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Birth Center vs Hospital: What They’re Like and Factors to Consider

Hospitals are the most common place for giving birth but they aren’t the only option. In this blog post, learn about what a birth center is like and how it compares to a hospital, including what each is like, how much they cost, options for pain management at each, and who can be there.

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Most women in America give birth in the hospital. But that number is slowly decreasing. More and more women are choosing alternate birth locations.

If you don’t give birth in the hospital, what are your other options? Well, you have two: a birth center or home.

Today I want to talk about birth centers, specifically how hospitals and birth centers compare.

Why Birth Location Matters

But first…why is it important you know your options? Because where you give birth matters. It matters because the experience of giving life to a new little human is undeniably one that you’ll remember for the rest of your life – and one that will affect you for the rest of your life. 

Women who don’t like their birth place have a harder time relaxing and tend to feel more anxious. That not only leads to an unsatisfying experience but also can cause labor to slow or stop and lead to complications requiring medical intervention.

And medical intervention can have negative effects that last for weeks and years to come.

But the effect your birth experience has on you isn’t just physical. It’s emotional, too. Birth is one of the most highly-anticipated and emotionally-charged events in a person’s life. If it goes poorly, it will affect the way you experience motherhood and postpartum.

Knowing that, the choice of where to give birth takes on a little more weight.

The 3 Cs of Choosing a Birth Place

The number of factors that go into choosing a birth place can get overwhelming. To make it easier, let’s divide some of those factors into 3 simple categories: Creed, Convenience, and Cost.

Creed

Creed is the philosophy of birth the care providers have at any given location. Is birth viewed as a medical event? or is it seen as a natural process that should be left alone?

Creed affects the way doctors and midwives manage labor, the way they treat the mother, and how they do things immediately after the baby is born, including prioritizing (or not prioritizing) breastfeeding and bonding.

This is why who you give birth with is so important – and so connected to where.

Convenience

There is an element of convenience to choosing certain birth places over others. This includes driving time, filling out paperwork, and packing bags.

Cost

Of course, different places also have different price tags. And those prices can vary drastically. Insurance plays a role in cost, too, covering some things and not covering others.

What is a Hospital Birth Like?

Let’s start by looking at what hospital births are like. We’ll go over the 3 Cs then some other important factors.

The 3 Cs: Hospital

What is the creed, convenience, and cost of a hospital?

Creed

Usually, OBGYNs and nurses (including many nurse-midwives) view birth as a medical event. They see pregnancy and birth as conditions that need to be treated. That’s how they’re taught to see it.

Because of that perspective, OBGYNs tend to rely on technology and medication during birth. They prioritize fast labors and routines that make birth predictable.

Convenience

If you choose to give birth in a hospital, you’ll have to drive there while in labor. That can be quite uncomfortable. The good thing is, unless you live in a small town away from a big city, your hospital probably isn’t far away, so the drive won’t be too long.

Paperwork is a necessary evil wherever you give birth. Usually, you (or rather your husband, probably) will have to fill out paperwork before being admitted to the hospital and getting settled in a room. For some women, the travel and logistics of getting into a hospital room causes labor to slow or stop for a while. That is inconvenient in and of itself.

Because you’re leaving home, you’ll need to pack bags. You’ll want a bag for you and your husband (think comfy clothes, toothbrushes, hair ties, etc). Your hospital will probably provide diapers and other baby care items, just make sure to bring an outfit and the car seat to bring him or her home in.

Cost

As birth places go, hospitals are usually the most expensive. According to Forbes, having a baby at the hospital costs $18,865 on average (including prenatal and postpartum care). That number is before insurance though.

After insurance, a vaginal birth at the hospital costs, on average, $2,600.

But OBGYN and hospital costs get complicated. Without getting too much into it, you have to pay the hospital for your time spent there. But you’ll also have to pay your OBGYN separately for being at your birth, plus the cost of prenatal care with them. 

Before I decided to do a home birth, from the best I could estimate, I would have paid about $6,000 for my daughter’s birth – about $2,500 for hospital costs and about $3,500 for my OBGYN fee and other prenatal fees.

Pain Management: Hospital 

The next element to consider about birth location is what forms of pain management each place offers. While every woman’s experience of pain in labor is different, you’ll want a way to cope with the intensity of contractions, whether that be medication or natural methods.

