to birth somewhere besides your home, though many can be worked through.
You are sure you do not want a home birth.

Choosing a Birth Center Birth

A freestanding birth center is a place dedicated to caring for pregnant, birthing, and postpartum women. Some birth centers offer comprehensive reproductive health services for women of all ages, as well. It is generally much more low-tech and less invasive than a hospital.

Birth centers have low intervention rates compared to hospitals.
They are intimate and have a home-y atmosphere that many women find comfortable. They include private rooms set up like comfy bedrooms and often have kitchens and family gathering places as well. They also often have water birth facilities.
There will not be a lot of people coming in and out of your room and you will most likely be very familiar with the staff - your midwife and perhaps a nurse.
A birth center is a central place; you will most likely have all your prenatal care done there and you will be very familiar with it.
A birth center may be equipped to handle a little more than a home birth - perhaps an IV (though transfer is still needed for big complications).
Many insurance companies cover birth centers.

Reasons not to choose a birth center are similar to those for not choosing a home birth - review that list. If you are considered "high risk" you may want to choose a hospital birth.

In addition, Peggy O'Mara notes in Having a Baby, Naturally that a home birth may be better for you than a birth center birth if you desire even more control over your experience than a birth center can provide.

Some small community hospitals and some birth centers attached to hospitals may be similar to a freestanding birth center and may be worth considering.

Choosing a Hospital Birth

Most women choose to give birth in a hospital. They usually have the most current technology immediately available to women, and if you desire chemical pain relief then you will need to be in the hospital. It is not always in mother and baby's best interest to have numerous technological interventions and restrictions placed on them, however.

If you have a pre-existing medical condition, you may want to choose a hospital birth.
If you have a lot of fear about labor and birth you may prefer to be in the hospital. Many of these fears are normal and can be worked through, however.
A care provider you know and trust may work only in the hospital.
If you want to have chemical pain relief, you will need to go to a hospital.

You may wish to choose a birth center or home birth over a hospital for several reasons.

You must abide by the hospital's rules and procedures. Some may be completely non-negotiable. Many hospitals require routine IVs and electronic fetal monitoring, even though these have not been shown to improve outcome in low-risk women.
You are at a proven increased risk for interventions such as assisted delivery (forceps, vacuum extraction) and cesarean section, a major abdominal surgery.
You may not be allowed to eat or drink what you want. You may also be told you cannot wear what you want, though many hospitals will let you bring a nightgown or birth clothing.

Do you need labor and birth skills you can take anywhere? The Pink Kit is an amazing childbirth study kit you use right at home. I've reviewed it and give it my highest recommendation.

You'll be in control of your body and your labor - no matter where you've chosen to give birth. Work with it throughout your pregnancy so you can be prepared when labor begins!

Natural Birth and Baby Care.com