Planned home birth, delivery at a birth center, midwife delivery, labor and delivery at a hospital—when it comes to creating a birth plan, there are lots of options available to expecting moms. This short primer will help you understand each option and decide which is the best choice for you and your baby.
If you have health problems or pregnancy complications, are at risk for problems during labor and delivery, or simply want access to the most advanced medical equipment and highly trained doctors, the hospital may be your best option. In a hospital, doctors can perform cesarean delivery if labor becomes dangerous for you or your baby. You can also choose from a variety of pain relief options such as epidurals. Many hospitals are now offering on-site birth centers as well.
Is a hospital right for you?
Hospitals can offer you the highest level of care in a clinical setting. One trade-off is that you may be laboring and giving birth in a less relaxed setting than other options may offer. Eating and drinking may also be restricted if directed by your physician.
Birth or birthing centers can be inside hospitals, affiliated with hospitals or completely separate facilities. They offer a more relaxed, home-like environment for labor and delivery. They aim to make the birth process more natural and personal by doing away with most high-tech equipment and routine procedures. If you choose to give birth at a birth center you won't automatically be hooked up to an IV. You won't have an electronic fetal monitor around your belly the entire time either. Instead, a midwife or nurse trained in midwifery will check on your baby from time to time using a handheld monitor. Once your baby is born, all exams and care will take place in your room.
Is a birth center right for you?
Birth centers offer many of the comforts of home—like showers or tubs, large beds and rocking chairs—while also providing you the reassurance of a doctor on staff. Some drawbacks are that you will not be able to receive an epidural if you decide you want one, though some pain relief medicines may be available. If a cesarean delivery becomes necessary, you will need to be moved to a hospital for the procedure.
If you choose a birth center, make sure that it meets the standards of the American Association of Birth Centers, the Accreditation Association for Ambulatory Health Care or The Joint Commission. Accredited birth centers are required to have doctors who can deliver at a nearby hospital in case problems arise with you or your baby. If you are experiencing a high-risk pregnancy or have serious health issues, a hospital is still your best option as it gives you quick access to highly skilled professionals and advanced medical intervention if problems arise.
During a home birth, you'll labor and give birth in your home instead of at a hospital or birthing center. You'll be assisted during labor and delivery by a certified midwife or, in some cases, a doctor. During labor, this healthcare provider will periodically—rather than continuously—monitor your blood pressure, pulse, temperature and your baby's heart rate. After delivery, she will examine your new baby and determine whether or not the baby needs to be transferred to a hospital. She will also give you information on how to care for your baby, and she may include follow-up care such as home visits and lactation support.
Is a home birth right for you?
With careful planning and the right professionals in place, a home birth can be a positive, joyous experience. However, if you are experiencing a high-risk pregnancy or have serious health issues, a home birth is not recommended. Life-threatening problems can occur during labor and delivery and infant deaths are about two to three times more common with home births than with planned hospital births. If they do, the need to transfer you and your baby to a hospital could delay care and put both your lives at risk.
Talk to your doctor about the risks and benefits of your labor and delivery options and let her help you decide which option is right for you.