At the hospital, you’ll have an array of pain medications available to you. Many women choose to use an epidural, which can numb the sensations of contractions. Opioids are often available and can lessen the discomfort a little. Some hospitals also offer nitrous oxide (laughing gas). 

If you hire a doula or your husband or mom knows how, you can also use natural forms of pain relief, such as massage and guided relaxations

Many hospitals will offer showers, occasionally even birth tubs, so you can use the warm water to help you relax. Just know that you’ll be asked to get out of the water before your baby is born.

Who’s There: Hospital

Usually, your care provider at the hospital will be an OBGYN. Some women may choose a midwife and a hospital birth, but most nurse-midwives who practice in hospitals do things in much the same way as an OBGYN would.

In addition to your doctor or nurse-midwife, nurses will be in and out of your room to check on you and your baby. 

The hard thing about the hospital is that most of these people will be strangers.

Depending on how big of a clinic you went to for prenatal care and who’s on shift, you may or may not know the doctor who is there for your birth. And the nurses will usually be unfamiliar people too.

When it comes to loved ones you want at your birth, most hospitals allow you to bring 1-3 people. This can be your husband or partner, your mom, and a doula, or whoever else you want there.

Some hospitals may allow more people than that but policies vary so check before you decide. Young children are usually not allowed.

Atmosphere, Intervention, and Outcomes: Hospital

Finally, let’s talk about the atmosphere of a hospital, the likelihood of interventions, and what the outcomes of your birth might be.

Atmosphere

If you give birth in the hospital, the rooms you labor and give birth in will be like any other hospital room – a hospital bed, medical machines in the room, no decor. You’ll be in a hospital gown. And you’ll probably be attached to an IV stand and some fetal monitors. 

The doctor and nurses will be in and out of your room frequently, which might make it hard to relax and get in a groove of coping with contractions.

Interventions and Emergency Equipment

As a positive, emergency equipment is readily available in the hospital should anything go wrong. That can provide some women with reassuring peace of mind.

But, as a downside, having medicine and equipment so easily accessible makes it more likely that it will be used unnecessarily. Because OBGYNs prefer fast labors that proceed according to a predictable pattern, most are quick to intervene.

Pitocin to strengthen contractions, frequent cervical checks to monitor progress, and c-sections are common.

And these interventions aren’t without consequence or risk. Often one intervention leads to another and that pattern continues in a downward spiral. This is called the cascade of interventions.

Outcomes

Though many women have good hospital birth experiences, too many do not. Nearly one third (33%) of all hospital births in the US end in c-section. About 3% of births (3 in every 100) are accomplished using forceps or a vacuum extractor device.

Episiotomies (a cut in the vaginal opening) are more common in hospital births, as are premature and low birth weight babies. 

Fewer women report satisfaction with their birth experience in hospitals than outside of hospitals.

And finally, fewer mothers and babies successfully initiate and continue breastfeeding after a hospital birth than an out-of-hospital birth.

What is a Birth Center Like?

Now let’s talk about birth centers.

The 3 Cs: Birth Center

What is the creed, convenience, and cost of a birth center?

Creed

Your care provider at a birth center will be one or more midwives. Midwives see birth as a natural, healthy process that is most effective when left alone. They will usually take a hands-off approach and let you manage labor however your body directs.

Convenience

When it comes to convenience, birth centers do well in some areas and not as well in others. You’ll have to drive to a birth center while in labor. And you may even have to drive farther to get to your birth center than you would to a hospital.

Paperwork is still necessary. But the nice thing about midwives (and, therefore, birth centers) is that many midwives will have you fill out paperwork ahead of time, in the final weeks of pregnancy. That way, you don’t have to worry about legalities or logistics in the middle of labor.

Like a hospital birth, you’ll need to pack bags. You’ll want a bag for you, your husband or partner, and the baby. In fact, a birth center may be the birth location that requires the most packing because birth centers will usually allow you to bring any extras you want – lights, oil diffusers, affirmation cards, or whatever else you’d like.

Birth centers will provide pads and underwear for mom, but they may or may not provide diapers, wipes, or other supplies for your baby. Make sure to ask your birth center what they normally provide so you can bring what you need.

Cost

Generally, birth center births cost anywhere from about $2,000 to $7,000. Many accept insurance, though some may not.

