For many of us, the hardest part of being pregnant is giving birth. It is also the most necessary part of the process and can often be a bit scary as well. Some of the ways we can combat this fear are by reading lots of positive birth stories and doing research to ensure that we understand everything that is going on and can be better prepared for every possible outcome.
This research phase is also crucial for helping us decide which birth method is best for us. There several to choose from, which include the main two—hospital or home birth—along with a few subcategories such as:
- Water Birth
- Cesarean Section
- Medicated Birth
- Natural Birth
- Unassisted Birth
- Orgasmic Birth
- Emergency Car Birth
Admittedly, that last one isn’t usually one we choose so much as wind up in. To help avoid some confusion—and maybe clear up some as well—let’s take a look at some pros and cons for the two big choices: hospital or home birth. There is a lot of information available on both options and each will vary in their appeal to us personally. Some will favor a home birth more strongly while others won’t need to think twice about whether or not they will have a hospital birth.
Pros: Hospital Birth For The Win?
Hospital births are the most common type in the United States, as well as most other developed nations. For more than 100 years now, birth has been viewed by our society as a medical procedure more so than the natural and biologic experience that it truly is. While some are aiming to change that, the shift to view birth as beautiful and safe is slow. Why? That may be primarily rooted in fear. Women are scared to give birth. The best anecdote for that? Knowledge…
The Comfort Of Modern Medicine
Prior to the advancements made in modern medicine, birth was the most dangerous and terrifying part of a woman’s life—very often ending on a sad note for many. But nowadays with such things as hygiene, ultrasounds, fetal monitoring, intensive care units, and emergency Cesarean sections—those sad days are far and few between.
For pregnancies with multiples or premature babies especially, the hospital is a life-saver. As Healthline tells us,
“In fact, extremely preterm infants born today are more likely than ever not only to survive but also to have far fewer major complications, such as chronic lung disease or potentially life-threatening infections.”
Trained Assistants Make All The Difference
The maternity ward nurses will be the people who will stay with us throughout the entire process of labor and delivery and then they will stick around to help care for us afterward as well. Nurses are the unsung heroes of the delivery room (apart from us, of course, since we are the ones in labor after all). They are knowledgeable, kind and often know exactly what we need to help speed the process along or relieve the pain or even just shift into a different position. It is also a pretty hard job for them, as Cosmopolitan points out:
“It requires you to care about your patients on an emotional level because they’re not just a client, they are real people who are going through real, intense things.”
Pain Relief On The Spot
One big advantage that the hospital has over a home birth is pain relief. We can go into a hospital intending to keep it all natural and push without any pain relief, but with the freedom of being able to change our minds halfway through if it turns out we just can’t handle it.
A home birth does not have that option—requiring us to relieve the pain by pushing out the baby. A hospital also offers different options for pain relief; so, if an epidural isn’t our cup of tea, we can easily choose something else—though most all drugs given during labor carry potential risks to mom and baby, and many are opioids. According to The Bump,
“The doses and techniques we use are designed to be as safe as possible, so if you try one and it doesn’t work, you can move on to another.”
Emergencies Only Have One Safe Route
We can argue the pros and cons all day long, but one thing is for certain; in the event of an emergency, the hospital is the way to go. Whether that emergency is a broken finger or consistent decelerations will vary from person to person, but as Mother Magazine says,
“Some people feel more comfortable in a hospital setting, knowing they are surrounded by medical professionals in the event of an emergency.”
There is nothing more reassuring in a stressful situation (especially for first-time parents) than knowing that if something goes wrong, there are procedures and people around who can handle it without too much fuss.
The Nursery When Night Falls
One thing that first-time parents and fifth-time parents have in common is finding someone trustworthy to watch the children. This is a trial and a half for many of us but eventually, we settle on that one aunt, his mom or the lady across the hall who also has kids.
One benefit that we can take advantage of at the hospital is the nursery. And on top of that, there are trained babysitters who can expertly watch our new bundle of joy while we get some much-needed rest. As Mother Magazine can confirm, “You have assistance from trained nurses to help care for your baby, while you heal and rest after giving birth.” That being said, some moms still prefer not to let their little ones out of their site, and that’s okay, too.
