Hospital, Birthing Center, and Home: From a Mom Who’s Done Them All

November 14, 2016 at 6:49 pm

Though I haven’t had an operating-room birth or an unassisted road-side birth, I have given birth in just about every other location with just about every type of birth attendant. For those who may want to know how my births compared, I thought I’d give my pros and cons for each scenario. Before I do, however, I’d like to emphasize that I don’t think birth location is as important as who you choose for birth attendants. I believe most women can have a positive birth experience in any location as long as the people they are surrounded by are kind, supportive, and capable. See my post on this topic here. Keep in mind that these were my personal experiences, and I do not intend to imply that my experiences would be expected to occur in every hospital, birth center, or home birth.

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1) Large Teaching Hospital, Attended by a Resident

 Pros

  • I felt safe knowing that we would already be in the hospital in the event of a life-threatening emergency.
  • I knew I had the option of pain relieving drugs if I needed them.
  • All of my bodily fluids were getting on a bed, sheets, and hospital gown I didn’t have to clean.
  • The hospital had lots of equipment available for use (portable monitor, birth ball, adjustable bed, rocking chair, etc)
  • After the birth, I had lots of support with breastfeeding, access to a hospital breast pump, prescription pain killers for the crazy insane pain from my stitches, and near-constant monitoring of myself and the baby, easing any of my new-mom concerns.
  • Other people brought all my meals to me.
  • I didn’t have to get in a car for a couple of days following the birth.

 Cons

  • I had to get into a car while in labor and drive to the birth location. Car contractions are awful.
  • I had to get an IV per hospital policy, and it made me super swollen.
  • I had to have constant electronic fetal monitoring.
  • I didn’t know which doctor was on-call, and he didn’t even arrive in time for the birth (a resident caught the baby).
  • I had many painful cervical checks.
  • I didn’t get any perineal support, oil, or warm compresses, and I tore horribly.
  • I was coached to take the standard hospital birth position, coached in how/when to push and how/when to breathe.
  • I didn’t get to hold my baby until after she had been poked, weighed, cleaned-off, and wrapped in blankets.
  • The doctor who stitched up my tears afterward was grumpy, abrupt, rough, and kept telling me to put my bottom down.
  • I had to have a Pitocin drip after the birth per hospital policy, and I think it messed with my oxytocin levels and bonding.
  • I wasn’t able to watch my baby’s first bath.
  • My baby would not sleep in the plastic bassinet, but my hospital bed wasn’t a safe place to sleep with her.
  • I didn’t sleep basically until we left the hospital.
  • The nurses urged me to give my baby formula when I was having trouble breastfeeding.

post-birth-swollen

2) Small Community Hospital, Attended by a Nurse-Midwife

 Pros

  • I felt safe knowing that we would already be in the hospital in the event of a life-threatening emergency.
  • I knew I had the option of pain relieving drugs if I needed them.
  • All of my bodily fluids were getting on a bed, sheets, and hospital gown I didn’t have to clean.
  • My midwife was present while I labored to advocate for and encourage me.
  • I was able to drink in labor.
  • I was able to have a hep-lock rather than IV fluids.
  • I didn’t have to be tied to the electronic fetal monitor constantly.
  • I was able to labor in the tub, and it helped tremendously with the hardest contractions.
  • My midwife supported my perineum with a warm washcloth, and I only had a very small “skid mark” that healed very quickly.
  • My baby was placed immediately on my chest after the birth where I could touch and smell her, greatly improving our bonding experience.
  • I was able to watch my baby’s first bath in the hospital nursery.
  • Other people brought all my meals to me.
  • I was able to leave within 24-hours of the birth.

Cons

  • I had to get into a car while in hard-core labor and ride to the birth location.
  • The bathtub at the hospital was really shallow, so the water didn’t allow for me to completely submerge my body.
  • I had nurses trying to cover me up with sheets after I got out of the tub, but I just wanted them to stop touching me and let me be naked.
  • I had several painful cervical checks.
  • I was coached to take the standard hospital birth position, coached in how/when to push and how/when to breathe.
  • One of my nurses was rude and told me to stop making so much noise while I pushed (my baby was posterior).
  • I didn’t get to hold my baby skin-to-skin as long as I would have liked to immediately after the birth.
  • My midwife pulled really hard on my placenta to get it out.
  • My hospital bed was not conducive to sleeping safely with my baby.