That cost will include prenatal and postpartum care, so you’re not going to have to add any extra on for that, which is nice.

Some birth centers have their own testing lab and many have sonographers on staff (people who do ultrasounds), so those prenatal costs may or may not be included in your fee.

Pain Management: Birth Center

What about pain management at a birth center? Most birth centers won’t offer traditional methods of pain medication, like epidurals and opioids. Some will offer nitrous oxide (laughing gas). But for the most part, the pain management methods at a birth center will be natural.

Birth centers can offer a less painful experience by creating a comfortable atmosphere and offering soothing techniques like water birth and massage. Most birth centers will also provide a birthing ball, birth stool, or other props which can help you manage the pain.

READ MORE >> How to Cope With Contractions: Natural Pain Relief During Labor

Who’s There: Birth Center

As we already covered, your care provider at a birth center will be one or more midwives. And since birth centers usually take only a few births at a time, your midwife will likely be with you throughout all of labor (once you leave home).

Depending on the birth center, you might also be cared for by other birth assistants. But if you go to the birth center for your prenatal care, you will likely know all of the midwives and assistants by the time you give birth, so no one will be a stranger.

If you choose a birth center, you will usually be able to bring anyone you want to the birth with you – your husband, your older children, parents, friends, anyone! Of course, a doula will be welcome too. 

Atmosphere, Intervention, and Outcomes: Birth Center

Lastly, let’s talk about how a birth center compares to a hospital in terms of atmosphere, interventions, and outcomes.

Atmosphere

Birth centers are designed to be like a home. They will have rooms that look like your bedroom at home, with a comfortable bed, decor on the walls, normal furniture, and space to move around freely.

They likely won’t have any machines or monitors and you’ll be able to wear whatever you choose. 

Your midwives and other assistants will probably stay with you for most of labor but will usually take a much more hands-off approach so you can do your thing. Most midwives don’t do regular cervical checks unless you ask them to, and they monitor your baby only intermittently as needed.

Interventions

While most birth centers will have IVs, Pitocin, and oxygen on hand in case they are needed, they will be used only sparingly, as needed, rather than routinely. One of the benefits of giving birth at a birth center is that they consistently have lower rates of medical intervention than hospitals.

Outcomes

When it comes to birth outcomes, birth centers blow hospitals out of the water. According to a study done in 2013 only 6% of moms who labor at birth centers will get a c-section. 

The same study found that only 1% of moms laboring at a birth center will have an assisted vaginal birth (forceps or vacuum device).

Midwives rarely cut episiotomies.

Birth center births (and other out-of-hospital births) attended by midwives have lower rates of preterm birth, low birth weight babies, and deaths of babies.

And to reiterate what I said in the hospital outcomes section, more women report satisfaction with their experience in birth centers than in hospitals, and more mothers and babies successfully initiate and continue breastfeeding after an out-of-hospital birth.

The last thing I want to add is that birth centers rarely keep you overnight.

Most mothers and babies leave the birth center within a few hours of birth. Because of all the other good outcomes that birth center provide, there’s no need to stay! Midwives know mom and baby will do better at home in their own space.

Birth Center and Hospital: Two Safe Options

I want to make sure I’m absolutely clear about one thing. Birth centers are just as safe, if not safer, than hospitals. While birth centers don’t have medicine, equipment, or an operating room, most often they aren’t needed.

The studies I’ve cited throughout this blog post show that, when managed the way midwives manage it, labor is usually uncomplicated and doesn’t require a hospital.

As we’ve already covered, midwives achieve better birth outcomes, which is a huge measure of safety. If you avoid the need for a c-section in the first place, for example, you avoid all the risks that come with it!

Conclusion: Birth Center vs Hospital

To begin as I started, most American women give birth in the hospital. But that’s not your only option! A birth center is a safe option that provides lots of benefits.

That said, a hospital can be a good birth place too.

It’s up to you to get informed and then make the right decision for you and your baby. I hope this blog post has helped you be more informed and maybe even opened your eyes to a different kind of birth experience that might be right for you.

Until next time,

Allison

P.S. If you’re hoping to have a natural (unmedicated) birth, you can still choose whatever birth place you want. To learn more, check out these blog posts:

READ MORE >> Birth Center vs Home Birth: Similarities and Differences

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