Tuesday, June 21, 2016

Which is Right for You - Homebirth or Birth Center?

To birth at home or at a birth center... That is the question for couples wanting an out-of-hospital birth. We devote an entire class at Birth Boot Camp to birth places, care providers, and policies that may affect your birth, but I felt a blog post of questions might be helpful, too. Of course, where is you live is likely a factor and these options may not be available to you depending on your state laws and insurance coverage.

Photo Credit: Birth Boot Camp

Here is a nice little list of questions and considerations:

Birthing in a Birth Center:

1. Do they charge more, or less, to birth there? 

I've seen this go both ways. I've seen a discount given if a couple is willing to come to the birth center, but I've also seen midwives charge a lot more money (as in over $1000) to birth at the birth center. If I were a midwife, I'd want everyone to come to me at the birth center. I'd know where all my supplies are and not have to haul them all over town. That being said, I'd also have to do the clean up and disinfecting for the next couple. 

2. How long will you be allowed/encouraged to stay at the birth center? Under what conditions might you stay longer? Who is watching after mom and baby in the immediate postpartum period?

It's pretty typical to be out of the birth center within 3-6 hours. Are you OK with that? Does the midwife stay with you, or someone else? What is their training and expertise? 

3. Who and where is their emergency backup? 

Often, the birth centers choose locations that are close to their emergency backup, but not always. You need to ask. If you need to transfer, will your insurance cover their backup hospital and/or care provider? I've heard many couples complain of paying for their birth twice.

4. Do you have your own space to labor? What if someone else is in labor at the same time? What about your family? Will they be sharing space?

How do you feel about the possibility of sharing space, even if you are in separate rooms? Will you feel self-conscious if you are vocal? Do you each have your own bathroom, too? A lot of women like to labor at length in the bathroom...

5. Speaking of family... Are siblings welcome? Or just tolerated? 

If you are wanting your other children at your birth, take a Birth Boot Camp Sibling Birth Prep class, or even just pick up a workbook. You won't regret it. Has your child(ren) met the midwife and toured the facilities with you? If not, make sure that happens before the big day.

Photo Credit: Birth Boot Camp

Birthing at Home:
Many of the same questions apply, but there are some other things to consider. 

1. If an emergency were to arise, where is the closest hospital? Are they friendly towards homebirthers and your midwife? How does your midwife feel towards them? Is it her usual backup? Is she familiar with their protocols, or will you be met with uncertainty and hostility? 

Under normal circumstances and great preparation, I don't expect anyone to transfer, but I believe the fear of the unknown can play into your emotional relaxation. Knowing the answers to these questions is important.

2. Who does the cleanup? 

I've seen some midwives clean everything up, down to draining the tub and putting fresh sheets on the bed. I've also seen midwives do nothing. This is a good thing to know so there aren't angry feelings because of unmet expectations. 

3. If your labor is on the long side, does your midwife have space to rest? Are you feeding her meals and snacks? 

If you are birthing at the birth center, she will have her own space and food. Discuss this with her at your home visit. You both will be glad you did.

4. Are you the type of person that is going to be stressed out about cleaning beforehand? Is this going to be how you spend your early labor - cleaning? If things aren't cleaned up, are you going to have a hard time relaxing with "visitors" in your house?

You know yourself better than anyone. The times I have seen this become an issue is when labor came on fast and furious and there was no time to straighten up. Once the baby came, mom was up and cleaning before the midwives were even out the door, instead of bonding with her baby.

5. This isn't really a question, but more of a comment. Many people (especially dads) take comfort in driving somewhere. Truth is, generally, in a homebirth, the midwife is just bringing everything to you.

In most cases, there really isn't much difference except those things I've listed here. They are important, however, and they should all be carefully and thoughtfully considered and answered. 


Unknown said...

Or are you even allowed to birth in a center? VBACing in Fl rules birth centers out. Home birth or hospital birth. Guess they made the choice for me. Home it is!

Donna Ryan said...

Right, Alexandria. It varies by state. Many of these questions are still relevant for you and I hope you found them helpful.

Unknown said...
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