How to Choose Your Birth Setting: Options & What to Know

How to Choose Your Birth Setting

before I start – let’s leave assumptions aside. did you know that you have a choice in where you give birth? if you said no, I’m not surprised. most people in the US think the only place to have a baby is in the hospital. even further, some may think the hospital is the safest place for everyone to give birth. (I have some thoughts about the last sentence, but I’ll save that for another day.) spoiler alert: you have options when it comes to the location or facility you have your baby! And in line with our mission to support empowered birth, let’s break down the pros and cons of various birth settings.

Home Birth

this means having your baby in your house (or maybe someone else’s house) but this option involves a midwife and her team coming to you in a home. I think this option often gets a bad rap, but it is safe for someone who meets the criteria and is the perfect option for many people.

PROS

• comfort
• control
• price
• personalized care
• limited medical interventions

CONS

• limited medical interventions
• additional planning/costs needed
• possible hospital transfer
• insurance may not cover

Birth Center

PROS

1. more personalized care compared to a hospital
2. home-like environment
3. access to medical interventions

CONS

1. Limited Access to Emergency Interventions
2. Insurance May Not Cover
3. Possible Hospital Transfer

Hospital

PROS

1. Access to medical interventions and emergency care: in a hospital setting that is the ideal place to receive medical interventions and easy access to emergency care. For those who have high-risk, pregnancies and extensive medical history this is the perfect place to for your birthday.
2. Availability of pain management options: similar to the last point, the hospital setting is where you would receive an epidural or IV pain, medication for coping with your discomfort and labor.
3. Additional medical staff & medical equipment on hand: contrary to a homebirth and birthing center option, the hospital setting has access to more medical staff and equipment simply because of it being a hospital. If you are a person that enjoys having many different care providers around and available to you, this is a great place to birth

CONS

1. Increased likelihood less personalized experience: in the hospital, you are one of many, and there are usually many other patients that are there for the same thing at the same time that you are. While you have a dedicated nurse and doctor, they also have other patients to consider, and therefore it very difficult to have a personal life experience.
2. Hospital policies may limit options: when you enter the hospital system, you enter that system. And there are policies and procedures put in place to create order and protect the hospital. These policies are forced despite your patient rights, and yes, if the policies don’t align with your personal desires then you are likely to still be limited in your experience.
3. Higher risk of interventions and c-sections: because of the previously mentioned cons of the hospital setting, there is a greater risk of unnecessary medical interventions and a necessary C-section. When. This is in a place that treats, all people essentially the same, when, and the interventions that are in place can cause negative outcomes for, mom or baby there may be a rush to fix things that are happening because of the expenses that were put in place.

CRITERIA TO CONSIDER

Medical history: simply put, there are some medical conditions that would deem you/your pregnancy as high risk. That would mean that the best route for pregnancy care would be in the hospital setting.

Previous c-section: a previous belly birth is not an automatic indication, that you need to have another surgical birth, or that you need to have birth in the hospital again, but every person is different. It is important to have a good assessment of the pregnancy to determine if an hospital or out of hospital would be ideal setting for your birthday.

Vaginal birth after cesarean (VBAC) may only be an option in certain settings

Other considerations

when you consider where you want to give birth, think about these major factors:

• availability of support from your birth team (are all members of your birth team welcome?)
• distance from home (closest isn’t always best)
• cultural preferences and traditions (are accommodations made for cultural needs)