Where to have your baby: Hospital, Birth Center, or at Home?

Congratulations: You are pregnant! Pregnancy is a special time for women. Despite the discomforts and challenges you may be feeling, there is no denying the magic of the little person developing inside you. During pregnancy, it is sometimes easy to focus your attention on your changing body and the baby's development and forget about how and where the baby will be born.

Though most mothers still give birth in a hospital setting, more and more women are electing to have their babies in birth centers or even in the comfort and privacy of their own homes. The decision of where to have your baby is a highly personal one, and it is a good idea to explore your options. Even if you decide on the traditional hospital setting, understanding the benefits and drawbacks of each birth environment will ensure that you've made the best decision for you and your family.

Having a baby at a hospital is clearly the most common birth setting for most women. The benefits of a hospital birth are many. Most women see OB/GYNs for their prenatal, birth, and postpartum care, and most OB/GYNs have privileges in hospitals rather than in birth centers. There are two major types of hospitals as well. A teaching hospital has the most up-to-date equipment and part of their mission is to teach the next generation of doctors and nurses about medical care. In a teaching hospital, the birthing mother may be asked if interns and other medical students can watch or assist with the labor and birth. Smaller community hospitals are more likely to have a more intimate feel and are less likely to have medical students helping care for patients. All hospitals provide opportunities for pain management for laboring women, from local anesthetics to epidural and spinal blocks. What a hospital lacks in comfort and privacy it makes up for in access to emergency care. Women with complicated pregnancies or babies with special needs will benefit from neonatal care found in hospitals.

Depending on the type of birth you are hoping to have, a hospital may not have the intimacy you and your family are seeking. A birth center may be a good alternative to a hospital if you have had an uncomplicated, low-risk pregnancy. Birth centers are small places where women can give birth with the support of midwives and their families. The Cambridge Birth Center, for example, gives women a home-like atmosphere while providing the security of a timely transfer to Cambridge Hospital across the street should additional medical care for the mother or baby be needed. Not all birth centers are affiliated with hospitals, but many are. Most birth centers do not induce or augment labor with pitocin, use continuous electronic fetal monitoring, or perform Caesarian sections. If you want a natural childbirth, a birth center provides support through trained midwives while maintaining an more intimate, home-like feel.

More and more women are turning to home birth as well. Some home births are attended by midwives, while others are just the laboring mother and her birth partner. The woman is, theoretically, in complete control during a home birth.  She is free to move about in the comfort of her surroundings. Such an environment is beneficial for many women; because her surroundings are so familiar, there is little to distract her from the work of labor. At the same time, there are no medical interventions available for laboring women at home. Women can certainly reduce their discomfort during labor by spending time in the tub or shower, having their partner use massage to manage tension, or by simply practicing their own laboring techniques. If you are experiencing a high-risk pregnancy, home birth is probably not for you. In the end, however, it is the job of the mother and her partner to decide where to give birth.