You know you want to have an unmedicated delivery, but what are your natural childbirth options for where to deliver? Will you choose a hospital, a birth center, or home? Let’s compare so you can begin to make the decision about what is best for you and your baby.
Estimated reading time: 11 minutes
In the US, 98 out of every 100 women give birth in a hospital (1). Many consider it to be the default option, with other options being seen as alternative choices. Hospitals vary widely, but here’s a general idea of what to expect with the most common of the natural childbirth options.
While only low-risk pregnancies are candidates for an out-of-hospital birth, anyone can deliver at a hospital.
Most babies born in a hospital are delivered by an obstetrician, though a certified nurse midwife is an option in some hospitals. Care is provided by a range of nurses and other support staff. It’s the people who make the difference from one hospital to another. Choose a hospital with skilled staff whose attitudes reflect a belief that birth is a normal healthy process.
Most hospital maternity wards these days are not cold and clinical-feeling. Many hospitals have comfortable, inviting birthing rooms (that often look more like hotel rooms!) where women labor, give birth, recover, and stay with their families until they’re discharged.
In some hospitals, you may not have as much control as with the other natural childbirth options. A doctor is the one “managing” your birth. However, you can choose a provider who sees you as the main player in the healthcare team, respects your birth philosophy, and wants to support you to have the unmedicated, natural childbirth you desire.
Most hospitals that offer maternity services have complete obstetrical and anesthetic services, surgical facilities, a blood bank, 24-hour laboratory services, and a neonatal intensive care unit (2). While you hope not to need advanced intervention, you may find it comforting to know that everything you might need is there.
Interventions are most likely to occur in a hospital setting for a combination of reasons. One reason is that all high-risk deliveries happen at hospitals. Also, OBs are trained in surgery and a wide variety of medical procedures, which they may use more readily. Another factor is that all the equipment and medication is at your fingertips in the hospital. Your caregivers may suggest that you take advantage of options like pain medication simply because they’re eager to help you get through delivery as comfortably as possible.
This does not mean that you can’t have a natural birth at a hospital! Most caregivers are eager to help you have the birth you desire once you’ve made your preferences known. If you’re naturally-minded, you have to help the staff understand that you don’t want a standard, medically-managed birth. Search around and choose caregivers who support your birth plan, respect your wishes, and encourage you to make your own best choices.
Learn More: Why Choose Natural Childbirth in Hospital
A birth center is a facility that is lower-tech and often more focused on natural birth than a hospital. Still, a birth center offers more medical support than birthing at home. Birth centers may be independent or affiliated with a hospital, but even independent ones have a relationship with a local hospital where you can be transferred in the event of any complications. They are often seen as the middle ground of the natural childbirth options.
A birth center is a possibility for you only if you have a low-risk pregnancy. Many birth centers can not provide care to a woman who has had a prior cesarean birth.
In most cases, certified nurse-midwives deliver babies at birth centers. Staff may also include registered nurses, other nursing and support staff, and doulas. The center may have obstetric and pediatric consults, but there usually aren’t physicians on site. However, there may be lower patient-to-caregiver ratios, meaning more continuous personal care during pregnancy, birth, and the postpartum period.
Like hospitals, birth center environments vary. Birth centers are usually designed to be relaxed and cozy for couples. Choose a birth center that shares your birth philosophy and where the staff make you feel welcome and heard.
At birth centers, you can usually move freely, eat and drink, and may able to control more closely who you surround yourself with. You can choose only essential interventions and may feel more encouraged to participate in management decisions.
A birth center will have equipment for monitoring mom and baby during labor and delivery, IVs and fluids, oxygen, and the basics for taking care of mom and baby. If any complications arise, mom and/or baby will be transferred to a hospital where a full range of emergency care can be provided. Transfer is typically easier from a birth center than from a home birth, because centers do it more frequently and have a system set up for it. Still, the care that is given during transport is far short of what’s available inside a hospital.
The rate of medical intervention is lower in a birth center than in a hospital. This is partly because both caregivers and patients are more likely to be natural-minded and partly because only low-risk deliveries are eligible for birth centers. Additionally, the midwives who staff birth centers are limited on the type of medical procedures they can perform. This requires them to navigate challenges with less intervention.
While low-intervention may be what you’re seeking, it’s important to be aware that if you decide you want an epidural, for example, a transfer will be required.
In 1900 fewer than 5 percent of births took place in hospitals; birthing at home was the norm. By 1970 the percentage of births in the hospital had risen to 99% (3). Today, still fewer than two percent of deliveries are at home, but home births have been increasing in recent years (1). This reflects a trend toward more natural birth, though of course home is not the only place to have a natural childbirth.
You are typically a candidate for home birth only if you have a low-risk pregnancy, although some midwives may accept a VBAC. Additionally, some states do not license lay midwives. (Lay midwives are those who are not certified nurse midwives.) This can make finding a home birth midwife and verifying her credentials more difficult.
A midwife is likely to be the only attendant at a home birth, perhaps accompanied by a doula if the mother has chosen one. This small crowd is a positive for some women. A downside is that not all midwives have an obstetrician backup to consult if needed. Also, if a transfer is needed, mom will likely see an anonymous ER doctor with whom she has no existing relationship.
With adequate planning and support, the environment can be whatever the mother wants. Mom is in her own home and surrounded by only those she chooses. If mom has chosen the care team carefully, the environment should reflect exactly what she wants for her birth. There is less concern about timing and less fear that unwanted interventions will be suggested.
A home birth is the setting where you have the most control. You have complete freedom of movement, freedom to eat and drink, freedom to surround yourself with whomever you prefer. If you have a supportive team and family, you are able to control essentially everything in your environment.
In a home birth, the only equipment is what the midwife brings. A good midwife brings essential equipment to monitor mom and baby, sterile instruments for delivery or suturing, suction device for clearing baby’s nose and mouth, medications to stop excessive bleeding, oxygen, etc. This is enough for a typical delivery, but if an emergency arises, it takes time to get to emergency services. Care may be limitied while waiting for transport and also during transport to the hospital. Even an ambulance and skilled EMTs can’t provide all the care that a hospital can.
Interventions are lowest in home births. This is partly due to lack of access and partly due to the fact that those who choose home births are typically the same crowd who seek a low-intervention birth.
With a variety of natural childbirth options, how do you begin to choose? Ultimately, only you can decide what is best for you and your baby. For many couples, it comes down to the question of where do they feel safest and most comfortable?
Given that the majority of women give birth in a hospital, Kopa Birth® childbirth courses provide specific instruction to prepare couples for natural hospital birth. This includes a deep dive into labor coping tools to help couples manage the discomfort of contractions without pain medication. You’ll also learn about the most common interventions offered in the hospital, empowering you to make your own best choices during labor. Additionally, the course will instruct you how to best communicate your plans for a natural birth with your doctor in the months leading up to the birth, as well as in the hospital. We believe that natural childbirth in a hospital is absolutely an attainable goal with the right education, personal preparation, and communication. (If your plan is a hospital birth, check out this article for some helpful natural hospital childbirth tips!)
Only you can decide which natural childbirth options are right for you. But rest assured that you can have a safe and empowering birth in a hospital, birth center, or home. Good luck in your birth journey down whatever road you choose!
Kopa Birth’s online childbirth classes allow you to prepare for a natural childbirth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class to learn more about preparing for a natural hospital birth.
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You know you want to have an unmedicated delivery, but what are your natural childbirth options for where to deliver? Will you choose a hospital, a birth center, or home?
