Home, Hospital, or Birth Center Deliveries: What's Best for You and Your Baby?

The decision of where you plan on delivering your baby is, for most, a simple decision. For many years, it was said that the best place to have a baby was in the hospital because the hospital has all the medical supplies, training and personnel that a laboring and birthing woman could need if in trouble.

However, around 1970, many women began questioning the purpose of so much preparation for trouble. Statistics show, that in a comfortable environment, a healthy woman carrying a healthy baby could birth without any need for medical intervention. Because of the new interest within these women, hospitals began offering new services that would provide more personal and comfortable atmospheres for laboring. Homebirth was more commonly chosen and birth centers began appearing. Now there are many choices, all with their benefits and disadvantages. As a doula, it is part of my responsibility to help parents make the choice that is best for them. If you have interest in one of these options, inform your doula who will then give you more specific information.
Here are the above mentioned options, with their pros and cons. All of the below information is backed up by scientific data, which you can refer to the author of this article for.

Hospitals
The doctors and nurses are trained to undertake emergency situations, which often lead them to perferm the same emergency procedures on healthy women and their babies. The understanding of most of society is that hospitals are where people are born and die, no ifs, ands, or buts. Hospital are a good place ot bring sick or endangered women and babies, but healthy ones should at least consider another route.

Pros:
For women who doubt their capabilities with pain, there are a variety of drugs to choose from.
Drugs can also come in handy when a woman has been in hard labor for a long time and needs sleep.
Food is made for the couple.
Nurses take care of the mother and her baby after he/she is born.
Doctors are ready to handle emergencies immediately.

Cons:
Often the mother delivers with a different care provider than planned.
Often the doctor or nurse will perform procedures or give drugs without asking permission of the mother or father.
Most hospitals require restricted movement and birthing positions, which are harder to handle with IV's, Epidurals, and Fetal Monitors.
The baby is usually taken away right after the birth for a couple hours at a time.
The mother is more likely to suffer from infection and/or sickness, as is her baby, since she is in a place where sick people congregate and her immune system has not yet had a chance to adjust (immunities pass from the mother to her baby via the placenta).
The chances of unnecessary intervention are high and very risky.
The baby is more likely to suffer injury and need help after the birth.
The umbilical cord is usually cut immediately after the birth, preventing the baby from receiving a gentler transition to breathing in their oxygen and cutting off a huge amount of iron that might otherwise have been absorbed into their systems.
It will be strongly recommended that the mother and baby stay at the hospital for at least two days, sometimes longer for baby. Many women enjoy this time, others are ready to go home within 24 hours of the birth.
Depending on the staff, the mother may not be encouraged to breastfeed, even if it is just by the nurse feeding her baby sugar-water in the nursery, which can greatly interfere with the initial feedings.

Home
Originally, women had their babies at home. It wasn't until the last century or two that doctors took over this womanly function as their own responsibility. Women at home can function as their bodies are told by nature and are more likely to have a safe and satisfying birth, with themselves and close women for assistance.

Pros:
Less chance of infection for mom and baby since mom is used to the germs and has passed her immunities to the baby.
Mom has more control during labor and birth.
Mom can move around and change into whatever position during labor and delivery.
After the birth the baby stays with the family at all times.
They can eat their own food.
Less chance of medical intervention of any kind.
Moms tend to have better birth memories.
The mother doesn't have to worry about packing or rushing to the hospital. Instead she can continue her daily life through early labor.
They can have as many or as few people as desired in the room.
Midwives tend to be more caring and understanding than doctors are. The fact that they don't have as many other clients as doctors helps.
Mom can eat and drink as much as she wants during labor.
After the birth mom doesn't have to go anywhere.
The mother is encouraged to breastfeed.

Cons:
If there is a dangerous situation arising, it may take longer to get the help needed, even though the midwives are trained to take care of many circumstances, and any good midwife will create an emergency care plan with her clients.
In the case of an emergency, it would take longer to get the baby to the neonatal ICU.
The mother is not as likely to have a "babysitter" (as a nurse would be) if you need rest. This is when the couple should assign the job to a family member.

Birth Center
Basically a mix between home and hospital, a birth center tries to provide a labor and birth friendly environment. Yet it generally has more safety equipment and usually more medical connections than a home-birth midwife. Most women who go to a birth center want a natural childbirth experience but feel they would be safer in a clinic.

Pros:
Most birth centers are run by care providers who realize that normal healthy women and their babies need a place to give birth where their bodies are expected to function normally.
There is emergency equipment nearby, and many birth centers work hand in hand with hospitals so there would be no fear of a transport emergency, which is rare.
Women are free to walk and move in labor and to try new positions.
Women can eat and drink in labor because they are not expected to have a cesarean birth.
Babies stay with the family.
Generally speaking, the woman can have as many people as she wants in the birthing room.
Less chance of infection than in the hospital because there are no sick people.
Less chance of medical intervention.
After the birth, most couples are not required to stay there for a couple of days.

Cons:
There is more of a chance of infection than in the home.
Most times the couple has to bring in their own food to eat.
There are more women in the birthing unit than there are on a midwife's plate (usually), so the mother is less likely to get the care that she would if she were planning a home birth.