2ndbirth

3) Home Births, Attended by Midwives and Doulas

 Pros

  • I didn’t have to travel anywhere for the birth!
  • I was in my own space, wearing my own clothes, with only the people I invited to be present.
  • I chose my midwife and knew she would be the one to attend my births.
  • My children could be present or nearby throughout the births.
  • I was able to labor in a birth tub that was deep enough to completely cover my belly.
  • My midwives and doulas were present throughout the labor, delivery, and immediate postpartum.
  • I was able to eat and drink in labor as I chose.
  • I didn’t have to be tied to an electronic fetal monitor.
  • I could be naked or clothed as I wished without anyone batting an eye.
  • My midwife supported my perineum with a warm washcloth and olive oil, and I didn’t tear or need stitches!
  • I was able to push on my hands and knees in my 2nd home birth.
  • My babies were placed immediately on my chest after the birth where I could touch and smell them and have a full hour of skin to skin contact and nursing.
  • I was able to delay my babies’ first baths until we felt ready to bathe them.
  • My midwives cleaned up all the birth mess.
  • I didn’t have to go anywhere after the delivery.
  • I was able to sleep right next to my newborns in my own bed safely.

Cons

  • I had many painful cervical checks.
  • I was encouraged to take the standard hospital birth position in my first home birth.
  • I was coached to push before I had the urge to push.
  • We didn’t have immediate access to medical assistance if something had gone wrong (fortunately, everything went great).
  • We didn’t have anyone (besides us) monitoring myself or my babies for complications once the midwives left (though we were instructed to call them or go to the hospital in the event of a problem).

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3) Birthing Center, Attended by Midwives, Doulas, and an Obstetrician

Pros

  • I was in a lovely and peaceful birthing space with a large birthing tub, a birth sling, a birthing stool, a kitchen where food could be prepared for me, and a comfortable bed with bedding I didn’t have to wash.
  • I was able to wear my own clothes.
  • I was able to choose which room I wanted to labor in.
  • My daughter was able to attend the birth.
  • My midwives gave me herbs throughout the labor to facilitate the birth process.
  • My midwives (and/or obstetrician) and doulas were present throughout the labor, delivery, and immediate postpartum.
  • I was able to eat and drink as I chose.
  • I didn’t have to be tied to an electronic fetal monitor.
  • I could be naked or clothed as I wished.
  • No one checked my cervix.
  • My midwife allowed me total freedom to do whatever felt right for me and push whenever I felt ready.
  • I was able to have the upright delivery (supported semi-squat).
  • My baby was immediately in my arms after the birth where I could touch and smell her.
  • We were able to have several hours of skin to skin contact and nursing following the birth.
  • I was able to delay my baby’s first bath until we felt ready to bathe her.
  • My midwives cleaned up all the birth mess.
  • We were right across the street from a children’s hospital and down the road from another hospital, which was comforting to know.
  • The obstetrician on-staff (whom I had met with frequently during my pregnancy) would have been able to take over my care in the event of a hospital transfer.

Cons

  • I had to get into a car while in labor and go to the birthing center which caused a significant slowing in my labor progress.
  • I didn’t have any perineal support and needed stitches for a tear.
  • Getting into the car and traveling home after giving birth was awful. I felt like I was going to die until I got home to my bed. (I probably should have rested there longer, but it was Christmas and I wanted to be home with my kids.)
  • I had a hard time with some of our interactions with the on-staff obstetrician.

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*****

No one else can know what will be the right place for you to give birth. I can’t even say at this point where I would give birth if I were to be pregnant again in the future. Each baby is unique, and with each birth you, as the mother, will be a different person than you were in previous births. Where you feel safest may change over time. It changed a lot for me! I hope my experiences are helpful as you ponder the right place for your baby’s birth.

Have you experienced many different birth locations? I’d love for you to share your own pros and cons in the comments to help others as they make their decision.