pregnancy hospital selection

Where to Give Birth: Hospital, Birth Center or Home?

You now have more choices about labor, delivery, and post-birth than at any time in the past. Here we explain the different types of hospital and other birth options you may want to consider.

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More and more hospitals, obstetricians, and midwives are providing women with the option of a traditional hospital birth or a birth center birth. For women who are having a low risk pregnancy and want a more natural birth experience, a birthing center or even a home delivery might be the best choice.

What about a Hospital Birth?

In a traditional hospital birth you will go from a labor room to a delivery room and then, after the birth, back to a regular room. Often you will not be allowed to eat or drink and you will be required to deliver in a certain position. You will have the availability of pain medications during labor and delivery, labor may be induced, and typically both you and the baby will be electronically monitored throughout the labor and delivery.

Some hospitals, in an attempt to keep up with birth centers and the desires of many women, are now offering an option for low-risk births known as family-centers and family-centered care. This may include a private room with a private bath where you can have the labor, delivery, and recovery all in one place. Another option that some hospitals are offering is called "Rooming In" where the baby stays with you most of the time instead of in the hospital nursery.

The biggest advantages of a hospital birth are that your doctor can deliver there, anesthesia and/or other pain medication is immediately available if you need it, and hospital emergency equipment is on hand if a C-section is needed or some complication arises.

The disadvantages are that hospital procedures often place restrictions or your mobility, eating and drinking while in labor, choice of position for birth, etc. Additionally, nursing staff may change throughout the labor, birth is viewed as a medical event and interventions such as I.V.'s, electronic fetal monitoring and medical intervention are commonplace. This can all feel very intrusive and make you feel more like a patient and less like a mother.

Is a Birth Center a Better Option for Me?

A birth center is a good option if you are a healthy with a low risk for birth complications and you want a more natural, family-centered experience without routine medical interventions. In general, a birth center offers a low-tech, highly personal and personalized environment and birth experience. Typically you will be cared for by a midwife and a nurse, with a backup hospital ready in case of an emergency.

Birth centers offer a warm, personal and user-friendly birth experience for the mother, baby, and extended family. In most cases, birth centers are freestanding buildings, although they may be attached to a hospital. Since epidural anesthesia is not typically offered, you are free to move around in labor, get in positions that are most comfortable to you, and eat and drink as you desire. Comfort measures such as soft lighting, music, hydrotherapy, massage, warm and cold compresses, and visualization and relaxation techniques are often used. Natural childbirth is the focus in a birth center. Birth centers are not hospitals and they do not offer the same options as a hospital. Your labor will not be induced and birth centers do not do C-sections. But they are equipped with emergency equipment if it is needed.

As is the case with a hospital birth, a delivery at a birth center has its pros and cons. Advantages over a hospital birth include the fact that they are usually less expensive, have fewer restrictive policies, and are less intrusive then the traditional hospital setting. Generally, the same center staff will be with you throughout the birth process and the staff is focused on on empowering the mother to make choices about how to give birth and on making the birth experience positive.

One of the biggest potential negatives of a birth center is that in some states the care is not covered by insurance. The second major potential problem is that if there is a complication, it may be necessary to transfer you to a local hospital.

If you are considering a birth center you need to check with your health care provider and your health insurance carrier to make sure that your prospective hospital or birth center is acceptable. The American Association of Birth Centers provides a list of all accredited birth centers in the United States on the American Association of Birth Centers: Find a Birth Center website.

Should I Consider a Home Birth?

Home birth is childbirth that occurs outside a hospital or birthing center setting, usually in the home of the birth mother. Home births are usually attended by a nurse midwife or a midwife and doula. If you are a healthy woman with a normal pregnancy and you have no medical or obstetrical risk factors, giving birth at home may be an option for you.

Wikipedia points out that increasing numbers of pregnant women in the United Kingdom are choosing home over hospital when it comes to giving birth and in Denmark, about 80% of all births occur at home or in freestanding birth centers and in the Netherlands, about 30% of all births occur at home. The U.S. lacks far behind these percentages, but home birthing is a growing option in the U.S. as well as in Europe.

What is Waterbirthing?

In a water birth you get into a special pool or tub of water that is between 90-100 degrees Fahrenheit. Some women get out of the tub to give birth while others remain in the water for delivery. The water helps you to feel physically supported. It also keeps you warm and relaxed. This eases the pain of labor and delivery for many women. Plus, it is easier for laboring women to move and find comfortable positions in the water.

The phenomenon of water birthing is relatively new in this country. Ask your doctor, midwife, or birth center if you are a good candidate for water birthing. Water birth is not safe for women or babies who have health issues. For additional information about water birthing visit the websites:
WaterBirth International

Where Can I Find Additional Sources of Information?

For a more information about your pregnancy and about selecting a hospital or birthing center, please visit the website Pregnancy And Children and the website listed below.

American Association of Birth Centers: Find a Birth Center