Best Tips for Choosing Your Maternity Hospital (2024)
Best Tips for Choosing Your Maternity Hospital
Choosing where you want to give birth is one of the first decisions you’ll make after finding out you’re pregnant.
It’s important for you to weigh all of your options and figure out where you feel most safe and comfortable. The 3 options you have when is comes to birthing place are:
Maternity Hospital
Birthing Center (Freestanding birth center or hospital-based birth center)
Home
Let’s chat more about some things to think about prior to choosing your maternity hospital/birthing place!
How to choose where to give birth
Firstly, what is most important to YOU regarding how you labor/give birth?
Where do you feel most safe?
Do you already have an idea of how you want to labor/give birth?
Are you already under the care of a midwife or OBGYN? Do you want to stay with them? Ask where your provider has hospital or birth center privileges.
Have you experienced labor/birth before? Do you want to have a similar or different experience?
Do you have any conditions that would deem you “high-risk” during pregnancy?
Is there a freestanding Birth Center within a reasonable driving distance from you?
Are there home birth providers within a reasonable driving distance from you?
Where have your friends and family given birth? What were their experiences? Do you want to have the same or different experience as they did?
What features make you feel safe and confident? (i.e. access to pain control like nitrous oxide epidurals, having a high-risk neonatal intensive care unit, etc.)
Next, what is important to you about your birthing place?
Does your current provider attend births at your place of preference? If not, who does?
What is the current cesarean and induction rate? If you’re attempting a VBAC (vaginal birth after cesarean) what are those rates?
How many births typically occur per month?
What happens when multiple people are giving birth at once?
How are emergencies handled?
If birthing outside of a maternity hospital, what does a transfer look like, if you need one?
How do they help support the individual desires of families?
How are they working to improve outcomes and reduce disparity (when different groups of people have worse outcomes than others)?
How will your provider handle your choices if they’re outside of the “norm”/”standard”?
Once you are able to answer those questions, making a decision about where you want to give birth will be much easier.
Maternity Hospital vs Birthing Center vs Home Birth
The four options you have when it comes to birthing place are:
Maternity Hospital - A standard hospital that has labor and delivery, NICU, and postpartum floors.
Freestanding Birthing Center - A freestanding birth center is a birth center that stands alone; not next to a hospital (although they are usually within a few miles of a hospital).
Hospital Birthing Center - This is where a birth center is located within hospital walls or very close by, but is still under the jurisdiction of the hospital’s liability and protocols.
Home - This is where you give birth in the comfort of your own home. You would have a midwife who would bring equipment needed for monitoring you and baby, resuscitation equipment if needed, and medications to prevent hemorrhage.
So, what are the differences between birthing at these 3 different places?
Let’s talk about the pros and cons of each.
| MATERNITY HOSPITAL | |
|---|---|
| PROS | CONS |
| Access to doctors (Obstetricians) and sometimes Midwives | Medical procedures and interventions are more common and sometimes overused |
| In the event of something urgent/emergent, medications and other interventions are readily available | In the event of something urgent/emergent, medications and other interventions are readily available |
| Epidurals and IV pain relief are readily available | If you see providers in a larger practice, there is a chance you may have never met the provider who will attend your birth |
| If baby needs any medical attention, (urgently or continuously) it is readily available | There are more disruptions during labor and after birth (vital signs, monitoring, IVs, blood work, etc.) |
| Breastfeeding support provided during your stay (typically 24-72 hours) | It is sometimes difficult to make decisions that go against hospital “norm”, i.e. declining an IV or baby medication(s) |
| Healthcare providers (doctors, midwives, and nurses) are available 24/7 during your stay | Sometimes, they want to take baby from the room to do newborn tests/screening *You can always decline this* |
| During your stay, meals are provided and usually free | |
| FREESTANDING BIRTH CENTER | |
|---|---|
| PROS | CONS |
| Lower rate of unnecessary interventions (like inductions and cesarean section) | In the event of a rare emergency, a hospital transfer does take some time |
