Pregnancy and Children

Birth Center or Hospital Birth

Birth Center or Hospital     Birth Center or Hospital

More and more hospitals, obstetricians, and midwives are providing women with the option of a birth center birth as opposed to a traditional hospital birth. For a woman who is having a low risk pregnancy and wants a more natural birth experience, a birthing center might be a good choice.

Birth Centers and Hospitals

Choosing where to deliver your baby is a decision you should think about long before you are due to give birth.  Once you have decided on either a hospital or a birth center, you may still have to choose which hospital or which birth center.

The following information about hospitals and birth centers has been adapted from websites listed at the bottom of this page.

Hospital Births

Traditional hospital births in which the mother moves from a labor room to a delivery room and then, after the birth, to a semiprivate room are still the most common option.  In most cases, you are not allowed to eat or drink (possibly due to anesthesia or for other medical reasons) and you may be required to deliver in a certain position. Pain medications are available during labor and delivery (if you so choose), labor may be induced and the fetus is usually electronically monitored throughout the labor.

Many hospitals offer other options for low-risk births, often known as family-centered care. These may include private rooms with baths (known as birthing suites) where you can have. Rooming in, when the baby stays with you most of the time instead of in the infant nursery, is an option now available in many hospitals.

Advantages and disadvantages of hospital births

Advantages: Epidural anesthesia, and/or other pain medications, are available for women who choose to use them. Emergency equipment to deal with any complication is immediately available.

Disadvantages: Hospital policies often place restrictions on the choices you can make and hospital policies may affect mobility, eating and drinking while in labor, choice of position for birth, etc. Nursing staff may change throughout the labor and are typically strangers to you. Birth is viewed as a medical event where frequent assessments are performed to monitor for possible complications, and labor may be managed with medical interventions such as I.V.'s, electronic fetal monitoring and medical induction in order to prevent possible problems.

Birth Center Births

If you are a healthy woman at low risk for complications and you want a more natural, family-centered experience without routine medical interventions (such as IVs and electronic fetal monitoring), you may want to deliver at a birth center. Birth centers offer a comfortable place for childbirth. If you choose an accredited birth center, you will be cared for by licensed professionals, usually a midwife and a nurse, with a backup hospital nearby and a doctor on call in case of an emergency.

Natural childbirth is the focus in a birth center.  You will be carefully screened early in your pregnancy.  When you are ready to deliver you will not be induced and c-sections are not done at birth centers.

Since epidural anesthesia is not typically offered, you will be free to move around in labor, get in positions that are most comfortable for you, spend time in the jacuzzi, or do whatever is needed to help you deal with labor in a positive way. Techniques such as hydrotherapy, massage, warm and cold compresses, and visualization and relaxation are often used and you are generally able to eat and drink as you so desire.

A variety of health care professionals operate in the birth center setting. A birth center may employ registered nurses, CNMs, and doulas (professionally trained providers of labor support and/or postpartum care). Although a doctor is seldom present and medical interventions are rarely done, birth centers may work with a variety of obstetric and pediatric consultants. The professionals affiliated with a birth center work closely together as a team, with the nurse-midwives present and the OB/GYN consultants being available if complications during pregnancy or labor develop.

Birth centers typically have medical equipment available and are able to provide natural pain control and pain control with mild medications.  But if you decide you want an epidural, or if complications develop, you will be transferred to the hospital.

Advantages and disadvantages of birth center births

Advantages: Birth centers are typically less expensive, have fewer restrictive policies, and are less interventive then the traditional hospital setting.  Birth centers are positive environments centered on childbirth, not institutions focused on treating illness. They are similar in philosophy to home birth, with a focus on birth as a natural event, and on empowering the mother to make choices about how to give birth.

Disadvantages: Insurance coverage is possible in some states, not in others. There is a chance of transfer to hospital during labor: 6% for mothers who have birthed before, 25% for first-time mothers. Most transfers (96.6%) are for non-emergency situations, such as prolonged labor, exhaustion, meconium in amniotic fluid, prolonged ruptured membranes, or a desire for pain medication. Most birth centers ask the parents to leave the birth center a few hours after the birth; some parents are ready to leave at that time, some wish they could stay longer.

How to choose a birth center

If you have chosen a particular health care provider, he/she may only practice at a particular hospital or birth center, so you should discuss your decision with your health care provider. You should also verify your choice with your health insurance carrier to make sure that your prospective hospital or birth center is covered.

If you have any conditions that would classify your pregnancy as higher risk (such as being older than 35, carrying multiple fetuses, or having gestational diabetes or high blood pressure, to name a few), your health care provider may advise you to have your child in a hospital where you and your baby can receive the required medical treatment, if necessary.

The American Association of Birth Centers provides a list of all accredited birth centers in the United States on the American Association of Birth Centers: Find a Birth Center website.  If no birth center in your area meets your criteria, you may be able to find a hospital-based midwifery practice that meets your needs. You can get more information on this option from the American College of Nurse-Midwives.

Additional Information

For additional information about birth center, hospital and home births, please visit the websites listed below.

American Association of Birth Centers: Find a Birth Center

American Pregnancy: birthing center

Baby Center: Birth centers--Alternatives to hospitals

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