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Many women have strong views about where and how they'd like to deliver their babies. In general, women can choose to deliver at a hospital, birth centre, or at home. You will need to contact your health insurance provider to find out what options are available. Also, find out if the doctor or midwife you are considering can deliver your baby in the place you want to give birth.
Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during labour and delivery. Hospitals offer the most advanced medical equipment and highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labour. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centres, which aim to offer a style of care similar to standalone birth centres.
Questions to ask when choosing a hospital:
- Is it close to your home?
- Is a doctor who can give pain relief, such as an epidural, at the hospital 24-hours a day?
- Do you like the feel of the labour and delivery rooms?
- Are private rooms available?
- How many support people can you invite into the room with you?
- Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby?
- Can the baby stay in the room with you?
- Does the hospital have the staff and set-up to support successful breastfeeding?
- Does it have an on-site birth centre?
Birth or birthing centres give women a "homey" environment in which to labour and give birth. They try to make labour and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. So, you will not automatically be hooked up to an IV. Likewise, you won't have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at birth centres. Healthy women who are at low risk for problems during pregnancy, labour, and delivery may choose to deliver at a birth centre.
Women can not receive epidurals at a birth centre, although some pain medicines may be available. If a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.
Many birthing centres have showers or tubs in their rooms for labouring women. They also tend to have comforts of home like large beds and rocking chairs. In general, birth centres allow more people in the delivery room than do hospitals.
Birth centres can be inside of hospitals, a part of a hospital or completely separate facilities. If you want to deliver at a birth centre, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centres must have doctors who can work at a nearby hospital in case of problems with the mom or baby. Also, make sure the birth centre has the staff and set-up to support successful breastfeeding.
Homebirth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labour or delivery. It is also important women have a strong after-care support system at home. Some certified nurse-midwives and doctors will deliver babies at home. Many health insurance companies do not cover the cost of care for homebirths. So check with your plan if you'd like to deliver at home.
Homebirths are common in many countries in Europe. Whilst a home birth can be safe and wanted, in case of an emergency, a hospital's equipment and highly trained doctors can provide the best care for a woman and her baby.
If you are thinking about home birth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labour and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience.
The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. Plus, women who deliver at home have no options for pain relief.
To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe backup plan. You will need fast, reliable transportation to a hospital. Without this, home birth is not safe. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.
by Phuong Le