Where Do You Want to Have Your Baby?
Giving birth in a hospital is the default option, but it’s not the only one. Here’s a quick guide on your choices and how to decide which one is best for you and your baby.
For a mother, one of the defining moments in her life is when she becomes a mother. The moment she sees that baby for the first time, whether she gave birth or adopted, is the moment she becomes a mother. There are millions of decisions to be made over the course of her lifetime, but one of the biggest may be where to give birth.
It’s generally assumed that you’ll give birth in a hospital, but that may not be your only option. There are a few other choices you can consider before making a final decision.
It’s also important to remember even once you’ve made your final decision, it may not truly be final. Childbirth can be unpredictable and what you expect may not be what actually happens. So it’s important you make your decision, yet remain open to accepting whatever may happen.
A hospital birth is the default. Your family, friends, and doctor are likely to assume that you’ll be delivering your child in a hospital. And it’s not a bad option.
With a hospital birth, you’ll be surrounded by medical professionals trained to deal with any circumstance that might arise. If things go sideways, they’re prepared to give you blood or oxygen, perform a C-section, and ensure the baby’s health and safety.
A hospital birth also guarantees that you can have an epidural if you want to reduce the pain of childbirth. If things don’t progress the way you and your doctor would like, you can also use medication to move things along. It’s also where you’ll go if you need to be induced, have a scheduled C-section, or go into labor prematurely.
Hospital births are also typically covered by your insurance.
However, a hospital birth can also mean that you are pushed for interventions and medications that you don’t want. Medical staff may change while you’re in labor as shifts change, which means you may deal with more than one nurse and even more than one doctor. This can be a very uncomfortable experience for many women.
The typical hospital birth is on your back in a bed and walking around during labor is often limited. You’re usually limited in what you can bring with you, so if you want to use essential oils for relaxation, candles, or even music, you may not be allowed. The number of people allowed in the room during labor and delivery may be restricted, in order to allow hospital staff more room to work. If you needed an excuse to keep your mother-in-law out of the room, that’s great — but if you were envisioning being surrounded by all your loved ones as you pushed this new life into the world, you may have to adjust your vision.
Many women have also expressed that their hospital births were traumatic for them. From interventions that they felt were forced on them, to doctors who were rude and demanding, many women feel that a hospital birth made the experience a negative memory for them and they don’t want to repeat it.
A hospital birth can also mean your baby has shots and treatments that you may or may not want simply because they’re required. Depending on hospital policy, it can also mean that your child is mostly in the nursery, limiting your chances to bond. You may also find that you’re pushed to get up and start walking around sooner than you’d like — or forced to stay in bed when you’d like to get up.
Sleeping in a hospital is often difficult, particularly when nurses wake you up to check on you. You may find post-birth exhaustion is increased because you’re unable to get any sound sleep.
Visitors may be limited both in number and timing, which you may or may not appreciate depending on your own desires.
Birthing center birth
A birthing center is usually a middle ground between giving birth in a hospital and giving birth at home. This can be ideal for the expectant mom who wants a more natural birth with the comfort of knowing that medical assistance is close at hand in an emergency.
Birthing centers often have a homey feel to them, with rooms that look more like a bedroom than a hospital room. You’ll typically deliver with a midwife, and the midwife has usually attended each of your prenatal appointments, so you’ll already know and be familiar with them.
In many birthing centers, your midwife will stick with you until your baby is born, whether she should technically be off the clock or not. Other staff may or may not change out as shifts end, but even when new staff comes in, the vibe is often more comfortable and friendly.
Certain interventions, such as epidurals, may not be available, but you have other options for making labor and delivery easier. You can utilize several other options besides lying on the bed, such as birthing balls, squat bars, stools, during labor and delivery. If you feel more comfortable delivering on your hands and knees or in another position, a birthing center can usually accommodate this.
You can also have a water birth in a birthing center — or even simply use the bath for pain management during labor. Most birthing centers are more flexible about bringing in essential oils, flameless candles, music, and other things you might want to bring with you to make your birthing environment more inviting and relaxing. They also usually have beds that are at least a full or queen-size, allowing more room for your partner to cradle you from behind or sit or lie beside you for more physical and moral support.
Birthing centers are better equipped than a home to handle emergencies, but they are still somewhat limited. A birthing center can be freestanding (a building on its own, unassociated with a hospital) or hospital-based (associated with a hospital, either housed within the hospital itself or in a building very near the hospital). If your birthing center is freestanding, this may mean that significant medical interventions (such as a C-section) may be delayed while you’re transported to the hospital.
If you’ve had concerns throughout your pregnancy that may require interventions, such as high blood pressure or a breech baby, a birthing center may not be your best option. If previous pregnancies have resulted in C-sections, or had other medical emergencies such as significant blood loss, you may want to at least ensure that your birthing center is housed at the hospital for your own health. If you want a scheduled C-section, a birthing center won’t be an option since they don’t perform them.
