Hospital, Birth Centre, Home, Oh My! Pro’s and Con’s of each birth place
It can be pretty daunting choosing the place you want to give birth. For some, hospitals are the last place they want to be, for others, the thought of birthing at home sounds dangerous and scary. Some don’t even know they have options! Here, I have pulled together a list of pro’s and cons of each birth place in to one place to help you make the right decision for you.
Over the years, hospitals have become the go-to place for women to give birth and it’s become a bit of a longstanding tradition that women go to hospital to have their baby. In recent years, birth centre’s have increased in popularity due to their homely feel and environment. What about home births? A rarely seen, rarely talked about option for birth however this too is increasing in popularity - after all, its the OG of birth places.
So which is best? As this quote rightly states, the choice of birth place is unique to every birthing person and their needs. The aim of this post is not to tell you which is front runner and is the correct one to choose, but to help you make an informed decision about what would work best for you. My aim is to provide a balanced weigh-up of all settings so that you feel you can make this decision for yourself.
Lets start with…
Labour Ward/Hospital
Most births these days happen in a hospital on a delivery ward. If you choose to give birth on a delivery ward, you will have access to a team of midwives, with doctors available to you should you need them.
Ipswich Hospital Labour ward adapted to make a cosy environment
Pro’s of giving birth on a labour ward
• Medical assistance is readily available when needed.
• There are more options for pain relief - Epidurals are available should they be requested
• Doctors are on site to offer advice should there be a complication or to intervene if there is an emergency
• Some women feel more at ease knowing that medical professionals are available and that all options of pain relief are accessible
• Paediatricians are on site for baby's health post birth if needed, plus access to NICU if needed, without the need for transfer.
• Women will still be cared for by a midwife through unless there is need for an Obstetrician.
• Hypnobirthing strategies can still be used effectively on a labour ward and can be used alongside medical pain relief
Con’s of giving birth on a Labour Ward
•Some women may be intimidated or frightened by a hospital environment which will caused increased adrenaline (a hormone that can slow labour down)
•Each hospital has its own policy on how long labour should take so women may be encouraged to receive intervention that will speed up her labour however this can cause more intense surges, leaving the woman unable to manage the sudden change
•Women are more likely to receive intervention in hospital, often unnecessarily, due to the availability of it (Birth Place Study) You're more likely to have an epidural, episiotomy, or a forceps or ventouse delivery in hospital.
•There could be a lack or privacy on a labour ward, often other women will be in labour on the same ward which could make some women uneasy, this can affect labour hormones
•A hospital environment is much more clinical than any other birth setting, with bright lights, loud noises, lots of people rushing around, which can reduce the ability to relax which in turn results in reduced oxytocin (the hormone responsible for progressing labour smoothly).
•Ability to be mobile may be limited as expectant mums may need to be monitored continuously which requires them to be attached to the monitor.
•Birth Partners have to leave the ward after the baby is born and can usually only visit during hospital visiting hours
Midwife-led Unit or Birth Centre
Birth Centre’s exist in two forms, stand-alone birth centre’s and alongside birth centres. Stand alone birth centre’s are situated separately from a hospital, under the sole care of a team of midwives. Alongside birth centre’s are attached to a labour ward, still under the care of midwives with the availability to transfer over to the labour ward if obstetric or anaesthetist care is needed.
Birth Centre’s are increasing in popularity due to the additional comfort and homeyness they provide in comparison to a maternity unit in a hospital.
Prince Charles Hospital Alongside Midwife-led Unit, Merthyr Tydfil
Pro’s of giving birth in a birth centre
•The environment of a birth centre is set up to have a homley, relaxing feel to it. Birth centres are less clinical looking than a labour ward, often they have bedrooms - with double beds vs a hospital bed, with an en suite bathroom, and birth pool rooms available too.
