One of the biggest decisions you make while you are pregnant is where you plan to give birth. If you are currently asking yourself “Where should I give birth?” or are wanting to change your birth location for this next baby this podcast episode is for you. In the episode I chat with birth doula, childbirth educator and mother of three Bria Florell about our three birth experiences. We have very similar birth experiences because our birth locations were the same for our three births. Both Bria and I gave birth in a hospital setting with our first, birth center birth with our second and a home birth with our third babies. We break down some of our personal experiences and what made them different based on the birth location. Our hope is that by sharing our personal experience with the three options it can help you to decide what is right for you! Spoiler alert, there is no one size fits all right answer here on where to give birth you truly need to trust your instincts and do what is right for you and this baby.
Now here is something that I didn’t know when I first got pregnant.. You have options on where to give birth!! Hospital Birth is just one option. Before we get into all of your options, remember that these are options that we are discussing with our personal opinions and offer up some statistics and evidence based childbirth education. Certain health factors may limit your options on birth location, but ultimately we hope that you feel like you know all of your options and are able to make a decision that is best for you and your baby.
Your birth place and team truly does make a huge difference and can impact your entire life. Birth trauma is on the rise and more and more birthing families experience birth trauma. Your birth location can either support your overall well being or cause birth trauma and suffering. Your birth experience can impact the rest of your life and truly makes a HUGE DIFFERENCE. Take your time, interview options, ask good questions and do not settle.
Where to give birth: hospital, birth center or home birth?
First up, here are your options and this really does change based on where you live. You may have all of these options available to you or be limited based on your state, city or specific location or health factors.
Hospital Births
- You can be supported by a physician (OB/GYN or MD), midwife or doctor of osteopathic medicine in a hospital.
- OB/GYN – Obstetricians, or OB/GYNs, are medical physicians who specialize in pregnancy and delivering babies, as well as gynecological care to non-pregnant women. OB/GYNs care for all types of pregnancies but their focus is in high risk pregnancies. They are speciality surgeons and perform C-sections or surgical births and other interventions. They predominantly work in hospitals.
- MD – Family physicians sometimes care for pregnant patients and attend births. They usually specialize in low risk pregnancies and sometimes specialize in unmedicated birth. They predominantly work in hospitals and operate under hospital protocol above all else.
- DO or Doctor of Osteopathic Medicine – DOs are licensed physicians who can specialize in caring for women during pregnancy and birth, as well as provide gynecologic care. A DO focus in medicine is a more holistic and patient centered approach.
- Midwifery Care – Midwives are highly trained professionals who provide holistic care and support to women through pregnancy, birth and the postpartum period. Midwives attend birth in hospitals, birth centers and at home. Midwifery care often results in fewer medical interventions, though you absolutely can still have an epidural, ultrasounds and other procedures with a midwife. Midwives usually care for low-risk pregnancies and specialize in unmedicated birth and water birth. If you require additional medical interventions during your pregnancy or birth, you will likely be transferred to the care of an obstetrician.
- Specializes in high-risk pregnancies and responding to emergencies
- Higher interventions
- Doctors are on shifts and you may not have your doctor at your birth
- Protocol of the hospital and Culture of the hospital can impact your birth experience more than your doctor’s practice
- Labor and delivery nurses you have never met support your labor vs. your doctor
Birth Center (Freestanding Out of Hospital Birth Center)
- Freestanding out of hospital birth centers are pretty rare
- Not a Hospital labor & delivery ward that has named themselves a “birth center”
- Specializes in natural unmedicated birth, water birth and hypnobirthing
- Led by a group of midwives – You typically will meet with a group of different midwives that will work together to care for you prenatally and you may have 1-2 of them at your birth. They will rotate who is on call.
- Sometimes Birth Centers will have on staff doulas, acupressure or acupuncturists
- Midwifery Care – Midwives are highly trained professionals who provide holistic care and support to women through pregnancy, birth and the postpartum period. Midwives attend birth in hospitals, birth centers and at home. Midwifery care often results in fewer medical interventions, though you absolutely can still have an epidural, ultrasounds and other procedures with a midwife. Midwives usually care for low-risk pregnancies and specialize in unmedicated birth and water birth. If you require additional medical interventions during your pregnancy or birth, you will likely be transferred to the care of an obstetrician.