It’s also important to note that you’ll want to confirm whether or not your insurance covers a birthing center before making a final decision unless you can afford to pay for it without insurance.
A home birth offers the most flexibility in ensuring that your child’s birth goes the way you’d like it to go. You can have as many people present as you like and even the family pet can be there. You can set up a birthing tub or use your own bathtub for a water birth or pain management.
A home birth means working with a midwife and possibly a doula (you may also have a doula in a hospital or birthing center). It is extremely rare that an obstetrician will attend a home birth. Midwives and doulas are typically very calm and relaxed, which helps to create a calm and relaxed environment for the mama-to-be. Being in your own home will also contribute to that calm and relaxed feeling.
You will have everything you could want at your fingertips — you can watch TV, play any music you want, eat or drink as you like. You can sleep if you want to and are able, and depending on the midwife, you can also labor on your own with just your partner or select family or friends until just before you’re ready to deliver.
Midwives typically see you for all your prenatal visits. If any medical issues arise that would interfere with home birth, they’ll let you know. However, for low-risk healthy pregnancies, as long as you have a qualified medical practitioner (usually a midwife), home birth is just as safe as giving birth in a hospital — perhaps even more safe as there’s less stress, less risk of infection, and fewer interventions.
Of course, emergencies can happen. Midwives are trained to recognize potential complications and emergencies quickly, allowing time for them to call for a medical transfer. The need to call for a medical transfer, then the wait for it to arrive and the transfer itself means that assistance may be very delayed, depending on your proximity to a hospital. Therefore, if you’ve previously had significant issues with labor and delivery, home birth may not be your best option.
As with a birthing center, you’ll also want to check with your insurance before making this decision. Home births are still sometimes considered to be an “alternative” and thus, some insurance companies will not cover them. However, many midwives are aware of this fact and may be willing to work with you on a payment plan so that you can have the birth you want without worrying about how it will be paid for.
When most people think of an unassisted birth, they think of the mother who gives birth in a taxi during a traffic jam or goes into labor in the middle of a hurricane and can’t get to the hospital. While these are unassisted births, it can also be an intentional choice.
An intentional unassisted birth is exactly what it sounds like. You will give birth without the attendance of any medical professional: no doctor, midwife, nurse, etc. It doesn’t necessarily mean you’re all alone; your partner or other loved ones can be present to help you. You can have a doula there to assist, as well.
An unassisted birth allows you to have exactly the birth you want, much like the home birth. You can have whomever you like with you, eat or drink whatever you want, and follow your own body’s signals to know when to push and when to relax. You can avoid letting anyone even know you’re having the baby until it’s all over and you’re ready to share your joy with the world.
If you go with an unassisted birth, a call for medical assistance should be the first call once baby is born.
The drawbacks of an unassisted birth are a little bigger than those of any of the other options, though. Unless you or someone you choose to have with you is a trained medical professional, subtle signs of complications may go unnoticed. This means you may not call for assistance in enough time if something goes wrong. It can also mean even if you do recognize a complication in time, interventions may be delayed while you wait for help to arrive.
Unassisted birth is recommended only for women who have low-risk, healthy pregnancies. Even if you believe you are an ideal candidate for an unassisted birth, you should discuss it with your midwife before making a firm decision.
Which option is right for you?
Both of my children were born in a hospital. In all honesty, I would have liked to have had them in a birthing center or at home. However, I had significant blood loss with my oldest and my youngest ended up being a scheduled C-section because he was breech. Under the circumstances, the hospital really was the best place for us.
If you’re set on a hospital birth, there’s really nothing you need to do. Since it’s the default option, it will probably be assumed by your midwife or doctor anyway. If you want a hospital birth but want to do it without painkillers or have other requests, you should speak up and discuss those wishes to ensure that they are honored. But you should also keep in mind that your requests may be ignored if complications arise.
If you’re set on (or even just curious about) a birthing center, home birth, or unassisted birth, then it is important you begin exploring those options as soon as possible. Schedule a tour of any birthing centers you’re interested in. Ask your midwife or doctor about your pregnancy, overall health, and the baby’s health to be certain you’re a good candidate for your choice.
Many doctors will advocate for a hospital birth and try to dissuade you from any other options. You may disagree with them, but it is important that you hear them out to ensure that you make a fully informed decision. If you do find that your provider is adamantly against your wishes, but there is no reason specific to you or your pregnancy, you can seek out a second opinion and consider changing providers to have the birth you want.
The most important thing to keep in mind when making this decision is that you want a healthy and safe labor and delivery for both you and your baby. Advocate for what you want but be willing to listen to other perspectives so you can be sure that you’re doing what’s best for both of you.