Feeding Assistance Is At The Ready
For some of us, the labor and delivery ward is as far as we got before our focus and attention went out the window. Now that that is all over, we suddenly have a new little person in our arms and he is hungry! Some of us will want to breastfeed and some of us won’t—a hospital is equipped to handle both.
There is usually a lactation consultant on hand to help us through those bumpy first attempts at nursing and Mother Magazine says, “For those who do not wish to breastfeed, hospitals supply formula for baby during your stay and enough for the first few days after returning home.” If you’re not keen on corn syrup, there are alternatives, such as homemade goat milk formula, donor milk or coming prepared with better-quality brands like HiPP and Holle.
The Hospital Bill Beckons
Having a baby is an expensive business, regardless of the location chosen for the big event. Mother Magazine says, “Depending on your medical coverage, your entire birth may be covered by insurance.” This is arguably a very nice benefit because a home birth is out of pocket and can range from $2,000 and up. For low-income families, that number is very big.
With a hospital birth, we can usually be guaranteed a bed, pain management, any emergency procedures, along with at least two days snuggled up with our baby with doctors nearby before we’re sent off home. Insurance is definitely something nice to have in this regard because otherwise, hospital bills can reach into tens of thousands for a birth. Sometimes baby is covered as well for the first few weeks of life.
The Hospital Bed
Finally, there is one luxury item that only a hospital has and that is a hospital bed. New parents or frequent hospital patients likely won’t see the appeal of the hospital bed but for repeat moms (especially those of us who have had both home and hospital births), the hospital bed is amazing.
There are buttons on the side that can raise and lower the bed without having to sit up on our sore bits, TV controls right there, guard rails so we don’t slip off and a call button for further assistance so we don’t have to walk anywhere except to the bathroom. As Giving Birth With Confidence states,
“During labor, birth, and the immediate postpartum, the hospital bed can be a very useful and versatile tool in helping you cope with contractions and find optimal comfort.”
Cons Of The Hospital: Maybe It’s Not So Great?
You didn’t think we had forgotten that the hospital isn’t everything it’s cracked up to be, did you? While it certainly has a place in the modern birthing era, it’s also been known to overstep those bounds and venture into territory it doesn’t really belong in.
Those C-Section Rates Keep On Climbing
When we are shopping around for a place to give birth, one of the main things we look when it comes to hospitals is their Cesarean section rate. The overall percentage of women having a C-section in America is at an all-time high of 30% with no signs of stopping.
For many women, this is a very concerning number—especially when we hear that the bulk of these surgeries are performed simply for the doctor’s convenience. According to Discover Magazine,
“Today, newborn babies in the US have a one-in-three chance of entering the world through an abdominal incision. In the UK, the odds are lower – more like one in four, but everyone on both sides of the Atlantic agrees this still represents too much help.”
The Need For Interventions
One of the hospital’s primary functions is to treat and prevent everything from the common cold to more serious illnesses like cancer—which often leads to the question of why we would want to give birth in this type of environment.
Because of this treat and prevent mindset, doctors often approach pregnancy and labor as a disease that needs treatment and then intervene in an otherwise natural process—to the point where medical intervention becomes necessary to undo the damage of the previous unnecessary interventions. According to Best Ever Baby, “C-sections are frequently the end result of a series of unnecessary interventions.”
But I’m Hungry
The freedom to eat during labor is one of the biggest appeals of home birth. As Romper tells us, “Most hospitals take that ability away from laboring moms, which may leave you struggling earlier in labor, and possibly more apt to require interventions.” When we are working hard (and labor is very hard work), we want to eat to keep up our strength and energy to finish the job.
Our individual ideas of a labor snack might vary from crackers to tuna to pizza or maybe just fruit smoothies and lots of water. But the bottom line is that no laboring woman would choose ice chips over food if given a choice.
Little Water Babies
Most of us know what our body needs to help relieve intense pain. Some of us like movement while others go for moist heat or dry heat or cold ice packs strategically placed. A popular option for women looking for a natural birth experience is a water birth.
As Romper says, “Although some hospitals now have showers and even tubs to use during labor, most still do not allow for this.” If we do have a hospital with a water birth situation set up, they will have a limit on how hot the water can be (which likely won’t be hot enough) and we won’t actually get to deliver in the tub.
