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Written by: Allison, RN, IBCLC
Depending on where you live, you may have multiple options for where you choose to give birth. Some moms who live in a rural area may like the comfort of having a home birth if they do not want to travel far to their nearest hospital. Others who live in urban areas may like the option of going to a large medical center with a neonatal intensive care unit. And out of hospital birth centers, while few in the United States, can be found in rural areas, suburbs, and in large cities. Here’s a rundown of what to expect in whichever birth setting you choose:
A hospital birth can accommodate any mother, whether you have a low-risk pregnancy or have some complications. At a hospital, you will have a staff of nurses, OB/GYNs, pediatricians, and sometimes certified nurse midwives to attend to your medical needs at all times. Depending on the size and location of the hospital, it may have a neonatal intensive care unit for babies who are born premature or need closer monitoring. Smaller hospitals or those in rural areas may have a small area of the well-baby nursery set aside for babies who need closer monitoring. Some mothers may need to deliver in a hospital if they have medical problems or instances where it is known that the baby will need more medical attention. Other mothers looking for a more natural birthing experience may have the option of delivering in a bathtub if the hospital provides them. A hospital birth is a good option to consider for first-time moms or any mom who likes the safety in knowing that there is always someone to call for reassurance and help.
A birthing center is a freestanding facility that is not part of a hospital but provides a home-like environment for giving birth. Moms who deliver at a birthing center must have low-risk pregnancies, meaning no preexisting medical problems or complications in pregnancy such as high blood pressure or diabetes. Birth centers have contracts with their nearest hospital so that if a problem does arise during labor, the mother can be safely transferred to the nearest hospital. Birthing centers are staffed by certified nurse-midwives with an overseeing OB/GYN and typically have a lower C-section birth rate than a local hospital. Freestanding birth centers have much of the same medical equipment that a hospital has for attending to both mom and baby’s needs. Many also offer routine lab exams and childbirth education classes at their facility. A freestanding birth center is a good option for moms who want hospital-grade technology but with the comfort of a home-like experience.
Up until the industrial boom of the early 1900s, home birth had been the norm for most in the United States. Now, many pregnant moms may opt for a home birth for a variety of reasons. Home birth offers the opportunity of being less expensive than a hospital birth and allows as many loved ones as you want with you during your birth experience. Home births are typically performed by midwives and a birth assistant, and the midwife typically has a contract with a backup physician and hospital should you need to be transferred. Like a birth center, home birth is not for mothers with preexisting medical conditions or high-risk pregnancies. Midwives bring much of the same portable equipment and medications provided in a hospital and can also bring a tub for a water birth. After giving birth at home, it is usually recommended to have your baby seen by a pediatrician within 24 hours. Home birth may be a good option for mothers looking for more freedom and flexibility with their birth choices or those who have previously given birth and want other children present.
The decision of where to give birth is a very personal choice. What’s right for one person may not necessarily be right for you. It’s most important to discuss with your partner where you both feel comfortable. You should both feel that you are on the same page with whatever decision you choose. Family members will always have their own opinions, but at the end of the day, it is you and your partner’s decision on where you feel safest giving birth to your baby. Childbirth Connection is an excellent resource for helping you determine both your maternity care provider and your place of birth.
Allison is a registered nurse, lactation consultant, and adjunct nursing instructor living in New Jersey with her husband and two fur babies, Tasha and Shelby. She enjoys helping new moms on their breastfeeding journey and supporting new families as they navigate the joys and challenges of parenthood.
Home Birth. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/home-birth/
The Birth Center Experience. American Association of Birth Centers. https://www.birthcenters.org/page/bc_experience