I’ve had two cesareans that were caused directly or indirectly by the actions and beliefs of my OB’s. With this pregnancy, I am planning a VBA2C, or vaginal birth after two cesareans. I am considered “high risk” because I have had two prior cesareans and two prior premature births. Being high risk limits some of my birth choices, but it is still very possible to make choices and advocate for myself. Today I’m going to talk about one of the most basic birth choices that pregnant women must make, where to give birth. In a later post, I’ll be discussing birth plans which will include a lot more birth choices, but for now, we’ll stick with different birthing locations!
Where to Give Birth
Hospital Birth
This is probably the place that first comes to mind when you hear “where to give birth”. It is the most common place to give birth, and many people believe that it is the only choice. Many women give birth at their local hospital with the help of an OB or certain midwives. Pros are that you have ready access to medications if you are choosing a medicated birth, and you are seconds from an OR/emergency team/NICU should an emergency arise for either you or your baby. Cons are that many women experience unwanted (and often unnecessary) interventions at the whim of their OB’s or the hospital’s policy, and many women feel anxious at hospitals which can stall labor.
Birth Centers
Birth centers are buildings that are separate from a hospital where women can labor and give birth with a midwife. They tend to be a lot more “home-like” and the policies are a lot more relaxed than a hospital. For example, they tend to encourage women in labor to eat and drink to keep up strength whereas the hospital can refuse a laboring woman anything but ice chips. Pros are that many women feel more comfortable here and it is easier to obtain a natural delivery when there are no drugs around. Birth centers also tend to have really good relationships with the local hospitals and OB’s so in case of a transfer you’ll be in good hands. Cons are that in a true emergency you will need to be transferred to a hospital to receive a cesarean if it’s necessary, and you must be extremely low risk to qualify to deliver in a birth center. Also, some insurances will not cover birth that is outside of a hospital.
Home Birth
This is possibly the most controversial place to give birth, but it really shouldn’t be. Studies have shown that a homebirth is as safe if not safer than a hospital birth for healthy low risk pregnant women and when attended by a qualified midwife. Many women who choose a home birth do so because they want a natural birthing experience without fighting OBs and hospital policy for it. Pros include being in a comfortable environment and the ability to labor and birth on your own terms. Cons are that in the case of emergency you have to travel to the nearest possible for services, and a lot of people will criticize your choice.
Overall, where you birth should be your choice. In some cases that choice can be made for you by outside circumstances. For example, I am risked out of birth centers and home births because of my previous cesareans and preterm labors. That said, if you are experiencing a low risk healthy pregnancy there is no reason that your options shouldn’t be wide open. Where do you choose to birth?
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