I have this memory from preschool, where I was playing “house” with my preschool “husband” Chris and we were getting ready to have a baby. We made pretend breakfast in my Little Tikes toy kitchen, packed a bag + jumped in the Cozy Coupe for the drive to the hospital.
We were 5 years old + having a baby was simple: there was only 1 way + 1 place to have a baby.
Fastforward into adulthood and real marriage (not to Chris) and the time to actually consider having a real baby — turns out, there’s about 101 ways to have a baby + my mind was blown.
Part of me felt defeated realizing that there were such things as home births + water births + gentle Cesarian sections + standard Cesarian sections + free births + birth center births + births with interventions + births without interventions + births in cars, planes + trains…
Why hadn’t someone told me?
I felt like I was lightyears away from the education that I should’ve gotten when I became a woman. What good was that junior high health class?
The only reason I happened to even unearth the multitude of options was because I studied to become a doctor + after a career in medical research, my natural curiosity just led me there.
Even my intensive, expensive health education hadn’t offered these options up to me. What. The. Heck. Everything began + ended with birth in hospital. That’s it. Where was the rest of the conversation?
When I realized this — in my dual amazement + disgust — I called my mom + sister over to watch a birth documentary with me. Surely, my mom must’ve just overlooked sharing these options with us, right?
She had no idea either.
The reason no one had told me there were so many birth options was because no one knew.
I went on to connect with hundreds — thousands — of other women who had a similar overwhelming feeling when realizing they suddenly had so much to learn + so many decisions to make in such little time.
I asked myself:
Would the 98% of American women still choose a hospital birth if they knew they had other options?
So, I started dissecting the information myself — coming up with the resources I was in desperate search of as my husband and I pumped the brakes on our baby fever.
I felt like I couldn’t rightfully get pregnant without knowing what I was truly, actually getting into for birth. I needed to feel like I had some confidence behind the many decisions I had the right + privilege to make as a woman in control of her health + motherhood.
Now, I’m no bra-burning feminist or conspiracy theorist, but something obviously had to give here.
So, the following descriptions are my simple summaries, but the decisions you’ll make about them for your pregnancy may feel complicated because they’re new to you. That’s okay — it’s normal. Take your time.
Above all, be grateful knowing that you do have options — that birth doesn’t have to be a one-way highway in a hospital if you don’t want it to be.
Wherever you feel the most safe + supported is where you should give birth.
Option #1 — Hospital
Most healthy women can birth a healthy baby vaginally without intervention when they are allowed to move freely, hydrate + rest according to their instincts.
But, some women feel more comfortable having access to all possible technology + specialists + medications in case an emergency arises during birth. There’s absolutely nothing “wrong” or “inorganic” with birthing in a hospital if that’s where you feel the most safe + supported to carry out what your body was made to do.
In a hospital setting, there are more restrictions during labor + birth due to inflexible policies + procedures. So, with that fact, it’s important to weigh the importance of how you want to birth when you consider where you want to birth.
A hospital birth is most likely for you, if:
- You have chosen an OB-GYN or family practitioner as your care provider
- You have a chronic medical condition or a pregnancy-related complication
- You are expecting multiples + need proximity to specialties like a neonatal intensive care unit (NICU)
- An organic birth is not your top priority
Make sure to tour your hospital before your birth to learn about all the guidelines + policies regarding laboring techniques, routine interventions, when C-sections are required, use of cameras or video + routine newborn care.
Option #2 — Birth Center
A birth center is like an intermediate facility between birthing at a hospital + birthing at home. They’re furnished with queen-sized beds, kitchens, TVs + other comforts of “home away from home”. You can have water births + a selection of birth equipment to choose from, like birthing balls + stools. Midwives are in charge in birth centers, as opposed to OB-GYNs who direct hospital births.
Birth centers promote a more organic birthing atmosphere — making interventions like IV fluids, epidurals, electronic monitoring + Pitocin drips unavailable, which many moms find helpful. Birth is intense + when you go into it with a plan for no interventions, but experience the intensity + have interventions offered to you in those vulnerable moments, it can steer your plan off-course. I’ve heard choosing a birth center being equated to “putting the cookies out of the house when you’re on a diet — better to not even have the temptation there for taking advantage of in a vulnerable moment.” That made sense to me!
Contrary to popular thought, birth centers are often safer than hospitals.
Low-risk women delivering at birth centers are less likely to be induced, had less vaginal tearing, less likely to be transferred for a C-section, less likely to experience intervention + infection, + their babies were less likely to be admitted to the NICU.
A birth center birth is most likely for you, if:
- You have chosen a midwife as your care provider
- You + baby are healthy, low-risk candidates
- You want to give birth in a less clinical atmosphere, but also don’t want to give birth in your own home
- An organic birth is your top priority
Keep in-mind: there are 2 kinds of birth centers. A freestanding birth center is independently owned, often by midwives who see you through your entire pregnancy. A hospital-based birth center is owned by a larger hospital group, where you could end up seeing a variety of birth practitioners + still needing to follow hospital guidelines at-large. Beware of hospitals calling their labor + delivery wings “birth centers” — a birth center not run primarily by midwives will not offer you the same care standards even though it might look like it will.
Option #3 — Home
Home births are exactly where they say they are: at home. You have the comforts of your own bed, your own bathroom, your own food + as many (or as few) people + pets as you want around you for support. You can setup a birthing pool for a water birth in your home, too.
Just like birth center births, low-risk women delivering at birth centers are less likely to be induced, had less vaginal tearing, less likely to be transferred for a C-section, + equal or perhaps even better safety than hospitals.
You read that right: better safety.
Regardless of the growing evidence that home births are perfectly safe for qualified women + babies, women who choose home births are met with lots of opposition, concern + questioning.
A home birth is most likely for you, if:
- You have chosen a midwife as your care provider
- You + baby are exceptionally healthy, low-risk candidates
- You have a strong conviction to birth this currently “unconventional” way, regardless of what naysayers may say or think of you
- You are most comfortable in your own home
- You live within a 30-minute drive to a hospital
- An organic birth is your top priority
I chose a home birth for my first pregnancy + had such an incredible experience that I will be doing another home birth for Baby #2.
Home births aren’t always covered by health insurance, but that doesn’t mean a home birth isn’t feasible. Often, it’s cheaper than what you’d pay out-of-pocket at a hospital. We paid for our home birth out of our Health Savings Account — another great option for saving towards birth.
To be thorough, I need to mention that there are 2 kinds of home births. An assisted home birth would be with a midwife (+ usually her assistant) at your home, but an unassisted birth at your home would be considered a free birth. Some women choose to birth alone or with their partners.
I do not know specifics about free birthing, but I do know people who have had free births + found them to be incredible, too. Animals free birth all the time + it’s completely safe, instinctive + natural for healthy moms and babies. Don’t rule out this option, but *do* consult with your health practitioner.
Educate, educate, educate
As always, use your best judgment for what is right for you + your family. I believe that requires extensive, varied education.
Change up your sources: talk to experienced midwives who have nearly seen it all, talk to women who have had each kind of birth you’re considering, read Ina May’s Guide to Childbirth, scour this blog + others for the opinions of health-focused careerwomen + mothers, and ask me questions. I’m here to help.
Be a sponge + enjoy the pursuit of listening to your gut. That mother’s intuition was put there for a reason!