• The birth centre environment is easier to adapt to reflect the woman's wishes and vision of what makes a relaxing environment
• Gas and Air is freely available and Pethadine can also be made available
• Midwives are trained to support a natural birth and will encourage this unless intervention is absolutley neccessary
•Water births are encouraged and there is often more than one birth pool available
• Women will recieve more individualised care with less staff involved in their care
• Birth partners are often allowed to stay overnight with mum and baby
• Rooms are private and solely for the birthing couple
•Women are allowed and encouraged to get in to whatever positions feel most comfortable for them and lots of midwives in birth centres are now starting to become trained in Hypnobirthing
•Breastfeeding support may be more available as midwives can usually dedicate more time to this than midwives in a hospital can
•Need for medical intervention is already reduced due to the relaxed nature of setting. There is a lower likelihood of having an intervention such as forceps or ventouse than giving birth in hospital
•Labour can progress more quickly due to the relaxing nature and flexibility of the environment
Con’s of giving birth in a Birth Centre
• In the event of a complication, the mother may need to be transferred to a hospital which can be stress provoking - this can hault or slow labour
• 'High risk' pregnancies will be asked to avoid giving birth in a birth centre because they don't have the trained medical staff available to intervene if needed
• Obstetricians and Paediatricians are not available on site should there be a complication or need for intervention
• Epidurals are not accessible in Birth Centres because they need to be delivered by an anaesethist who will only be present in hospitals
• Women may still need to be transferred to a hospital post- birth if they have experienced excessive bleeding,3rd and 4th degree tears, and if baby needs medical attention.
Home Births
If you have a straightforward pregnancy, and both you and the baby are well, you might choose to give birth at home.
Pro’s of giving birth at home
•Giving birth in a familiar setting can make women feel more comfortable and relaxed
• Liklihood of intervention is reduced compared to birth centre and hospital births, particularly if its a second or subsequent birth
• Women have more control of their labour and birth experience
• Midwives are sent to the home, meaning mothers will have two dedicated midwives caring for them throughout
•Water births are also available at home - its possible to hire a birth pool
• Gas and Air will be brought to the home by midwives
• Mothers can arrange the environment however they see fit
•Mothers will have the opportunity for unlimited skin to skin post-birth
•Women have access to their own shower or bath if they wish to use it for natural comfort/pain relief
• Candles can be used to aid relaxation - real candles cannot be used in medical settings
•Pethadine can be made available however it needs to be requested before hand
•TENS machines can be used to support comfort during contractions
Con’s of giving birth at home
•In the event of a complication, the mother may need to be transferred to a hospital which can be stress provoking
•'High risk' pregnancies will be asked to avoid giving birth in at home because they don't have the trained medical staff available to intervene if needed, particularly for multiple pregnancies
• There may be a lot of cleaning involved after the baby is born and needing to pack away the birth pool etc
•Although pethadine can be made available, it needs to be requested before hand. Some mums may not like the idea of doing this as it means they may be more likely to use it if its on hand - and this may not have been something they wanted to do initially
•Women may still need to be transfered to a hospital post- birth if they have experienced excessive bleeding,3rd and 4th degree tears, and if baby needs medical attention.
•Epidurals are not available for home birth options
In Summary
Giving birth is generally very safe wherever you choose to do it.
There aren’t huge difference in the outcomes of stand alone birth centres and alongside birth centres
Women who plan to give birth in a birth centre )whether alongside or stand alone) have significantly reduced likelihood of receiving medical intervention than those who plan to give birth on a labour ward in hospital
For second time or subsequent mothers, home births are considered the safest option for low risk pregnancies (hospital transfer rate is around 10%) The Birth Place Cohort Study
Ultimately, wherever you choose to give birth has to be and feel like the right decision for you. If you are keen to learn more around your rights to choose where to give birth, Birthrights.org.uk is a good place to start! By signing up to a hypnobirthing course, you are giving yourself all the tools and knowledge you need to make the best, informed choices for you!
Visit my Courses tab to see what courses are available and coming up over the next few months