| There are typically a small group of midwives, meaning you will have met the provider who will be attending your birth | Sometimes, birth centers offer nitrous oxide (gas) for pain relief, but if you need more relief, birth centers do not offer epidurals or IV pain relief |
| Equipped to handle non-surgical emergencies (oxygen, bleeding (hemorrhage), stitches, resuscitation equipment, etc). | You may have to pack a cooler/bag with food/snacks, depending on what your birth center provides |
| Often offer the option of a water birth | Not all birth centers take insurance; so you may have to pay out of pocket |
| Allow free movement throughout labor and encourage birth in any comfortable position | Breastfeeding support may not be available at the birth center, but they will refer you to help if needed |
| Transfers are typically non-emergent. Midwives are trained to detect “issues” before they become emergent | You do not get continuous care/monitoring for 24-72 hours like you would in a hospital environment |
| Birth centers usually have established relationships with nearby hospital(s) to ensure smoother transfers, when necessary | A free-standing birth center may not be an option if your pregnancy is deemed “high risk” |
| You typically leave around 4 hours after birth | |
| The labor/birthing environment is typically very “homey” and comfortable | |
| HOSPITAL BIRTH CENTER | |
|---|---|
| PROS | CONS |
| A great option if you are looking to be within a hospital, while still having an experience similar to that of a birth center | You are still birthing within the hospital system, which means all of the same policies/procedures remain “standard of practice” *You can always decline these* |
| You will likely have the option of being in a “birthing suite” rather than a standard hospital room | While your suite may have a tub, most hospitals allow you to labor in the tub, but not to actually give birth in the tub |
| You will have more flexibility when it comes to pain management, just like you would in a hospital | Possibly unnecessary interventions may be heavily encouraged just as they would in a hospital setting (continuous monitoring, induction medications, artificial rupture of membranes, etc.) |
| In the event of a rare emergency, you will not have to transfer to a hospital | You will likely be expected to follow hospital “rules”, i.e. no eating or drinking during labor, free movement around the room may be limited, and they may want you to have an IV *You can always decline these* |
| Breastfeeding support will typically be readily available | If you see providers in a larger practice, there is a chance you may have never met the provider who will attend your birth |
| During your stay (typically 24-72 hours), meals are provided and usually free | |
| If baby needs any medical attention, (urgently or continuously) it is readily available | |
| HOME BIRTH | |
|---|---|
| PROS | CONS |
| Great option for a low risk, healthy pregnancy | In the event of a rare emergency, a hospital transfer does take time; especially depending on how far you live from the nearest hospital |
| You can give birth in the comfort of your own home without ever having to leave | In the event of a hospital transfer, your care would usually be given up to a hospital provider; home birth midwives typically do not have hospital privileges |
| Similar to birth centers, it’s typically a small group of providers, so you will have met the provider who will attend your birth | If a transfer is needed, some hospitals look down upon home birth and may not treat you or your midwife with kindness and respect for your choices |
| You don’t need to worry about traffic or having to uncomfortably travel in the car while you’re in labor | There are no medical pain relief options available for a home birth |
| Equipped to handle non-surgical emergencies (oxygen, bleeding (hemorrhage), stitches, resuscitation equipment, etc). | Breastfeeding support may not be readily available |
| After birth, you can settle into your own bed with your baby/family, undisturbed | Not all home birth midwives take insurance; so you may have to pay out if pocket |
| Allow free movement throughout labor and encourage birth in any comfortable position | There is a chance of making a “birth mess” in your house, especially if you have a fast labor with no time to set up, but midwives often help you clean everything up and do laundry afterwards |
| Most midwives will offer at-home visits to check on you and your baby up until around 6 weeks postpartum | |
Can you choose where you want to give birth?
Depending on where you live, your health insurance, your health condition and your financial status, you may have more or less options when it comes to choosing where you want to give birth.
Some areas do not have birthing centers, which leaves you with the option of either a home birth or a hospital birth. Some states may make home birth illegal (or “a-legal”, meaning they require licensure but don’t provide licenses to midwives to attend home birth).