Doctors Are Not Gods
When we are in labor, doctors can range from nice to horrible, and sadly, the majority of women who have a bad hospital birth experience will chalk it up to the doctor who attended them. For centuries, births were attended only by women and this instinctive need to be surrounded only by women can still be seen today.
The bulk of OBGYNs available are men who find it hard to sympathize because they will never go through birth. As Romper puts it, “When hospital staff refuse to listen to your concerns or respect your wishes, it makes the hospital a frightening place to be when you’re already at your most vulnerable.”
Hold The Position!
Epidurals are a modern medicine marvel but they come at the steep cost of not being able to move around during labor (among many other side-effects). If we pass on the epidural, we still can’t move around much because of all the cords and monitors strapped to our bodies and hospital policies no one has time for during labor.
The most common position to give birth in at a hospital is on the back—the worst position for labor. At least at home we can change the position and get somewhat comfortable. According to Best Ever Baby, “Not being able to walk during labor deprives women of a lot of benefits for bringing baby down. Hanging out for hours in bed can create poor contractions, discomfort, slow cervical dilation, longer labor and failure of baby to descend.”
Time’s Up! You Lost!
A hospital is a business and it is run like one at the expense of many patients. Once we enter the doors, we are on the clock. We are given only so long for each stage of labor and only so long to push before our time is up and we are either sent home (for early labor) or given a c-section.
And then we are on the clock for how long we can stay postpartum. According to NPR, “Women with low-risk pregnancies should be allowed to spend more time in labor, to reduce the risk of having an unnecessary C-section, the nation’s obstetricians say.”
The Side-Effects Are Nearly Endless
Almost everything in a hospital comes with a long list of side-effects—from the obvious interventions, such as a C-section or an epidural, to the less obvious things that may spring up, like the Vitamin K injection—which is far from being just a vitamin. We are given oodles of paperwork listing all of the side-effects, adverse reactions and other warnings and fine print. We sign these without reading any of it because who has time to read while in labor?
Shuffled in among these papers are consent forms and release of liability forms just in case we are one of the magic few who might want to sue the hospital later. According to Mama Natural, “Nearly 60% of mamas get an epidural during birth. But I don’t think most women get the full story about the true side effects of this intervention.”
The Worst Case Scenario
Finally, while both the hospital and the home have their share of tragic endings to labor and delivery stories, the hospital on average has the majority. This is arguably increased by the fact that the hospital receives all the high-risk pregnancies as well as the emergency home births when someone calls it quits and sends the laboring mother to more qualified personnel.
Unfortunately, the number of maternal deaths is still tragically high. According to Parenting,
“Ours is one of only a handful of countries in the entire world whose maternal mortality rates are rising. And they’re doing so rapidly. Our maternal death rate has doubled over the last 25 years. In California, it tripled in a mere decade (1996 to 2006).”
Pros: Home Birth Heaven
Thankfully, in this day and age home birth is still alive and well. The hospital is not the only option, mamas. Yes, you can birth without drugs. No, that doesn’t mean you’ll have no pain relief. You can have an amazing birth in the place that you feel most comfortable. Who wouldn’t want that?
Call The Midwife
One of the biggest attractions that a home birth offers women is that the labor will be attended by a female midwife or doula rather than a male OBGYN. When we are in labor about to deliver a baby, we are at our most vulnerable state and we don’t want or need anything to threaten that vulnerability. Sometimes, the presence of a strange man can upset the laboring mother to the point where labor stalls.
As Eco Child’s Play says, “One major reason is that while a male OBGYN may be technically proficient in his field, the fact that he hasn’t given birth, and can’t ever give birth, gives the midwife and doula a huge advantage in terms of actually relating to and understanding birth from a woman’s perspective.”
Hand-Selected Birth Attendants By Your Side
In the olden days, giving birth was a major family event that was attended by grandparents, aunts, uncles, cousins, and children. Of course, most of them stayed outside making food and waiting for the baby to be born while the core group of women actually stayed with the mother.
A hospital has a limit on the number of people we can have with us in our room but a home birth does not. According to Romper, “But if you’d like to have your other children present, or your parents, or siblings, or best friends, or a photographer, you might find that to be a great reason to have your baby at home.”
