Pregnancy is a time of anticipation, preparation, and decisions. Among the decisions facing you is choosing between a birthing center vs. a hospital for delivering your baby. Hospitals are the traditional choice, seen as safe for you and your little one. Almost 99% of deliveries occur in hospitals. Birthing centers seek to restore the process of childbirth to a more natural, non-medical experience. Both options have advantages and disadvantages.
What Is a Birthing Center?
Birthing centers give you a more natural birth in a home-like environment, based on the belief that most women require only minimal care when giving birth.
Birthing centers provide private rooms or suites with good decor, comfort, and soft lighting. A midwife or nurse-midwife will lead your care. They're professionals trained and qualified in pregnancy and birth care. They take guidance from obstetricians as and when necessary.
When delivering at a birthing center, you will stay in your suite through labor and delivery until you go home. You have the option of a quick return to your home after the birth.
In the U.S., 31.8% of births occur by cesarean section. Birthing centers have lower rates of medication, vacuum extraction, forceps deliveries, and cesarean sections.
You'll be very safe at a birthing center. Bad outcomes like vaginal tears, eclampsia, shock, or uterine rupture are rare. Similarly, undesirable results for babies like neonatal intensive care unit admission, severe sickness, or death are rare.
Birthing Center vs. Hospital
Birthing centers provide a warm and family-centered birthing experience. You can choose to have as many of your family members with you as you like. Hospitals usually allow you to have one or two people with you.
A hospital will have fetal monitors (for electronic monitoring of your baby's heart rate), labor rooms, and operation suites (if you need a cesarean section delivery). An obstetrician (a doctor with specialized training in the care of pregnancy and childbirth) will lead your care. If your delivery does not proceed smoothly, a hospital can perform a cesarean section within minutes.
If you choose a hospital delivery, your insurance plan will cover it. But your insurer may not cover delivery at a birthing center, and you may be out of pocket.
A birthing center provides you comfort, the support of friends and family, and lots of choices about where and how to deliver. A hospital allows you peace of mind. You know that if you or your baby get into trouble, the expertise and equipment for treatment are available on-site.
Birthing Center Pros and Cons
Birthing centers operate on the philosophy that women, designed to give birth, will do so naturally. They minimize interference to allow a natural birth.
Pros:
- A non-medical atmosphere assists with a natural-feeling birth.
- Limited use of medicines like Pitocin (also known as oxytocin, for stimulating labor). Birthing centers allow labor to progress at its own pace.
- You're not hooked up to monitors and can walk about during labor.
- You can choose from several birthing options — standing up, in a birthing pool, or on a birthing ball.
- Birthing centers don't perform any surgery and will allow you to eat and drink as you wish.
Cons:
- You can't choose the date of birthing. You go to the birthing center when labor starts.
- Obstetricians are not available at birthing centers.
- Birthing centers offer limited pain relief through some medicines, acupuncture, and massages. They don't give epidural anesthesia injections.
- If there is a complication before, during, or after the birth, birthing centers efficiently transfer you to a hospital.
When comparing birthing centers to hospitals, both have advantages and disadvantages. For both, you will have trained professionals caring for you in a place equipped for such care. The third option, home delivery, is considerably less safe, and you shouldn't consider it.
Hospital Birth Pros and Cons
Choosing to have your baby born in a hospital has advantages and disadvantages.
Pros:
- An obstetrician will lead your care. These specialists can conduct not only vaginal deliveries but also perform cesarean sections when necessary.
- You can choose the date of your baby's birth. A hospital can induce labor with a Pitocin (oxytocin) drip and other methods.
- If you want an epidural for pain relief, you only have to ask for it.
- Hospitals will monitor your baby with a fetal monitor during labor.
- Hospitals can perform an emergency cesarean section at a moment's notice. If you or your baby are in trouble, your doctor will deliver your baby surgically.
- Hospitals also have neonatologists available. These are doctors with specialized training in the care of newborn babies. If your baby has breathing difficulty at birth, is born with a malformation, or has any other problem, a neonatologist has the skills and equipment to treat it.
Cons:
- Hospitals don't provide the warmth and comfort you want during this momentous event.
- You may be moved from your room to a labor room to a delivery room as your birthing progresses.
- A hospital will allow a limited number of family members to be with you.
- A hospital will restrict your eating and drinking since they may have to perform surgery.
- Hospital bills are likely to be higher than birthing centers. If you don't have an insurance plan that covers maternity services, delivering in a hospital can be expensive.
Hospital Birth Plan
You can overcome many of the cons of a hospital birth by writing a hospital birth plan in advance. You hand it over to your doctor when being admitted. You can specify whether you want an epidural injection for pain relief, delayed cord cutting, circumcision for your boy, and your other preferences. If the choices in your plan don't put your baby or you in danger, your doctor will respect them.
Hospital or Birthing Center: Which Is Right for You?
A birthing center isn't for everyone. By design, they handle low-risk pregnancies. If you have conditions that make complications likely, you should choose a hospital delivery. These conditions include the following:
- Age over 35
- Diabetes
- Hypertension (high blood pressure) or pre-eclampsia
- Multiple pregnancies (twins, triplets, or more)
- An unusual presentation. Most babies are born head first (vertex presentation). If your baby is bottom first (breech presentation) or transverse, the likelihood of complications is higher.
- An earlier cesarean section. You're at risk for uterine rupture.
- Pregnancy over 41 weeks
- Any other disease that can complicate birthing
On the other hand, if you're young and healthy and have a single, vertex-presenting baby, a birthing center is appropriate for you. Be assured that either option is safe since a birthing center will transfer you to a hospital if you have any complications.
