Where should I have my baby?

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Introduction

Making a decision about where to birth your baby is a huge one! There are so many things to consider and your decision will require a commitment from you to inform and educate yourself as well as your family and friends.

Since medicated hospital birth is considered mainstream, your choice to birth in another location will be questioned by some. As people learn about natural birth and how best to be successful in birth, more and more families are choosing to give birth outside the hospital setting with midwives. Recent studies have shown that births attended in the US by midwives have greatly increased in the past few years!

Here are your options:

Home Birth:

Some advantages of home birth are:

When you choose to give birth in your home, you are opting for birth in the most intimate and personal space that you have. This has been shown to increase the mother’s comfort and decrease her fears about labor and birth. Women make the decision to birth at home after considering all their options and seeking education about all its advantages and disadvantages.

You have your prenatal care in a comfortable and intimate setting.
You have the same ability to have all the necessary lab tests, ultrasounds or other testing as with hospital or birth center providers.
You will possibly be able to get out-of-network insurance reimbursement after you give birth.
You will be provided with the best education to help you become the healthiest mommy possible.
You often have more continuity of care, with the same midwifes with you for prenatal care and birth. This helps develop a strong and trusting relationship with your providers!
Experienced, skilled midwives and registered nurse birth assistants will come to you, bringing with them the labor tools and emergency supplies that may be needed. Safety is always the top priority!
Your midwife has a relationship with medical and specialist providers ready to take care of you in the event of pregnancy or birth complications.
There is no chance of you or your baby getting a hospital-acquired infection.
At home there is a broader time limit on the normal process of labor and birth.
You home provides you the ultimate in privacy for your labor and birth.
You can birth in your own space, where you are the most comfortable.
You don’t need to drive anywhere in labor!
You don’t need to take your other children somewhere for care while you birth!
You are in control of all the little details like the lighting, the room temperature, the cleanliness of your home, etc.
You have access to your own food and drinks.
You wear your own clothes, you use your own blankets, sheets, towels, etc.
There is no limit on how many people are there, or who can be present to support you.
At home, we can use alternative treatment like herbs, essential oils, or homeopathy during your labor and birth.
We will be listening frequently to your baby with the Doppler.
In general, there tare no limits on how you move about during your labor and birth.
There are no “rules and regulations” about routine procedures like continuous monitors and IVs.
There is usually no limit on where you birth.
You will have the ability to choose from multiple positions for labor and birth.
You will have access to comfort measures like a swimming pool or tub, backyard, patio, etc.
When you are at home, there are typically no limits on how far, or where you can walk in labor.
Your baby is never separated from you.
After your birth we tuck you in your own bed!
You will have a postpartum visit in your own home.
There will be lots of postpartum support for breastfeeding.
Your midwife will file your baby’s birth certificate for you.
Home birth is a very cost-effective way to have great care, especially if you have no maternity coverage or high-deductible insurance plans like an HSA.

Challenges of home birth:

You have to be low-risk and healthy. If there are complications you cannot birth at home.
In case of an emergency we have to call 911. This may cause a delay in getting you help.
You cannot have narcotics or an epidural at home.
You cannot have a forceps, vacuum or cesarean birth at home if it is truly needed.
You cannot depend on your insurance to cover all the costs. You are responsible for payment of some fees even if you have insurance we are contracted with.
For some women it’s harder to rest since they may feel like they are entertaining the home birth team.
You are responsible for clean-up after the birth. This may include emptying and cleaning the birth pool, doing laundry and taking out all the trash, cleaning your bathroom, etc.
Someone will need to stay with you for a few days after birth.

Birth Center Birth:

Some advantages of Birth Center birth are:

‍When you choose to give birth at our birth center, you are opting for birth in our “home”. Our goal is to create a home birth experience for you without you having to prep your home for birth, or have any cleanup after! Our birth center is designed to resemble a bedroom with a relaxing environment, while still having all the necessary supplies to provide safe care during labor and delivery.

