Many pregnant women have strong views about where and how they’d like to deliver their babies. You can choose to deliver at a hospital, birth center, or at home. Before choosing, you will need to contact your health insurance provider to find out what options are available. You also need to find out if the doctor you are considering can deliver your baby in the place you want to give birth.
Hospitals are the preferred choice for pregnant women with health problems, pregnancy complications, or those who are at risk for problems during labor and delivery. Hospitals are generally equipped with most advanced medical equipment and staffed by highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labor. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centers, which offer similar style of care offered by standalone birth centers.
Consider the following points when choosing a hospital:
- Is it close to your home?
- Is a doctor who can give pain relief, such as an epidural, available at the hospital 24-hours a day?
- How is the feel of the labor and delivery rooms?
- Are private rooms available?
- How many support people can you invite into the room with you?
- Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby?
- Can the baby stay in the room with you?
- Does the hospital have the staff and set-up to support successful breastfeeding?
- Does it have an on-site birth center?
A birthing center provides pregnant women a “homey” environment for labor and giving birth. They try to make labor and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. They will not automatically hook you up to an IV and they won’t bother you with an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at a birthing center. Healthy pregnant women who are at low risk for problems during labor and delivery may choose to deliver at a birthing center.
At a birthing center, you can receive some pain medicines, but cannot receive epidurals. If a cesarean delivery (C-section) becomes necessary, you will be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.
Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. Generally, birth centers allow more people in the delivery room than the hospitals.
Birthing centers can be inside of hospitals, a part of a hospital or completely stand-alone facilities. If you want to deliver at a birthing center, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centers must have doctors who can work at a nearby hospital in case of problems with the mom or baby. Also, make sure the birth center has the staff and set-up to support successful breastfeeding.
Home birth is an option for healthy pregnant women with no risk factors for complications during labor and delivery. If you choose to give birth at home, make sure to have a strong after-care support system at home. Some certified nurse midwives and doctors deliver babies at home. Contact your insurance company to check whether they cover the cost of care for homebirths.
If you are thinking about a homebirth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience.
The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. You will also not have the option for pain relief.
To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.