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Pros and cons of different delivery locations

Baby birds have their nests, baby kangaroos have their mothers’ pouches, but what’s the place that Baby is going to see when he first comes into the world? There are a few different types of locations that babies in the U.S. are most likely to see in their first moments, and each of those locations has its own benefits and drawbacks.

Hospital

  • Pros: Planned hospital births are absolutely the safest choice for deliveries that are expected to face complications, even if they’re planned as vaginal deliveries. They’re also the only choice for delivery through a medically necessary, planned C-section. Hospital births make many women feel safer and more secure. They also offer epidurals and other medications for pain relief, and most also support natural pain relief strategies. Since hospitals are a center for medical care in other parts of life, women who choose hospital births may be able to choose hospitals they’re already familiar and comfortable with, as well. Some hospitals have midwives on-staff, and work closely with them, though others have policies and norms that are very different.
  • Cons: Hospital births tend to be among the most expensive, and depending on the hospital, they can also be less supportive of a mom-to-be’s birth plan, especially a birth plan involving different or alternative labor and pain relief strategies. Different hospitals have different practices, but in general, women who deliver in hospitals are more likely to receive C-sections that may not be medically necessary, and are much more likely to experience certain interventions like induced labor, forceps or vacuum extraction, and episiotomies.

Birthing center

  • Pros: Birthing centers are often connected to or are part of hospitals, and if they’re not, they do have established relationships with a nearby hospital, and an established system for transferring deliveries there in the event of complications. On the other hand, birthing centers tend to have a more welcoming environment than the hustle and bustle of a busy hospital, and to follow midwifery practice models instead of hospital models of delivery. This means that delivering in a birthing center reduces the chances of interventions like induced labor and forceps or vacuum extraction, as well as a decreased chance of C-section. Birthing centers often offer options like birthing pools and birthing balls for dealing with pain during labor, and have staff who are familiar with and supportive of alternative birthing styles and pain management techniques. Delivery at a birthing center is more likely to be covered by insurance in the U.S. than a homebirth with a midwife, and may end up costing less than a hospital birth, depending on your insurance.
  • Cons: Like planned home births, deliveries that look likely to have complications generally aren’t recommended for birthing centers, and deliveries that do end up having complications that lead to medical interventions need to be transferred to the hospital. Similarly, birthing centers don’t tend to offer epidurals for pain relief. And while birthing centers tend to be more prepared for complications than in planned home births, it still takes time to transfer from a free-standing birthing center to a hospital. Birthing centers that are attached to or within hospitals don’t have this problem in the same way.

A note about home births

Home births with midwives generally aren’t covered by insurance in the U.S., and home births aren’t considered a safe choice by many physicians, and especially not for anyone who looks likely to have complications during delivery. Midwives also often won’t perform deliveries at home in areas that don’t have quick access to a hospital in case of an emergency, which means that home births aren’t always an option, even to those who have healthy, uncomplicated-looking pregnancies. Planned home births that do encounter complications will end up taking a quicker and more unexpected trip to the hospital than would happen in a planned hospital birth.

The location where you give birth doesn’t define what your delivery experience will be like, and whichever one you choose, you’ll want to advocate for the type of delivery you’re hoping for. What choosing a delivery location does mean is that the likelihood of certain experiences can go up or down, and knowing what those trends are will give you a better understanding of how to ask for the type of delivery experience you want.


Sources
  • Mayo Clinic Staff. “Home birth: Know the pros and cons.” Mayo Clinic. Mayo Clinic, July 7 2017. Retrieved November 1 2017. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/home-birth/art-20046878.
  • Mayo Clinic Staff. “Labor and Delivery.” Mayo Clinic. Mayo Clinic, September 1 2016. Retrieved November 1 2017. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/basics/labor-and-delivery/hlv-20049465.
  • “Labor & Delivery.” Cleveland Clinic. Cleveland Clinic, July 26 2016. Retrieved November 1 2017. https://my.clevelandclinic.org/health/articles/labor-and-delivery.

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