You have your prenatal care in a comfortable and intimate setting.
You have the same ability to have all the necessary lab tests, ultrasounds or other testing as with hospital or birth center providers.
You will likely be able to get out-of-network insurance reimbursement after you give birth.
You will be provided with the best education to help you become the healthiest mommy possible.
You often have more continuity of care, with the same midwife with you for prenatal care and birth. This helps develop a strong and trusting relationship with your provider!
Experienced, skilled midwives and qualified assistants will meet you at the birth center when labor is active.
Your midwife will have a relationship with medical and specialist providers ready to take care of you in the event of pregnancy or birth complications.
There is no chance of you or your baby getting a hospital-acquired infection.
At our birth center there is a broader time limit on the normal process of labor and birth.
You will have control over how you would like the lights, music, temperature of the room, etc.
You have access to snacks, and have the ability to bring your own food and drink
You wear your own clothes, and we will provide linen such as pillows, sheets, towels, etc.
There is flexibility to who can be with you as your support team at the birth center
At the birth center, we can use alternative treatment like herbs, essential oils, or homeopathy during your labor and birth.
We will be listening frequently to your baby with the Doppler.
In general, there are no limits on how you move about during your labor and birth.
There are no “rules and regulations” about routine procedures like continuous monitors and IVs.
There is usually no limit on where you birth.
You will have the ability to choose from multiple positions for labor and birth.
You will have access to our birth tub
When you are at our birth center, you have the freedom to walk around inside or outside during labor
Your baby is never separated from you.
After birth, you will recover for a couple hours, and be ready to go home!
You will have a postpartum visit in your own home.
There will be lots of postpartum support for breastfeeding, parenting and mom’s groups.
Your midwife will file your baby’s birth certificate for you.

Challenges of birth center birth:

You have to be low-risk and healthy. If there are complications you cannot birth at our birth center.
In case of an emergency we have to call 911. This may cause a delay in getting you help.
You cannot have narcotics or an epidural at our birth center
You cannot have a forceps, vacuum or cesarean birth at our birth center if it is truly needed.
You will need to have someone to drive you and baby home after the birth.
Someone will need to stay with you for a few days after birth.

Hospital Birth

Hospital birth happens daily on a monumental basis. In our current medical culture, most people think that all babies are born in hospitals. Large city hospitals often attend between 7,000 and 10,000 births each year! We are blessed indeed to have facilities with highly skilled providers and support staff for any mom or baby who becomes ill. The highest level hospital can handle the women and babies who have the most serious of problems in the quickest way possible. For those who birth outside the hospital, we need quick and supportive access to this hospital care when it is needed.

The advantages of hospital birth are:

You have ready access to pain relief.
There is a nursery for the baby if needed.
There is an operating room if needed.
There is access to lab services and transfusion if needed.
There is access to intensive care for mother or baby if needed.
Hospital services are usually contracted with most insurance plans and AHCCCS plans.

The disadvantages of hospital birth are:

Sometimes a cascade of interventions (inductions, push for epidurals, lack of movement, continuous fetal monitoring) can lead to unnecessary complications such as unnecessary c sections
There are lots of routine procedures like hourly vaginal exams, IVs for all women, continuous fetal monitors, having to spend the night, routine vital signs when you’re trying to sleep, medications for your baby, routine baby baths, etc.
There is essentially no privacy in the hospital setting.
The hospital is a noisy and busy place.
Hospital food will not be organic or always be allowed or readily available.
In general, hospital kitchens cannot really meet special dietary requests. A kosher or gluten-free request, for example, will likely be met with something frozen.
There is a strong hospital belief that all women need and want medication for birth.
There is a strong hospital belief that all women and their babies are high risk until proven otherwise.
There is a strong hospital belief that all women must conform to the hospital timetable for their labor and birth.
There is a strong hospital belief that all women must conform to the hospital rules and protocols for every aspect of care.
There does exist a real risk of you or your baby getting an infection from the hospital environment or staff.
The hospital environment is structured for the convenience of hospital staff. This environment often induces fear in the client.
There will be limits on the number of your family and friends who can be with you to support you.
There may be large bills for individual services that you don’t expect. The hospital setting is the most costly.
There are some hospital services that won’t be covered by insurance or AHCCCS.
Your “in-network” benefits will still make you responsible for deductibles, co-pays, and co-insurances. These may total anywhere from $2000-5000 for a normal vaginal birth out of your pocket! Gone are the days when insurance covered “everything”