For most of history, women all over the world gave birth with the assistance of midwives. It wasn’t until the late 1800s and early 1900s that the shift toward physician and obstetrician-attended births began. With this shift, more and more mothers gave birth in hospitals rather than in their homes.
Today birthing people have a variety of options for their birth settings. And there are advantages and disadvantages that come with each choice.
Pros: A hospital is equipped for any and every possible turn your labor and delivery might take. This makes it the best setting for a mother with a high-risk pregnancy.
The definition of a high-risk pregnancy varies from one delivery setting to another. Having diabetes, high blood pressure, and/or a history of preeclampsia or preterm labor may put you in the high-risk category. (Or if your baby has a genetic condition such as Down Syndrome.)
Hospitals have a full staff of nurses, obstetricians, anesthesiologists, neonatal specialists, and pediatricians available to continuously monitor you and your baby to ensure you are both progressing through labor safely.
Cons: While some hospitals offer intermittent monitoring, many require continuous monitoring, which puts restrictions on your mobility. Some hospitals also have policies against mothers eating during labor.
You may find it harder to get comfortable (or as comfortable as you can be during labor) in a hospital. Others find the environment intimidating. Lastly, finding a hospital that fully supports unmedicated birthing preferences can be challenging.
Pros: Birth centers are usually considered to be a happy medium between a hospital birth and a home birth. Birth centers usually have a warmer and more comfy feel to them.
Certified Nurse Midwives (CNMs) or Certified Professional Midwives (CPMs), as well as a registered nurse or nurse practitioner, attend birth center births. Birth centers practice intermittent monitoring, allowing mothers the freedom to move around while in labor. They don’t tend to have as stringent restrictions on women’s activities while in labor as hospitals do.
Cons: If you are in a free-standing birth center that is not attached to a hospital, and there is an emergency during your labor, you may need to be transferred from your facility to a hospital, if the birth center is unable to handle the emergency. That’s because birth center births are not attended by the cadre of health-care professionals that would be available at a hospital birth.
Also, high-risk pregnancies are not considered viable candidates for birth center births.
Pros: Mothers who give birth at home usually do so because they feel their home is the most comfortable place for them to give birth. Many women feel more in control over what is happening with their bodies because they are in their own space.
Home births carry all of the same pros as birth center births. Much like birth center births, home births are attended by CPMs or CNMs; many mothers also employ a doula’s services as well.
Cons: Having a home birth comes with the same concerns as having your baby in a birth center. It’s also not advisable to have a home birth if you’re having a high-risk pregnancy.
If you’re considering giving birth at home, it’s important to contact your insurance company to ensure it will cover a home birth. Home birth can be less expensive than a hospital birth, but having to come out of pocket to cover the cost can be a deterrent. (However, many midwives are amenable to creating a payment plan for expecting moms.)
When choosing a place to give birth, the most important factors to consider are where will you feel most comfortable, and where will you and your baby be most safe. What is right for one person may not be right for another. Take your time with the decision, and listen to your instincts.