Families can choose to deliver their baby at a hospital, birth center, or at home. It is important to know the possible risks and benefits of the place you choose so you can make an informed decision with your prenatal care provider.
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. Hospitals differ in the level of complications they are equipped to manage in both the mom and baby.
Generally speaking, any hospital which offers maternity care can manage full-term deliveries (37 weeks gestation or more) without known complications in the mom or baby.
Higher-risk conditions, including preterm delivery, are best managed in a hospital that routinely accepts and cares for these types of patients.
Delivering providers in a hospital could include certified nurse midwives, family physicians, and obstetricians (OBGYNs).
Questions to ask when you are choosing a hospital:
- Is it close to your home?
- Does your insurance plan cover labor and delivery services there?
- 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 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 any 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? (See our Stepping Up for Utah Babies program for a list of hospitals with policies supporting breastfeeding.)
- Do they support the birth options you want (water births, options for birth positions, etc)?
Out-of-hospital birthing centers are multi-room birthing facilities designed to provide a homelike environment. They have safety support and clinical regulations in place. These centers are licensed and regulated by the state they are in. If complications arise at this type of birth facility, an ambulance or private vehicle transport to the nearest hospital may be necessary.
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 provide a home birth experience without having to give birth at home. One-room birthing facilities in Utah are not required to be licensed. If complications arise at this type of birth facility, an ambulance or private vehicle transport to the nearest hospital may be necessary.
Homebirth is an option for healthy pregnant women with no risk for complications during pregnancy, labor, or delivery.
Midwives mostly attend homebirths. Many health insurance companies do not cover the cost of homebirths.
You will need to weigh the pros and cons if you are thinking about a homebirth. 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.
However, a risk of a homebirth is that you and the baby will not have immediate hospital or medical care if it’s needed. You also won’t have access to pain relief medications and will need to be able to cope with labor and delivery using other methods.
To make sure you and your baby are safe, you must have a highly trained and experienced midwife along with a back-up plan in case you or your baby need medical care. Your midwife will need to have the necessary skills and supplies to start emergency care for you and your baby if they are needed. You will need reliable transportation to a hospital. If you live far away from a hospital, a homebirth may not be the best choice.
Utah laws protect the rights of parents to choose where they have their babies. Licensed providers have rules they must follow about the care they provide. Licensed midwives are required to attend only low-risk births and must transfer care when conditions arise that could risk the health of the mom or baby.
Unlicensed midwives do not have rules or conditions they must follow regarding what deliveries they choose to attend. Some unlicensed midwives are comfortable attending breech deliveries at home, but families should be aware that these deliveries are more commonly associated with bad outcomes for those babies.
Families should be aware that certain health conditions make labor and delivery more risky. Women with diabetes, hypertension, or other health conditions are most safe delivering in hospitals where complications can be managed quickly.
No matter where you choose to deliver your baby, it is important that you feel supported and listened to throughout pregnancy, childbirth, and beyond. Some women find that having a doula with them during labor and delivery, and shortly after the birth, can provide the physical, emotional, and informational support they want. To learn more about doulas visit DONA International at dona.org.