Your choices of where to deliver your baby include a hospital, a birthing center, or your home. The location you choose may affect, or be affected by, your choice of doctor or midwife or health insurance plan.
Most medical doctors (MDs) deliver only at hospitals. Some hospitals also allow registered nurses with advanced training (certified nurse-midwives) to deliver there under a doctor's supervision. Many hospitals offer special birthing rooms that are comfortable and homey, with large beds, wooden furniture such as rocking chairs, and pictures on the walls.
Hospital policies vary with respect to who can be present during the birth besides the partner or labor coach. But most hospitals allow the woman to have visitors during her labor. The hospital may reduce the number of visitors at the delivery to avoid overcrowding and risk of infection.
You can request a tour of the hospitals near you to see what options they offer. The advantage of a hospital birth is the availability of experienced staff and equipment if problems or complications develop. Also, a hospital offers a wide range of options for pain relief.
Birthing centers are usually staffed by certified nurse-midwives who have the option of calling in a doctor or sending you or your baby to a nearby hospital if problems or complications develop. Birthing centers are less formal and less institutional than hospitals. You may be allowed to have several people, including other children and family members, present at the birth.
Birthing centers are not recommended if you have a high-risk pregnancy. Emergency medical equipment and options for pain relief are limited. Delivering in a birthing center is usually less expensive than delivering in a hospital, although it may not be covered by insurance.
Some certified nurse-midwives (CNMs) will deliver in a home setting, as will certified professional midwives (CPMs) and lay midwives. A CNM is typically supervised by an obstetrician, which is important if you develop pregnancy or labor and delivery complications. CNMs and CPMs have extensive medical training, have passed stringent exams, and must be certified to practice. Lay midwives are not licensed and are not required to have professional medical training. A lay midwife can be helpful for routine deliveries but may not have the medical training necessary to handle a complicated labor or emergencies.
The advantage of a home birth is that you may feel more comfortable staying in familiar surroundings during labor and delivery, and you can have whomever you want in the room with you.
A home birth is the least expensive option, although it may not be covered by insurance. Like birthing centers, a home birth is not recommended if you have a high-risk pregnancy.
The major disadvantage of a home birth is the risk of an emergency situation, which will require that you or your baby be taken in an ambulance to a hospital. The time it takes to get you or the baby to hospital care may be critical.
eMedicineHealth Medical Reference from Healthwise
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