Hospital vs. Birthing Center

This is definitely a post I never thought I would be writing.

As month 5 is halfway complete, I am more than halfway through this pregnancy. The most common questions I get asked on a day to day basis are, ‘how are you feeling? [fantastic now that I don’t have a stomach virus]’, ‘do you have any cravings? [no]’, ‘do you have any morning sickness? [no]’, ‘do you have a name picked out? [yes, Jude]’, ‘have you felt him kick [yes, and Jason has too], and most surprisingly, people have begun to ask me if I’m going to get an epidural.

This awakened me to the fact that I am going to have to make some decisions soon. I hadn’t done any research or any fact checking on the birth process, partially because I am in denial. I know most women just allow themselves to be filtered through what is considered the normal baby having system: you find a doctor you like, you have a hospital birth, complete with drugs, a possible c-section, and maybe a couple overnight stays. As I started doing some research I was alarmed to find out more information about hospital births, starting with the drugs that are considered normal. The pain killers numb the pain and slow the birth, so you receive another drug that speeds the birth up. Seems counter-productive to me and makes me lean towards a natural birth. On top of that, America has the highest rate of any industrialized country for c-sections, infant mortality and maternal mortality.

This caused me to want to reassess what options where available to me. I had always thought of mid-wives and birthing centers to be too ‘crunchy’ for me. That’s just not what we do here in America. Only hippies entertain that option. The couple of friends I have had that have used a birthing center, I’ve always dismissed as, ‘oh, they didn’t have enough money to go to a hospital,’ or ‘oh, how strange.’ Turns out they are a lot more legitimate than I imagined and that the rest of the industrialized world relies on them to receive their children into the world instead of hospitals. Midwives have to be certified through a state board, and most are traditionally trained labor and delivery nurses. I had no idea. On top of that, birthing centers are typically exponentially cheaper to deliver in than a hospital. No $20 charges for that one ibuprofen pill. On top of all of the medical reasons for considering a birthing center, I hear that midwives tend to be more concerned, involved and less sterile and ‘business’ oriented than a hospital workers. They want to make you feel ‘at home’ (I know this is a blanket statement and not true across the board, but it’s worth considering).

So now, we are going to go visit and tour the Austin Area Birthing Center. The overwhelming responses I have read and heard from mothers that have had hospital births and birthing center birth is that they have preferred the birthing centers. I haven’t made a set decision, but I feel like I am leaning towards this option.

It’s a bit scary to be making a decision that 1) makes me feeling like I’m cheating on my OB/GYN – who I think is wonderful and highly recommend, 2) extremely countercultural in our society, 3) causes me to directly face the pain of childbirth.

Any readers out there have anything thoughts about these shenanigans? I’d love to hear about your experiences and friend/family experiences. . .

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22 Comments

  1. Posted February 9, 2009 at 9:52 am | Permalink | Reply

    I was reading my Google Reader when your post popped up, hence the fast reply. I, obviously, have no experience with birth, but I’ve heard a lot from friends. One friend has had two babies. The first was with drugs and the second natural (both in hospitals). She switched to natural because she didn’t like feeling groggy for days after birth from the drugs. The second birth was REALLY tough – she says the baby was trying to come out her thigh, as it was turned funny – and longer than almost any I’ve heard of. BUT, had she had the epidural, she would have been forced to have a c-section because she wouldn’t have been able to control as much or push as hard. She’s glad she went natural. (supposedly going through the birth canal exposes the baby to lots of stuff that is good for their immune systems that they miss out on if delivered through c-section). Another friend had her first baby natural and swore she’d never do it again, though, so there are both sides.

    Now I’ve been reading blogs of friends who are doing home births and all of them say it’s way better (they’ve done both home and hospital). We don’t have a birthing center here, so they actually do them in their homes with a midwife and often a doula. If there are any pregnancy complications the midwives won’t deliver at home, and because of that they are pretty safe, though a birthing center seems like it may be even better. From what I understand you can labor however you want to (walking around, in a baby pool or bath tub, etc) rather than being forced to lay down on a bed, which women only started doing recently and it’s because it’s more convenient for doctors. Standing allows gravity to do it’s thing and help with the process, or so I hear. So, yeah, I’ve thought about this quite a bit. If I had a birthing center, I think I’d be all about it! As it is, I’m not sure what I’ll do when the time comes. 🙂

  2. Posted February 9, 2009 at 9:53 am | Permalink | Reply

    ps. my comment is almost as long as your post! sorry about that.