A Well-Stocked Kitchen Is Your Best Friend
We already know that the hospitals won’t let us eat while in labor. There is nothing quite like being in labor, feeling like we are starving and watching the attending nurses clock off for their lunch breaks and then come back smelling like forbidden food.
At home, we are free to eat whatever we want and our supportive husbands, midwives and everyone else can eat too. As Birth Takes A Village confirms, “Some births are quick, some births are long, ALL births require the birthing mother and her support people to be well nourished in order to keep energy levels up.”
Ah, The Freedom To Roam
Walking around—even in circles around the dining room table—can help reduce pain and speed up the slow process of thinning and opening the cervix before it is time to birth our baby. We can follow our instincts as to whether we need to go up and down the stairs or just around the living room several times.
And when it is time to birthing, we can get into any position we feel comfortable in without needing to consult the doctor or get jostled out of our comfy position for his convenience. As Birth Takes A Village says, “Moving around freely and instinctively is a great way to facilitate smooth progress of childbirth. You can start to feel a bit like you’re on lock-down during hospital births, confined to your birthing suite.”
Warm Water Baby
Nothing soothes the pain of childbirth quite like a deep tub full of hot water. Birth Takes A Village says,
“While your hospital may have tubs, they might not be available in all of the rooms and the size of tubs will often vary between hospitals and between rooms in the same hospital! Not only that, many hospitals are reluctant to support pushing in the water.”
On top of that, the hospitals will regulate the temperature of the water and they likely won’t allow for the baby to be born in the water. At home, there are no such regulations and we can have a nice water birth with a calm entrance into our world for baby. Who knows? Maybe baby will grow up to be an Olympic swimmer due to his water birth experience.
Say Goodbye To Cesareans
The majority of C-sections are performed on first-time mothers in hospitals in America. This statistic is scary and puts those mothers at risk for future labors. Most women tend to have more than one baby and when presented with a VBAC (Vaginal Birth After Cesarean), many hospitals and doctors get a bit skittish.
To be fair, so do a number of midwives—depending on state and their experience levels. But overall, most women who want a VBAC ultimately turn to their homes, as Romper can confirm. “Many doctors and hospitals will refuse to allow women who’ve had previous c-sections the opportunity to have a vaginal delivery.”
Subsequent Births Are That Much Better
Statistically, our first birth probably occurred in a hospital. Whether this experience was traumatizing or not, we are likely looking into a different option this second or third time around because something just didn’t feel right with that first hospital setting.
A home birth sounds more and more appealing with the research we are doing and we can even dive into further sub-categories of it—such as an orgasmic birth or unassisted birth. As Romper puts it, “If you’ve given birth before, especially multiple times, and never had any problems, there’s an excellent chance you can have a successful home birth, especially if you didn’t need any interventions in those previous births.”
No Driving Required
Well, technically the midwife and other attendants have to drive. But the laboring mother can stay safely at home in bed or cruising the hallways focusing on each contraction and not on whether it is time to go the hospital yet.
Sometimes just getting in the car and driving to the hospital can distract mom enough that labor slows down or stalls—prolonging the entire process and creating stress hormones that get all mixed up with the birth hormones. According to Birth Takes A Village,
“During a home birth, that’s exactly what you get to do! There is no anxiety about choosing the ‘right’ time to go, avoiding going ‘to early’ or ‘too late’; you call your support people when you want them to come, and when it is time, they stay with you until you have a baby.”
Entering The Intervention-Free Zone
When we are intent on a natural birth experience, there is always a little voice at the back of head whispering, “We are in a hospital. They have epidurals and pain meds. Maybe we should try one and see if it really helps?” At home, that voice is silent because there are no epidurals and pain meds available. This forces us to dig deeper and find our core strength to continue and come out stronger than we ever thought we could be.
As Romper can confirm, “If you’re dead set on avoiding interventions (not that there’s anything wrong with having all the medical assistance you want or need during labor and birth), and you know yourself well enough to know that if the help is there, you might take it.”
Connection To The Ancients
Women have been giving birth successfully at home for centuries without the need of a hospital and will likely continue to do so long after the last hospital vanishes. While hospitals have their place and have saved countless lives, birth is something that supersedes a hospital and stretches out to connect the past with the present and the future in one beautiful experience.
