Where should you give birth
When I had my first child, it never occurred to me that I could give birth somewhere other than a hospital. It also didn’t occur to me that I could look at more than one hospital; I just went with whichever hospital my doctor told me to.
Also, I had heard of people giving birth at home, but dismissed them as completely crazy. Given the way a certain, popular pregnancy book painted childbirth -- a series of stages highlight by their own set of crises -- giving birth anywhere but the hospital seemed ludicrous.
Since that first baby, I’ve discovered that the hospital is not the only place to birth. Just as we have choices during childbirth regarding how we want to labor and who we want with us, we also can choose where to give birth.
You should give birth in a place where you feel safe and comfortable. If you feel safest in a hospital, that’s where you should have the baby. If you feel safest at home with a midwife, then if at all possible, that’s where you should be. It’s your birth, and it’s your choice.
Choosing a Hospital
Sometimes, a hospital birth is your only option -- if your pregnancy is considered high-risk, for example. (Note that if one doctor says you’re high-risk, that doesn’t mean every doctor or midwife would say the same. Be sure you ask someone who is supportive of birth centers and homebirth.) Also, many women just don’t feel comfortable with the idea of birthing at home or at a birth center. For them, a hospital is the best place, as well. Depending on where you live, however, you don’t necessarily have to give birth at only one particular hospital.
Often times, women will choose their doctor or midwife, and then they just go to whichever hospital they are associated with. Unless you’re truly in love with your caregiver, and know you won’t get one of their associates who you are less enthused with, you should research a couple hospitals in your area that offer labor and delivery floors.
Most hospitals will allow you to tour or visit the labor and delivery wings, and there should be someone there to answer questions for you. Ask about what special features the hospital has, and what makes them different. You might want to ask them if there is an option to labor in water, or even have a water birth, and if yes, what you need to do to get that option. Ask about their policies on visitors during the birth, what their rules are regarding video and picture taking during labor, and how much freedom of movement they allow.
Don’t forget to ask how their nursery works, for after the baby’s born. Ask if they allow rooming in, or even if they require rooming in. (If you had an extremely long labor, it can be disheartening to not have the option of sending the baby to the nursery for a few hours.) Also ask about breastfeeding help – do they have a lactation consultant on staff? Will they push a pacifier on your baby, or are they willing to calm the child without the pacifier, if that’s your request?
Whatever your concerns or desires are for your birth, ask. If you can, contact local childbirth educators or doulas, and ask them what their opinions are on the local hospitals. They will often know the details that the hospital either may not want to tell you, or answer questions that you didn’t think to ask. Of course, you should be aware that there are doulas who don’t consider hospitals positive places to give birth, period. If you’re picking up these vibes, consider the advice you received from the “anti-hospital doula” with a grain of salt, and find another doula else to ask.
Choosing a Birth Center
Birth centers are an option that fall somewhere in between a hospital and a home birth, and a good center may offer you the best of both worlds. They are better equipped in terms of birthing tools, like squat bars, birthing pools, and so on, and in some birth centers, there’s an option for medication during labor (but not epidurals). If you give birth in a birth center, you don’t have to clean up afterwards (or before), or get supplies for the birth.
The tone and atmosphere in a birth center is usually more family centric, and they are more trusting of the body’s natural birthing rhythms. While in the hospital, nurses and doctors are likely to want to speed things up artificially if labor slows down. At a birth center, as long as the mom and baby are healthy and doing fine, the midwife will usually allow things to progress without intervention.
Many birth centers have small kitchens available, where you or your partner can warm up food or drink. And, actually, this is another difference between giving birth in a birth center, as opposed to a hospital – birth centers rarely restrict your intake of fluids and nutrients. This is a big plus.
After the birth, usually you’ll stay a couple hours to make sure everything is going smoothly, and then, you’re able to go home. For some women, this is ideal. They want to get home as soon as they can, where they can really rest and feel comfortable. For other women, the idea of going home right after birth is scary, or difficult (if they have many young children at home and no help, for example).
When choosing a birth center, it’s very important that you interview the center, ask local midwives and doulas their opinions, and check if they are accredited by the Commission for the Accreditation of Birth Centers. You also will want to research what kind of education and experience the midwives at the center have, what kind of support is available during and after birth, and what they do to handle childbirth emergencies.
For more information on birth centers, you should check out the American Association of Birth Center’s website: http://www.birthcenters.org/
Choosing a Home Birth
Giving birth at home can be a beautiful, wonderful way to bring your new baby into the world. You’re at home, and therefore, may feel more comfortable and empowered. You also have much more freedom during labor, with fewer “policies” and people to deal with. And homebirth is safe. According to a study published in the British Medical Journal in 2005, a planned homebirth with a certified nurse midwife, during a low-risk pregnancy, is as safe as giving birth in a hospital.
If you want to give birth at home, you’ll want to find a doctor or midwife who is willing to attend the birth and has experience with homebirths. When you interview potential caregivers, ask them about their birth philosophies, when will they come to your home, and how long do they stay; what happens if they are unavailable, and can you meet their back-up; and how do they handle childbirth emergencies.
Asking local doulas and childbirth educators is one way to get recommendations. You’ll, of course, want to speak with prior homebirth clients before you choose a midwife to attend your birth. Just ask for references.
When giving birth at home, you’ll be responsible for finding certain supplies, and your midwife can help with this. If you want to labor in water, there are several companies that rent birthing pools.
Wherever you choose to give birth – at home, in the hospital, or at a birth center – it should be a place that fits your needs, both emotional and physical. There is no such thing as the “best” place to have a baby, because every mother and child is different. Consider your options, make a choice, and know that you’ve taken the first step to an empowering childbirth experience.