  3. Elizabeth
    Posted February 9, 2009 at 9:57 am | Permalink | Reply

    No, thanks Dar! I love the feedback. I’ve talked to one friend extensively about her experiences and she LOVED the birthing center and doing natural deliveries. She said she wouldn’t change a thing, not even the pain. She did highly recommend a Doula (she had one for her second child and said she made the pain so much more manageable) and she also loved being about to walk around, be in a tub and in general, have more freedom to labor in a way that would speed her delivery.

  4. Posted February 9, 2009 at 10:36 am | Permalink | Reply

    Every person I’ve heard talking about birthing centers and home births had really great experiences. I even have thought about that, but like you said, I love my gyno! I think too, depending on your doctor, you can discuss your birth plan and see what their open to as far as drugs and what you can do while there. My mom said she walked around the hospital all over the place while in labor before she had the baby because it helps so much (of course hospitals don’t have birthing pools if that’s what you want). I’m excited to hear about your trip to the birthing center here in Austin!

    And I know that I don’t have to face giving birth yet nor have I done it, but I kind of see it as pushing yourself through a marathon – there is pain, but you know it will be over and instead of getting a t-shirt in the end you get a baby! I know you can do it and I will be praying lots that you have a super easy and wonderful birth!

  5. Posted February 9, 2009 at 1:33 pm | Permalink | Reply

    I’ve heard wonderful things about birthing centers or home births as well. Some friends have gone all natural (at home, no ultrasounds, etc), and had great success.

    I was at the hospital with E, and did end up having stadol. Our hospital actually encouraged me NOT to use drugs – they had a jacuzzi for me to sit in, encouraged different relaxation methods, etc.

    Still, what can I say – the pain was pretty intense, and didn’t want an epidural, so they gave me stadol. I actually fell asleep between contractions and felt no desire to push. It really slowed the process down in my opinion.

    And yes, I felt extremely groggy after that. Don’t use stadol.

    I actually planned on using a midwife this pregnancy because my ob was not present at my last delivery, and so it was strange having a random doctor/nurse there. Midwives are there from beginning to end. Of course, the midwife I planned on using was no longer in the area, and our clinic no longer offered them as an option. Bummer.

    After having E, my nurse (our hospital was great) told me that I was the first person she didn’t have to give an IV to in months… maybe even a year. Yikes. I think IVs scared me more than childbirth, and that is saying a lot. 🙂

    All of this to say, I am using a hospital and a gyno this time around, but will be practicing my own breathing/birthing techniques. I think the idea of having a NICU available right away if need be, etc.

    Good luck in your decision! You’ll make the right one for you and Jude!

  6. Marie Larkin
    Posted February 9, 2009 at 2:06 pm | Permalink | Reply

    Beth,
    Talk this over with your Gyno and visit the hospital that you would be going to. Ask questions of the Gyno & hospital. Hospitals are more helpful nowadays.

  7. Posted February 9, 2009 at 2:54 pm | Permalink | Reply

    Have you checked into mothering.com yet? Or subscribed to the magazine? They cover home birthing/birth centers/natural child birth extensively. I love what they write, and think you would too.

  8. Posted February 9, 2009 at 2:55 pm | Permalink | Reply

    And just one more thing. 🙂 If we did have a birthing center in our area, I would do it in a heartbeat.

  9. Elizabeth
    Posted February 9, 2009 at 4:48 pm | Permalink | Reply

    Thanks for the tips Sheri! I will check out mothering.com. I will keep everyone updated on what we end up deciding and why. We have a tour date for the birthing center set up for the end of next week and an appointment with a Doula a week from tomorrow. I’m also going to quiz my gyno at the end of the month as to what the hospital will allow me to do. Now, more waiting . . .