Home Birth
- Midwifery Care – Midwives are highly trained professionals who provide holistic care and support to women through pregnancy, birth and the postpartum period. Midwives attend birth in hospitals, birth centers and at home. Midwifery care often results in fewer medical interventions, though you absolutely can still have an epidural, ultrasounds and other procedures with a midwife. Midwives usually care for low-risk pregnancies and specialize in unmedicated birth and water birth. If you require additional medical interventions during your pregnancy or birth, you will likely be transferred to the care of an obstetrician.
- Autonomy is the biggest pro with a home birth. You have the most control of your environment and other factors.
- Children can be present
- Do not need to get in the car
- In home prenatal visits, birth support, postpartum care, lactation support
“If you want sushi, you would not go to a pizza restaurant.” – Bria Florell
One of the hard things about birth when you are pregnant for the first time there is an assumption that everyone does the same thing. There is a wide range of ways we can get a baby out. OBs are specialty surgeons and are not trained in unmedicated birth.
“If you are looking for a water birth, that is not the hospital’s specialty. You asked them to create sushi in a pizza restaurant.” – Bria Florell
Interview Providers & Birth Locations…
Rather than getting your birth location statistics or asking “do you allow?” ask them “When is the last time you…”
“When is the last time you…”
- Caught a baby in the water?
- Supported an unmedicated vaginal birth?
- Worked alongside a birth doula?
- Had children in the birth space?
- Had to clean up blood out of carpet?
- Supported a hypnobirthing birth?
- Supporting someone with Gestational diabetes?
- Transferred to the hospital?
- Had an emergency c-section or surgical birth?
- Induced someone prior to 40 weeks?
Medical Insurance may or may not be a factor in your decision making
“I think first time birthers do not understand the impact that your birth has on the rest of your life. A traumatic birth can impact your bond with your baby and cause postpartum depression.” – Bria Florell
Sometimes money and insurance can get in the way from choosing the option that is best for you. Both Bria and myself have experienced and seen in our clients how money can impact their decision making.
Prepare for your Birth experience & Hire the RIGHT TEAM for YOU and this BIRTH.
- Hire a Doula – statistically improve your birth experience
- Take a Childbirth Education class that is not sponsored by your hospital
- Listen to Birth Stories. Learn about your options.
- What is your birth philosophy? Narrow down your birth preferences and what you want your birth to feel like and be like.
- Interview providers & Ask good questions – red flags can look like “I don’t allow, I let” when asking questions ask, “when is the last time you?”
- Prevent trauma by choosing a team that supports your bodily autonomy.
“There are a lot of professional differences of opinion in birth. Start with, what is your birth philosophy? There is no right or wrong answer here. Just like there is no right or wrong answer with how to parent. You have to figure out, where do you feel safe birthing?” – Bria Florell
Your Birth Philosophy
Your Birth Philosophy is not only an internal viewpoint on birth but a birth preference for your specific pregnancy. You may have a different internal viewpoint of birth than what your specific pregnancy needs due to health factors. For example, you may view that the majority of births can be done in a birther’s home and need no interventions but also understand that with your pregnancy you have gestational diabetes and may need to birth in a hospital and receive interventions to support a healthy delivery. Establishing your birth philosophy is helpful in finding out if you want sushi or pizza so then you know exactly which restaurant to go to to get the best pizza or sushi. Here are some things to consider when you are interviewing birth location and providers to see who is the best fit for you.
- Is your provider tolerant of your birth preferences or supportive?
- Listen between the lines of what your provider’s birth philosophy is. You want to be aligned with your provider.
If you’re thinking, well “everyone gives birth at a hospital” I will just go with the flow and do what everyone else is doing. Well, “everyone else” is also experiencing birth trauma (1 in 2 births), unnecessary inventions, inadequate postpartum and lactation support, increased risk of surgical births (1 in 3 hospital births) and truly the majority of birthing families do not enjoy their birthing experience.
“Go with the flow is not something I would recommend” – Bria Florell
If you liked this episode, please share it with a friend. We hope that we inspire you to put effort and thought into your birth place, birth philosophy and birth experience. Please connect with Bria Florell of Bright Earth Doulas for childbirth education, birth doula support in the twin cities and prenatal care.
“Birth matters. Peace on birth, begins at birth.” – Bria Florell