Some birth centers and home birth midwives do not accept insurance, which may leave you paying out of pocket for all of your prenatal appointments, birth, and postpartum care. If paying for all of this out of pocket is not an option for you, a hospital birth may be your only reasonable option. Be warned, most insurance companies will say they don’t cover home birth even when they technically do. Sometimes your midwife may be able to submit a test claim to your insurance to see how much is covered.
It’s also important to know what rules/regulations your state/country has. There are some states within the United States that do not give midwives permission to attend home births.
Lastly, if you have any health conditions that consider you a “high-risk pregnancy”, you may be considered “risked out” of a home birth or birth center birth due to the higher chance of complications during labor/birth.
Important options when choosing a hospital or other birth location
Once you decide how you want to give birth and where you want to give birth, you should find out which options your birthing place offers.
For instance, if you want to have a water birth in a hospital, some hospitals not only do not allow water births, but they may not even have tubs for you to labor in.
It’s important to find out what the standard of care is at your preferred birthing place.
If you are choosing a hospital birth:
Our Motherboard app covers all of these topics so you can skip the research, read all about the pros and cons, and choose the options that are best for you!
Remember: If you do feel safest giving birth in a hospital, but you are not keen on unnecessary procedures/interventions, the best thing you can do is create a birth plan.
Just because something is “standard” or “the norm” for hospital births, it does not mean you have to do it. Don’t be afraid to advocate for yourself to get the care you want.
Knowledge is power! 💪🏽💪🏾💪🏿
Finding a hospital, birth center, or home birth that supports VBAC (vaginal birth after cesarean)
What if you’ve had a previous cesarean birth? Are you required to have cesarean sections for all subsequent births?
The answer is usually no.
Some providers will not even attempt VBACs, while others specialize in them.
The American Congress of Obstetricians and Gynecologists say that VBAC is a safe and appropriate option for most pregnant folks who have had a prior cesarean section, but finding a provider to be on board with VBAC may be challenging.
Who makes a good VBAC candidate?
Someone who has had a previous vaginal delivery (including a successful VBAC)
Someone younger than 35 years of age
Someone who has a low transverse incision from the previous cesarean section
What was the reason for your first cesarean section? - If it were due to the health of the baby (i.e. baby’s position or heart rate issues) rather than the labor process, the chances of a successful VBAC are higher.
There are pros and cons to VBACs and it’s important to weigh these pros and cons based on your individual situation.
You can have a VBAC in a hospital or in a birth center or home birth. If you are having trouble finding a provider supportive of VBACs, check out this website. They can help you research your options and help to find a provider near you.
You can read all of the up-to-date information and evidence in one concise place on our Birth Plan App!
What to do if you have a high risk pregnancy
A high risk pregnancy can sometimes feel like you don’t have options when it comes to birth, but it’s important to remember that you are still in control of your care.
With a high risk pregnancy, it is most likely the safest option to give birth in a hospital. Depending on the reason(s) why your pregnancy is considered high risk will depend on the things that are important to you.
For instance, does your baby have a possible medical condition that may require some help right after birth? If so, it may be important for you to learn about Neonatal Intensive Care Units (NICUs), the different levels and what they mean, and what level NICU your place of birth has.
Having a high risk pregnancy may just require some extra monitoring during labor and birth, but it does not necessarily mean you’re going to be riddled with unnecessary interventions.
It is still very important to learn about common labor interventions and decide what is most important to you.
No matter what your health or baby’s health is, you still have the autonomy and agency to ask questions and shape the experience as much as you can!
The Takeaway
Deciding where you want to give birth is one of the first decisions you’ll make as a pregnant person. Whether you choose to give birth in a maternity hospital, a freestanding birth center, a hospital-based birth center, or at home, there are pros and cons to each option.
The most important factor when it comes to making this decision is that you feel safe. The best place to give birth is the place you feel safest and cared for. Once you figure out where you feel safest, then it’s time to find the right provider for you.
The Motherboard App has a ton of information and up-to-date research to help you make these decisions. Once you read through the information, you can make a decision to add to your birth plan. Having a birth plan is one of the best ways to ensure everyone on your birth team is on the same page!
🤍 The Motherboard Team