  10. Carly
    Posted February 9, 2009 at 9:27 pm | Permalink | Reply

    My husband and I decided to go with a CNM (Certified Nurse Midwife). I will still give birth in a hospital, but the midwife is much more supportive of a natural birth, and will do more to get you through the pain. I considered going with a birthing center, but decided this would be a good middle ground. My cousin who is a fanstastic midwife (had her two babies with one as well, totally natural) said she would recommend going with a certified nurse midwife. I trust her and that’s a lot of the reason we decided to go that route. Plus, I feel safe knowing that if anything goes wrong we are in the hospital, rather than a car ride away. I hope that helps! Good luck 🙂

  11. Posted February 9, 2009 at 10:19 pm | Permalink | Reply

    Well, I am no where close to even the possibility of having kids, but when I was a freshman in college, I took a class on women and health communication and that class pretty much convinced me to do either a birthing center or home birth. I think it’s a great decision and does not make you crunchy at all.

  12. Posted February 10, 2009 at 7:43 am | Permalink | Reply

    I’ve heard lots of good things about at home/doula/birthing centers. If you have no complications with your pregnancy, sounds like a really good option. But, I also think you shouldn’t feel like a wimp if you decide to have a pain reliever during labor. And, if you do have complications, it’s much better to do it at the hospital (and even schedule the c-section) than to go through hours of difficult labor and then have to do a an emergency c-section anyway (scheduled ones are much easier on both mom & baby!). I think I would have tried the hospital/no epidural route (I liked my OB-GYN doctors and the hospital was set up well), but I did have complications and needed a c-section.

  13. Posted February 10, 2009 at 9:10 am | Permalink | Reply

    Hi!

    Im a secret reader of your blog…not even sure now how I started reading it!

    Im a labor and delivery nurse, and have worked in the hospital setting for 7 years. I believe strongly in low intervention deliveries, but unfortunately, many women are fearful of birth and prefer epidural and interventions rather than working with their bodies. Education about the birthing process is key….and having great support. A nurse-midwife is an excellent option, and doulas are also great help during the labor and delivery. Not all midwives train the same way and not all are certified. CNM’s or (nurse mid-wives) have both nursing experience in labor and delivery and a master’s degree education with additional specific education and training in the field. This is not to say that other lay-midwives are not trained well, just to say that their experiences and training will vary.

    Birthing centers offer a unique environment and promote natural, low-intervention care of the laboring woman. They are also great options. They dont however provide cesarean sections (c-sections) which a low percentage of first time mom’s, end of needing. If the laboring woman is found to need a c-section at the time of birth, they can be transferred to a hospital, but this can be stressful for the mom and baby. Most birthing centers do not keep the post-partum woman more than a few hours after birth, allowing the woman to go home and rest in a familiar environment. Good follow-up from the midwife and breastfeeding support are imperative.

    Thankfully, there are lots of great options, you just have to find the one that fits for you. I had my first baby with a CNM in a hospital setting and it was a wonderful and natural experience! Find someone you trust and who shares your philosophy. Find out what you doctor does routinely, and how he/she makes decisions. Ask lots of questions. You are wise to consider these things now because once you are in labor…..its a bit too late!

    Happy Birthing!
    Jennie

  14. Elizabeth
    Posted February 10, 2009 at 10:02 am | Permalink | Reply

    Well hi Jennie! Thank you so much for leaving a comment and with so much fantastic information! I kinda wondered what people in the medical profession think of all of this, thank you for sharing your perspective.

  15. pearl
    Posted February 12, 2009 at 1:43 am | Permalink | Reply

    well, for my mother (all 5 done in the hospital), 4/5 births went fine i believe. but my other brother would have died for sure if she wasn’t in a hospital. he wasn’t breathing right when born, turned blue within minutes, and was in intensive care immediately for over a week. and they weren’t aware of complications beforehand.