As Eco Child’s Play says, “I know that it isn’t for everyone, but if you feel at all drawn to home birth, I say ‘Go for it – it’s not as mysterious as it sounds.’ It’s the way women have always given birth. Only recently has birth become the domain of the doctor and hospital, the insurance company and the pharmacy.”
Cons Of Home Birth: Could There Be?
Alas, no birth setting is perfect for all women. Sometimes we don’t figure out what works for us until we’ve fully explored it. Even then, sometimes we don’t figure it out until we’ve fully experienced it. Whatever the case for you, know that this journey to self-discovery is normal.
The Cost Factor
If we have ever seen a hospital bill, we know that by and far, a hospital birth costs a lot. But some (if not all) of the cost of a hospital can be covered by insurance. A home birth likely will not be covered by insurance—especially not state insurance which many low-income families rely on.
The cost of a midwife or doula to attend the birth will vary but expect the price to range from $2,000 and up, with any medical tests being an additional out of pocket expense.
As Healthline says, “With a home birth, your insurance policy may not cover any associated costs. Check with your insurance provider for more information. You’ll still need to work with a midwife and/or trained medical professional, and the cost can vary widely, depending on where you live.”
Emergencies Can Be Scary
With all births, there is always a chance (however small it may be) that something will go wrong. Most midwives are trained for these instances and handle them without too much trouble. But we will still hear stories of that one midwife who refused to call an ambulance or that one couple who had an unattended birth that ended tragically or the couple who ultimately ended up in the hospital when things took a scary turn at home.
The beauty of the modern home birth is that we have the ability to choose to go to a hospital. As Romper says, “If you live just a few blocks down from a hospital, you can feel more confident in having a home birth with the bonus of knowing you can make it to a hospital quickly if absolutely necessary.”
Prep Time Is More Substantial
For a hospital birth, all we really need to do is pack a bag and make sure we have gas in the tank. For a home birth, the midwife will usually give us a list of supplies to get and then we have to prep the room for the birth in the early stages of labor before things really get going.
For us—the one actually in labor—we likely won’t be doing much of the prep work at this stage. Our husbands or other birth attendants will be scurrying round like ants trying to get it all set up for us. As Kitchen Stewardship described it, “That all went fine and we had time to finish everything, but I know he was rushing around like a madman for a while there.”
The Birth Certificate
The hospital makes the paperwork postpartum pretty easy in comparison to the postpartum paperwork of a home birth. As Kitchen Stewardship says,
“A lot of stuff happens while you’re in the hospital after you give birth, and I was totally unprepared for the fact that I’d have to make an appointment, go to the hospital, and pay for the newborn hearing screening, as well as go downtown to get Gabe’s birth certificate.”
The midwife will likely file her side of the paperwork but the rest of up to us and depending on where we live, our home county might throw some extra hoops at us to jump through.
A Modern-Day Mess
The flipside of giving birth in the comfort of our own home is that we are giving birth in the comfort of our own home. We are aware of the dust bunnies under the bed that our nesting instinct missed and aware of any blood or other fluids dripping all over the carpets, the bed and everything else.
We also are responsible for the laundry that a home birth generates. According to Kitchen Stewardship, “I said above that this one is a two-edged sword. While it’s nice to be at home, you also end up worrying about getting blood on your carpet, sheets, mattress, etc.”
No Hospital Bed
As Kitchen Stewardship says, “As much as I might complain about not sleeping in my own bed during a hospital stay, it can’t be denied that for the non-sleeping times, a hospital bed that can mechanically help you sit up to nurse is darn handy.” A hospital bed is one of those devices that we really don’t like till we actually need it.
The convenience of the up/down buttons is the most appealing aspect of the hospital bed to the new mother and all of us secretly want a hospital bed for postpartum recovery. But after a few days, we learn to stack the pillows and make do with our own cozy bed instead.
Sources: Healthline, Cosmopolitan, The Bump, Mother Magazine, Giving Birth With Confidence, Discover Magazine, Best Ever Baby, Romper, NPR, Mama Natural, Parenting, Eco Child’s Play, Birth Takes A Village, Kitchen Stewardship