Many women have strong views about where and how they would like to deliver their baby. In general, women can choose to deliver at a hospital, birth center, or at home. You will need to contact your health insurance provider to find out what options are available to you. Also, make sure that the doctor or midwife you have chosen 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 labor and delivery. A hospital setting provides the maximum level of medical support for labor, birth and newborn care, although hospitals differ in the level of complications they are equipped to manage in both mother and child. Generally speaking, any hospital which offers maternity care will have specially trained RNs to attend the mother and newborn, and can manage full term deliveries (37 weeks) without known maternal or infant complications. Delivering providers could include CNMs, family physicians and obstetricians. Maternal or infant higher-risk conditions, including preterm delivery, are best managed in a facility which routinely accepts and cares for this type of patient. Although infants requiring a higher level of care may be transported after delivery to a hospital which is better equipped or staffed to address their specific medical concerns, it is preferable for high risk mothers to deliver in facilities that routinely handle critical care, as transport of a newborn increases the possibility of further complications.
Questions to ask when you are 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 labor and deliver 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 problem 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? (See our Stepping Up for Utah Babies program for a list of hospitals that have policies that support breastfeeding)
- Does it have an on-site birth center?
Out-of-hospital birthing centers are multi-room birthing facility designed to provide a homelike environment for birthing with more stringent safety supports and more defined clinical regulations in place. These centers are licensed and regulated by the state. Currently there is one of these birthing centers operating in Utah and many more working toward licensing. As with birth which occurs at home or in a birth suite, if complications arise at this type of birth facility, ambulance or private vehicle transport to the nearest hospital must be done.
Birthing suites may be used interchangeably with the term “birth center” but refers specifically to a one-room birthing facility. A birth suite is designed to be homelike and to provide a home birth experience without having to birth at home. One room birthing facilities in Utah are not required to license but can if they choose to and there are several currently operating in Utah. If medical complications arise for mother or newborn, transport to the nearest hospital must be initiated.
Homebirth is an option for healthy pregnant women with no risk for complications during pregnancy, labor or delivery. It is also important women have strong after-care support system at home. Some certified nurse midwives 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 would like to deliver at home.
If you are thinking about a homebirth, you need to weight the pros and cons. The main advantage is that you will be able to experience labor 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.
The ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. 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.
Learn more about homebirth in Utah. Homebirth Report