You'll make plenty of decisions during pregnancy, and choosing whether to give
birth in a hospital or a birth center is an important one.
Giving Birth at a Hospital
Traditional hospital births are still the most common option. This means the mother-to-be
moves from a labor room to a delivery room and then, after the birth, to a semiprivate
room.
In a hospital birth:
Pain medicines are available
during labor and delivery, if a woman wants them.
The baby is usually electronically monitored throughout the labor.
Doctors "manage" the delivery with their patients. A birth
plan can help a woman communicate her preferences, and her doctor will abide by
these as much possible.
Many hospitals now offer more options for low-risk births, often known as family-centered
care. These may include private rooms with baths (called birthing suites)
where women can labor, deliver, and recover in one place without having to be moved.
A doctor and medical staff are still on hand. But the rooms create a nurturing
environment, with warm, soothing colors and features that try to simulate a home-like
atmosphere that can be very comforting for new moms. Rooming in — when the baby stays
with the mother most of the time instead of in the infant nursery — also is more common.
Many hospitals offer childbirth and prenatal education classes to prepare parents
for childbirth and parenting
classes for after the birth.
How many people may attend the birth varies from hospital to hospital. In more
traditional settings, the limit might be three support people during a vaginal birth.
In a family-centered setting, more family members, friends, and sometimes even kids
might be allowed. During a routine or nonemergency C-section,
usually just one support person is allowed.
A variety of health professionals oversee hospital births:
Obstetrician/gynecologists (OB/GYNs) are doctors with at least
4 more years of training after medical school in women's health and reproduction,
including both surgical and medical care. They can handle complicated pregnancies
and also do C-sections.
Look for obstetricians who are board-certified, meaning they have passed an examination
by the American Board of Obstetrics and Gynecology (ACOG). Board-certified obstetricians
who go on to receive further training in high-risk pregnancies are called maternal-fetal
specialists or perinatologists.
If you deliver in a hospital, you also might be able to use a certified
nurse-midwife (CNM). CNMs are registered nurses who have a graduate degree
in midwifery, meaning they're trained to handle low-risk pregnancies and deliveries.
Most CNMs deliver babies in hospitals or birth centers, although some do home births.
Registered nurses (RNs) attend births to take care of the mother
and baby. If you give birth in a teaching hospital, medical students or residents
might attend the birth. Some family doctors also offer prenatal care
and deliver babies.
Anesthesia, if needed, will be administered by an . A variety of pain-control measures — including pain medicine
and local, epidural, and general
anesthesia — are available in the hospital setting.
Giving Birth at a Birth Center
Women who deliver in a birth center usually have already given birth without any
problems or have a low-risk pregnancy (meaning they are in good
health and are not likely to develop complications).
Women are carefully screened early in pregnancy and given prenatal
care at the birth center to monitor their health throughout their pregnancy.
Epidural anesthesia usually isn't offered at birth centers. So women are free to
move around in labor, get in the positions most comfortable to them, spend time in
the jacuzzi, etc. Comfort measures (such as hydrotherapy, massage, warm and cold compresses,
and visualization and relaxation techniques) are often used.
A variety of health care professionals work at birth centers, such as registered
nurses, CNMs, and doulas (professionally
trained providers of labor support and/or postpartum care). A doctor usually isn't
on-site and medical interventions are rare. But most birth centers work with obstetric
and pediatric consultants as a team. Nurse-midwives provide care during a woman's
pregnancy, labor, and delivery. The OB/GYN consultants are available if she develops
complications that put her into a higher risk category.
The baby's heart rate is monitored often during labor, typically with a handheld
Doppler device. Birth centers do have medical equipment available, such as IV lines
and fluids, oxygen for the mother and the infant, and other equipment necessary to
treat sick babies and moms.
A birth center can provide natural pain control and pain control with mild narcotic
medicines. But if a woman decides she wants an epidural, or develops complications,
she must be taken to a hospital.
Birth centers provide a homey birth setting for the mother, baby, and extended
family. In most cases, they're freestanding buildings, though some are attached to
a hospital. They often include amenities such as private rooms with soft lighting,
showers, whirlpool tubs, and a kitchen for the family to use.
Look for a birth center that is accredited by the Commission for the Accreditation
of Birth Centers (CABC). Some states regulate birth centers, so make sure the birth
center you choose has all the proper credentials.
Which One Is Right for Me?
How do you decide whether a hospital or a birth center is the right choice for
you?
Some things to consider:
If you've chosen a health care provider, find out if he or she can only practice
at a particular hospital or birth center.
Check with your health insurance carrier to see which options are covered. Often,
major insurance companies cover accredited birth centers as well as hospitals.
Some risk factors might mean that you're not eligible to deliver in a birth center,
such as:
And if you want interventions such as an epidural or continuous fetal monitoring,
a hospital is probably the better choice for you.
A birth center can be an option for women who:
don't have significant problems in their medical history
have a low-risk pregnancy
want a natural birth with minimal medical intervention or pain control
want friends or family members there for the birth
To help with your choice, arrange a tour of the hospital or birth center. This
lets you make sure that the staff is friendly and the atmosphere is one in which you'll
feel relaxed.
