Childbirth Options:  Home Vs. Hospital

Pregnant women have many different choices these days from deciding whether to breast or bottle feed, cloth or disposable diapers and where to give birth. Since the beginning of time women have given birth in an array of places - at home, in the fields, on a river bank, and more recently add to that - vehicles, birthing centers and hospitals. The fact is - if you are pregnant - you have a choice as to where to give birth - nature will take it's on time and the birth will happen regardless, where you choose is ultimately up to you.

HOME BIRTHS

With the advance in medical technology and the training of midwives - be it direct-entry midwives or CNM - certified nurse midwives - the chances of having a safe home birth are very high. Most all midwives work with an established doctor who is there should an emergency arise.

Nowadays, the qualifications for a woman to have a home birth have broadened. Even women with previous cesareans who are good candidates for VBAC - vaginal birth after cesarean - can attempt a home birth. Some of the reasons against home births would be high blood pressure - be in pregnancy induced or maternal, diabetes, ill mother or fetus, placenta abruption or previa ,or a complication from a previous birth that could hinder the current birth.

Advantages of a home birth are numerous.

1. The midwife will usually be with the laboring mother the entire time - not just show up to "catch" the baby.
2. The laboring mom is allowed time and freedom of movement.
3. She can eat and drink at will.
4. She can deliver in any position she wants - including water birth.
5. The baby will be with mom immediately after the birth and bonding and breastfeeding will not be delayed.
6. No medical intervention - such as IV's and constant fetal monitoring.
7. Cost is considerably less than that of a hospital birth.

Disadvantages of home birth

1. Should a problem arise - there is danger to the mother and baby - such as uterine rupture (though this is very rare), placenta abrupto (tearing away of the placenta from the uterine wall), prolapsed umbilical cord or distressed fetus. Note - some of these occurrences are rare and should they occur an emergency trip to the hospital becomes necessary. Should they arise the extra time it takes to get to a hospital could be detrimental to either the mother or the baby or both.
2. No anesthetic pain medicine (such as an epidural or narcotic). Only the use of over-the-counter medicines and herbs can be used.
3. Must meet "low risk" measures to safely have a home birth.
4. Must have "emergency" back up plan - i.e. a doctor to take over and a hospital ready should an occurrence arise.

HOSPITAL BIRTH

Hospital births are by far the most popular choice today for pregnant women - though the trend for home births once again are on the rise - still hospital births out weigh home births significantly. Perhaps this is because in the 20th century hospital births became the norm. Hospitals have come a long way in the past decade at making the birthing experience more "homey". Before that most all hospitals were very "sterile" and "medical" about the birthing process. There were separate labor and delivery and recovery rooms and Dad wasn't allowed in to share in the experience. He had to wait with all the other visitors in the waiting room, pacing the floors. Now a laboring mom can have anyone with her to "coach" and witness and share in her birth experience. Even if she is having a cesarean, most hospitals will allow one or two people in the operating room during the procedure.

Advantages

1. A well trained staff to help in case something goes wrong. All the necessary equipment needed to provide both mom and baby with the best of emergency medical care should the need arise.
2. In most hospitals - birthing rooms are available for the normal birth - where the labor, delivery and recovery is all in one room.
3. Most hospitals encourage rooming in - where the baby stays with mom the entire time. And there is usually a place for the "coach/support" person to stay as well.
4. The availability of constant fetal monitoring. This sometimes helps to ease the mind of a laboring mom.

Disadvantages

1. Medical intervention - such as an IV drip-fetal monitoring - can sometimes hinder labor and freedom of movement.
2. A set amount of time is given to the laboring mom to produce results - otherwise medical action is taken. i.e. Pitocin drip to augment contractions, breaking of the bag of waters, and sometimes a cesarean is performed if labor does not go as timely as the doctor deems necessary.
3. Forbiddance of food and drink during labor.
4. Lack of "personal" attention by the attending doctor - who usually makes it in time to "catch" the baby.
5. Cost is considerably more than a home birth. Cost can average up to $10,000 in some places.

Obviously the choice between home and hospital birth is as much a matter of personal preference as well as of the health and risk factor of the pregnancy. Some women may prefer the freedom to birth at home without all the medical interventions while others may not mind the fetal monitoring and the availability of anesthesia the hospital offers.

There is another alternative that goes in between the two choices - a birthing center. These offer the benefits of both home and the close availability of a hospital. Birthing centers are not found everywhere - mostly in larger cities. Most women that give birth in a birthing center usually go home a few hours after delivery. The cost is lower than that of a hospital birth but a little higher than a home birth.

©  by Lori Ramsey of Stages in Pregnancy