What is the best birth location? There are many factors that you should consider first before choosing what is the most ideal birth location for you.
There are so many more options than just the Hospital to delivery! You can delivery at the hospital (where a majority of people delivery), a freestanding birth center (out of hospital), at home (out of hospital), in your car, in an ambulance, out and about somewhere like Target, or even at outside of the planned birth location!
Sometimes the birth location is unplanned because baby had other plans!
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Hospital
This is where a majority of people in the US deliver their babies! It is what is considered the norm in our culture, the “number one” birth location anyone would suggest. There are different reasons someone chooses a Hospital Birth. Some reasons are below!
- They have the capabilities to do more medical interventions to assist or induce labor and birth. While this is a benefit for those who choose to delivery at the hospital, this is also considered a risk for those who choose to deliver outside of the hospital
- If you have a higher-risk pregnancies, this is the birth location where it is most recommended for you to deliver.
- Both low and high risk pregnancies choose to deliver at hospitals though.
- They also provide a higher level of care in regards to emergencies with both the baby and the birthing person. This can be a benefit to some and a reason they may choose the hospital, especially if it is known baby will need assistance after birth
- OBGYN are the most common provider in these settings but may can still find Midwives or Family Medicine Doctors who provide care in hospitals! If you are wanting a certain type of providers, such as a midwife, this may not be an option at the hospital closest to you.
- Both Vaginal birth and C-sections can occur in this setting, as well as operative vaginal delivery (forceps and vacuum)
- Care will be more medicalized and may not always support normal physiologic birth
- For hospital birth, you will travel to the hospital while in labor. Once you are in active labor you will be admitted. You will deliver baby and then stay in the hospital for an additional 24-48 hours on average depending on birth type and if there are any complications!
Community Birth
This is where you deliver at an out-of-hospital birth location. The two common options are a Free-standing Birth Center or Home. The births are usually attended by midwives.
This is an evidence proven safe birth location that is available to those with low risk pregnancies! In some states and practices this will include VBAC and Gestational Diabetes controlled by Diet!
It’s important to know that MOST pregnancies are low risk and do not require interventions in birth or postpartum! That is why this is a safe and preferred birth location for some!
If during your prenatal care you develop a complication that risks you out of delivering in your intended community location, this could include going past 42 weeks pregnant, developing Gestational Hypertension (elevated blood pressure), or even low amniotic fluid. You would then change your birth location to deliver at a nearby hospital.
If this did happen, you can always ask your midwives if concurrent care is an option. This is where they will still follow you during your pregnancy and postpartum BUT not attend the delivery at the hospital!
Free-standing Birth Center
This is a community birth location that is usually run by midwives. I like to consider this a middle ground between hospital and home. They usually will be able to respond to emergencies with more resources than at home, but less than at the hospital.
Key Differences from Home Birth:
- Have to travel to the birth center when in labor
- Home like room in their facility where you will labor. It is WAY more comfortable than a hospital but also not your home.
- You will stay at the birth center usually for 4-6 hours postpartum and then be discharged home when you are stable.
- You will have a 24 hour follow-up appt either at home or at the birth center depending on their protocol!
- More equipment/resources for care during labor and postpartum to tend to emergencies/complications
Similarity with Home Birth:
- They will check in on you periodically throughout labor and then when you begin pushing they will stay with you till baby is born and for the first few minutes postpartum.
- Low Intervention Care that supports the Normal Physiologic Birth Process
Each birth center is different in the way they may care for and approach birth, it is recommended to tour the center and meet the midwives at the facility you are wanting to deliver at to see if it is a good fit for you to choose it as your birth location! Some questions I asked when touring a birth center to see if it was the right fit for me as a birth location:
- If baby needs some resuscitation at birth what capabilities are you able to do?
- If I have heavy bleeding postpartum, what medications are available at this facility?
- What are your transfer policies for when I need to transfer? How and where would I transfer? Would you come with me to the hospital?
- How long after baby will I stay at the birth center before going home?
- Is there a tub that I can deliver in? (This was something I really wanted!
Home
This birth location is pretty self explanatory. You are delivering at your home with or without a medical provider (without a medical provider is considered Free Birthing).
Home Birth is where everyone delivered prior to hospital birth started becoming more popular and considered the norm in the early 1900s. It was the main birth location.
This is a safe location to deliver for low risk pregnancies, but may not be an option everywhere. There are only so many midwives who will attend home births, and they can be hard to book! In our town you have to book your home birth midwife THE MOMENT you test positive! Finding Home Birth Facebook groups in your area can be helpful to find a midwife!
Differences in Home Birth:
- You will have everything you need already in your home for the birth such as pads, towels, any tool your provider will need, birth tub if you choose, and whom ever you want to attend the birth! Your provider will usually provide you with a list of items you need to have and gather.
- Your provider has to travel to you. They will show up when you are in active labor and stay till baby is born. Then a few hours afterwards till you are stable. They will follow up with you in 24 hours at your home to check on both you and baby (same as with a birth center birth).
- Less options for responding to an emergency because your midwife cannot carry/bring high level equipment to you in their car or have quick access to bring to every birth.
- You stay home and everyone else comes to you! So you never have to think about when to transfer to the hospital, only when to call your provider!
Unplanned location
This birth location can be ANYWHERE! Sometimes it is an unplanned home birth, or a car birth.
If you are in labor and do not think you will make it to your intended birth location, call 911!
If baby is not imminently being delivered and you are in a car, have the driver continue driving to TRY to get to the birth location.
If baby starts to crown, call 911! They can either try to help you through the process and/or just sending someone to help in am ambulance!
We always recommend having a baby go bag in your car full of towels, blankets, disposable pads, and maybe a clamp of some sort just in case. You NEVER know how fast your labor will progress and if you will need it! Sometimes you choose the birth location, but sometimes the baby chooses it. You need to be prepared.
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