Hospital vs Birth Center vs Home Birth – What’s Right for You?

Hospital, birth center, or home birth? It’s a personal choice, and there’s no one-size-fits-all answer. I always remind my clients that birth happens best in the place where you feel safe—where you can relax, release, and trust your body. Let’s break down the pros and cons of each setting to help you decide which space feels right for your birthing journey.

HOSPITAL BIRTH:

PROS:

• Pain medication is readily available.

• Medical interventions are readily available.

• If your baby is requiring NICU or medical support,

  it's all readily available.

CONS:

• Routines and hospital protocols that may inhibit your ability to birth.

• Higher chance of needing interventions.

• Time limitations.

• May be difficult to get the desired birth experience due to the hospital protocols.

• Lack of continuity of care between nurses and providers.

The hospital system is designed to prevent law suits and it may not always be in alignment with what is evidence based. For example, the continuous electronic fetal monitor was designed to prevent unneccessary cesareans by continuously tracing the baby's heart rate; however, research shows the opposite outcome. Since the introduction of the continuous electronic fetal monitor in the 70s, cesarean rates increased due to many false positives and can be correlated back to the use of the continuous fetal monitoring. You can read more about the evidence of the electronic fetal monitor here.

There are numerous other routine hospital protocols done such as the continuous IV fluid given to the birthing person. The reasoning is because the hospital does not want people eating and drinking so this is a way to keep the patient hydrated. However, research also shows that the continuous IV fluid also has negative consequences. For example, too much fluid can dilute the natural oxytocin making contractions weaker and less productive. The IV fluid also retains and creates a lot of swelling within the birthing person and baby and can skew the weight of the baby post birth. Click here to read more about the evidence of continuous IV fluid during labor and birth.

*While you can decline or request alternatives to some of these interventions as the hospital, you may be met with quite a bit of resistance.

BIRTH CENTERS

(A free standing birth center is not associated with a hospital and has their own autonomy as well as standards, protocols, and guidelines.)

PROS:

• Less clinical and more aligned with the natural birthing community.

• Personalized and continuous care.

• Offers some emergency medications and equipment if needed.

• *May offer nitrous oxide for pain relief.

• Water birth is offered as a pain relieving measure.

CONS:

• If an intervention is needed during or after the birth you'll need to transfer to the nearest hospital.

• Birth centers cannot support high risk pregnancies or multiple births such as twins or triplets.

• If baby requires medical attention you will need to transfer to the nearest hospital.

HOME BIRTH

PROS:

• Continuity of care.

• Birth undisturbed within the comfort of your own home.

• Providers come to you during labor and during your postpartum.

• Thorough prenatal and post/natal appointments tailored to your individualized needs.

• Water birth offered as a pain relieving measure.

• Emergency medicines and equipment available if needed.

CONS:

• Pain medications are not readily available.

• In the event of needing medical interventions, you would need to transfer to the nearest hospital.

• Home birth midwives cannot serve any high risk pregnancies or multiple births (twins and triplets).

Water birth is different than laboring in the tub or shower. Water birth means to remain in the tub during the actual birth and when your baby is born in the water. It's been studied for years about its safety regarding birthing your baby in the water and the evidence is clear. Water birth is safe and wonderful tool for pain relief and relaxation.

Click here to read the evidence on water birth.

The doulas at In Joy Birth support all births at any location. We truly want you to have all of the benefits and risks and to be informed about where the best place of birth is for you and your family. If you have more questions regarding this article, reach out to us. We're here to support you!