  16. pearl
    Posted February 12, 2009 at 2:00 am | Permalink | Reply

    i mean, i’m sure that’s rare. and i’m sure birthing centers are indeed very nice. but that doesn’t change the fact that if it weren’t for intensive care being right down the hall, i’d be short one little brother.

  17. Elizabeth
    Posted February 12, 2009 at 9:50 am | Permalink | Reply

    Pearl – it’s pretty rare for something like that to happen, but birthing centers are typically located within minutes of a hospital and they do have doctors and nurses on staff to respond to emergencies like that. I think it’s a common misconception that birthing centers don’t have the medical capabilities to handle complications. . . I’m still not sure what my decision will be – it’s going to depend on how my conversation with my gyno goes and how the hospital that she works with is willing to accommodate our wishes.

  18. pearl
    Posted February 12, 2009 at 2:33 pm | Permalink | Reply

    you asked for family experiences 😛

  19. Elizabeth
    Posted February 12, 2009 at 3:13 pm | Permalink | Reply

    Pearl – I appreciate the story! I was just clarifying to anyone who might think that birthing centers wouldn’t be capable of handling a situation like your family’s circumstance! 😉

  20. Janette Kuhnel
    Posted February 17, 2009 at 3:56 pm | Permalink | Reply

    Hi Beth. I can’t believe you are already 5-1/2 months+!!!!
    Okay, so I’m not pregnant, but wanted to offer you my opinion! I am seriously considering doing a water birth or a standing birth, whenever the time comes… I know I will have tons of options to consider one day, just like you! But what does not make sense to me about hospital births is laying down with my legs up, when I could have some help from gravity, or give birth in water, which might be less of a shock to the infant, who would be coming out of a “little pool” inside of me, into a larger pool. (I have also heard about the baby learning to swim or being a better swimmer when he/she is older.) I have not researched any of this, but will definitely do my homework and talk to you and other friends when the time comes.

    Good Luck choosing the option that is best for you and Jude!!! Lots of Love, Janette

    P.S. I love all your posts, and I really love all the sewing you are doing! Especially the baby quilt, bibs, and others!! 😉 Keep it up!!! I am so happy for you! I want a sewing machine, not that I have time to use it now, but one day! I only do hand sewing and stitching for now!

  21. Elizabeth
    Posted February 17, 2009 at 4:17 pm | Permalink | Reply

    Janette – Sounds like you would be going to a birthing center! I don’t think my legs are strong enough to do a standing birth, but I’ve heard they’re really effective. It does make sense to work with gravity instead of against it. Kinda like the whole idea of being tied to an IV and your hospital bed slows labor because you can’t be active and walk around to speed labor. Standing up during labor can be really helpful since gravity is on your side! I don’t know the details on a water birth yet (although I’m sure I’ll learn some this Friday) but I know even being able to labor in water is helpful to relieve stress on your body.

    I’m sure I’ll have a follow up post to this one at the end of the month after I’ve met with a Doula, the Birthing Center and my gyno. . . I would definitely recommend people researching these things in the BEGINNING of their pregnancy!! I wish I had been more aware, but I think I was just in shock that I was actually pregnant!

  22. Brea
    Posted June 4, 2010 at 8:04 pm | Permalink | Reply

    So I’m a about a year and half late on this post but what the heck I’m gonna comment anyway. I’m not even pregnant and I’m researching all options. I’m actually leaning towards a home birth, it just seems like the place I would want to be when going through the pains of labor and after giving birth, but I’m trying to keep my mind open to other options. I’ve never been checked into a hospital and I don’t really want to, I was personally born at home, heck the midwife didn’t even make it, thank goodness for grandma’s! Pearls post does frighten me, as a home birth would not have medical doctors on hand, but that is rare and if I don’t have complications it seems that a home birth will be less traumatic for all involved. Anyhow, this is just a ramble as I browse through your baby blogs for tips and comments from you and your readers. It makes me want to be a real blogger but that I am not (at least not today anyway)
    Thanks for all your sharing!

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  1. […] that I would plan on doing an epidural. Turns out, that’s not for me! Also, a update on the hospital vs. birthing center that we were considering, our insurance makes it substantially cheaper to have a hospital birth […]

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