Hospital, Birth Center, or Home: Exploring Your Options

If you are pregnant, you are probably considering the question of where to give birth. Around 98% of babies in the US are born in hospital, so there is a good chance you are considering this option! However, a growing percentage of women are returning to out-of-hospital births, whether at home or at a free-standing birth center. Especially in the Portland area, we are blessed with a number of excellent birth centers and homebirth midwives. The good news is, there is a place for doula support in all of these settings! From my own experience and conversations with care providers of all types, the consensus is that there is no one “ideal” place to give birth. Rather, the best birth experiences happen when the mother is well prepared and informed, respected and listened to by her team, and surrendered to her own unique experience of birth. And that can happen anywhere! Joyful homebirths, empowered hospital births, sovereign c-sections, cozy birth center births - I have been privileged to attend them all.

Here are a few pros and cons of each setting…

Hospital Birth

Pros: equipped for emergency situations and high risk pregnancies; multiple pain medication options including epidurals; may line up better with your insurance benefits.

Cons: more interruptions throughout your birth; not an “at-home” environment; care team turnover; higher c-section rates; waterbirth sometimes not available; hospital visits postpartum rather than home visits by care team.

 Birth Center

Pros: suitable for low-risk pregnancies; optimal for natural/unmedicated birth; skilled midwife care; continuity of care throughout pregnancy and birth; quiet and private environment; waterbirth available; home visits after birth by care team.

Cons: fewer pain medication options; shorter stay in the center postpartum (sometimes a pro); risk of transfer (in which case your midwife and doula accompany you to the hospital).

Homebirth

Pros: suitable for low-risk pregnancies; optimal for natural/unmedicated birth; skilled midwife care; often less expensive; continuity of care throughout pregnancy and birth; quiet and private environment; waterbirth available; home visits after birth by care team; your midwives and/or doula make you a meal and tuck you into bed with your newborn after birth.

Cons: fewer pain medication options; shorter stay in the center postpartum (sometimes a pro); risk of transfer (in which case your midwife and doula accompany you to the hospital).

And if you are worried about the risk of hospital transfer during a birth center or homebirth experience…

Most transfers actually happen in the weeks before birth, due to complications like high blood pressure or gestational diabetes. Even during labor, the most common reason for transfer is exhaustion and the desire for an epidural. Since this isn’t an emergency, you usually travel in your own car, and your midwife accompanies you to take on more of a doula role at the hospital. True ambulance, lights-and-sirens emergencies are extremely rare, but midwives are equipped to handle those as well.

Did I miss any pros or cons?

As always, contact me for a free consultation if you have any questions about giving birth and whether I might be the right doula for you!

Warmly,

Clementine