Oh, the Places You Could Birth!

One of the first big decisions you must make as a parent is where to birth. Which hospital, if a hospital is your choice. Maybe you’d like to have a homebirth … but how does that work exactly? How much does it cost?  

The so-called middle of the road option is a birth center, but is it really that much different than a hospital or — beyond the perfect, creamy Pottery Barn décor — a homebirth? 

As a postpartum doula, I’ve heard many different birth stories, ranging from orgasmic to traumatic. I’ve worked with homebirth mamas, birth-center mamas and many hospital mamas. 

The “big truths” I’ve learned about choosing where to birth:

  • Birth is a big deal for everyone, no matter where you land.
  • Every birth is different.
  • It can really matter where you birth.
  • It can matter very little where you birth. 
  • One way or another, the baby comes out. 

Of course, there are pros and cons to each birth setting. As someone who has personally had one hospital birth and one homebirth, I have not only professional, but also experiential insight. 

Both my births were great. I chose a homebirth for my second child not because I hated my hospital birth, but because I wanted to try something different. 

From my personal experiences, the input I’ve received from the families I worked with and the wisdom of other birth professionals, I can offer a few major pros and cons about each birth setting. (Note: Birth doulas can be another part of the process, but we’ll address that another time.)

Hospital 

Pros:

  • Every imaginable medical intervention is readily available.
  • Help for Mom and Baby around the clock, after the birth.
  • Grace period before being sent off alone with — eek! — a newborn.

Cons:

  • Occasionally, unnecessary interventions are pushed.
  • Uncomfortable environment (hospital bed, cramped room, uncomfortable sleep setting for spouse).
  • Interruptions (and sometimes conflicting opinions from different hospital staffers) while Mom and Baby are trying to rest and recover.

Home

Pros:

  • More medical interventions than you’d think are available, but are used only in an emergency, plus some cool holistic tricks of midwifery.
  • Empowering ownership and control of one’s birth, possible because of the confidence built while working closely with the midwife during gestation. Midwifery = ultra-personalized, comprehensive care.
  • Comfort of own home and no travel. Your midwife comes to you! This allows the partner, siblings, other family members and caregivers to come and go easily and as needed.

Cons:

  • Many insurance companies will cover homebirth and midwifery costs, but only after a claim is filed — so parents typically have to pay upfront. Home birth can be cheaper than the out-of-pocket costs of a hospital birth, but not always, depending on your insurance coverage and the cost of your midwife. Some midwifery packages can cost up to $5,000. Check out some hospital-versus-home cost comparisons.
  • You might not care — but what will the neighbors think or say? The in-laws? 
  • Going against the grain can be hard!
  • Strong temptation to do too much after birth, since you’re in your own environment — grab your own cereal, tend to other kids, take the stairs to hang out in the family room. 

 

Birth center

Pros:

  • When adjacent to a hospital, birth centers can provide a synergy of natural, midwife-led birth with a safety net of ER/OR care.
  • Birth rooms in birth centers are usually lovely and often have a birth tub. 
  • Someone else takes care of materials and cleanup.

Cons:

  • Mom and Baby aren’t allowed to stay very long in most cases! Often the discharge is 4 to 8 hours after birth, for insurance purposes. This is an awkward time to travel home, when it’s ideal to stay put for another 20 hours.
  • Not much is offered that’s different than a homebirth, so it may be hard to rationalize the transport to the birth site.
  • Birth centers often have other events going on — such as prenatal education and yoga classes. So, you might be birthing in close proximity to excited expectant parents. 

If there were ever a “trust your gut” moment, this is it. Deep inside, you know where you want to be — and that feeling can change, even as late as the third trimester! Listen to that little voice, and birth where you feel happy and safe. 

For some, that’s going to be absolutely and firmly attached to an epidural drip, with a dozen nurses, an ICU and an OR nearby. For others, it’s somewhere home-like, if not home itself. 

You do you. The baby comes out, one way or another. 


Jen Wittes is a certified postpartum doula and writer who now works in marketing and communications. She lives in St. Paul with her two kids, two cats and husband. Send questions or comments to jwittes@mnparent.com.