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Hospital Birth vs Home Birth: The Truth About Your Options

Most women never consider giving birth anywhere but the hospital. But if you have wondered what your other options are, this blog post is for you. Find out how hospital birth compares to home birth and what factors you’ll want to consider as you make you choice between the two.

a mother holding her newborn in a hospital bed

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Hospitals are the socially acceptable place for giving birth. But that doesn’t mean they’re the only option or even the best.

While out-of-hospital births are controversial, the truth is that they are safe for most women, most of the time.

Today I want to look at home births and how they compare to hospital births.

But before you read more of this blog post, I recommend you check out Are Home Births Safe? because I’ll be writing from the understanding you’ll find in that blog post – that home births are safe when certain things (like a healthy mom and a good midwife) are in place.

The 3 Cs of Choosing a Birth Place

First of all, if you haven’t read Birth Center vs Hospital: What’s the Difference, Really?, let’s go over the 3 Cs of choosing a birth place. They aren’t the only elements to take into account, but they help establish a good foundation.

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.

A Look at Hospital Births

With that, let’s get started. We’ll start with hospital births. 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, so 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 Home Birth Like?

Now let’s talk about home births.

The 3 Cs: Home Birth

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

Creed

If you give birth at home, you’ll be attended by an independent midwife (probably a certified professional midwife). To reiterate, midwives view birth as a natural, normal event and usually let it proceed without intervention. And they don’t expect you to give birth within a specific time range.

Your midwife will likely act more like a guest at your labor than a manager (which is what most women prefer and which often has the best outcomes). Home birth midwives usually take a hands-off approach and let mothers labor however they choose. 

Midwives don’t expect emergencies at home but they know what warning signs to look for and when a hospital transfer is necessary. That said, before suggesting a transfer or medical intervention, they’ll do what they can to mitigate non-emergency challenges in natural ways. 

Convenience

Home births are the most convenient birth place when it comes to travel time and being surrounded by your own belongings. You don’t have to pack any bags and you don’t have to travel while in labor.

When it comes to paperwork, many home birth midwives will have you fill it out before labor begins so you don’t have to worry about in the middle of contractions.

One possible inconvenience of a home birth is that you have to provide many of the supplies. Your midwife may provide a birth kit but she’ll still need you to gather supplies, such as towels and bowls.

You will also be responsible for having diapers, wipes, and blankets ready for your baby. And you’ll need to have pads and other recovery items for you, too.

Cost

A home birth is often the cheapest option for giving birth. On average, you can expect to pay between $4,000 and $9,000 for a home birth (including prenatal and postnatal care).

The cost depends on your midwife’s fee, lab tests and ultrasounds you have done, and whether you hire a doula and a birth photographer.

If you want to learn about the cost of a home birth in more detail, check out How Much Does a Home Birth Cost?.

Pain Management: Home Birth

At home, your options for pain management will be limited to natural coping methods. Chances are that’s what you want anyways, though, if you’ve chosen a home birth.

You can start to practice your labor coping methods now. Check out 5 Types of Labor Coping Methods to Practice During Pregnancy to get started.

In addition to techniques, your body naturally produces pain relievers during labor; they’re called endorphins and they’ve been shown to be stronger than man-made opioids like morphine. (This applies to all birth locations IF you are comfortable, able to relax, and unmedicated.)

Who’s There: Home Birth

If you choose to give birth at home, chances are you’ll spend a lot of labor with just your husband (or whoever you choose as your main support person). A doula will likely come when active labor begins, if you hired one.

Your midwife will probably come as you near transition and the pushing phase.

Since it is your space, you get to decide who’s there. You can have your older kids there or not. Your pets can be there (though they may be more of a distraction). You can have as many or as few people there as you want. 

I also want to point out that just like you can ask anyone to come to your birth, you can ask anyone to leave. (This is generally true of any birth location but especially true at home.) 

Whether one specific person is stressing you out or you just need fewer people around, communicate that to your birth team. Then let them take care of delivering the message so that you can focus on labor.

Atmosphere, Interventions, and Outcomes: Home Birth

What is a home birth like when it comes to atmosphere, interventions, and outcomes?

Atmosphere

Home is where you have the most control over your environment and birthing atmosphere. It’s your space so you’ll already be familiar with it and comfortable in it.

You can turn lights on or turn them off. You can have music or noise makers on or off. You control the smells. You get to choose if you want to lie in (your own!) bed, go outside, or wander between rooms in the house.

There will be no machines and no strangers. You can wear whatever you want (or nothing at all!).

At home, your midwife will likely only do cervical checks when she feels it’s truly necessary or when you ask her to. She’ll monitor your baby intermittently with a doppler.

Interventions

At home you are unlikely to have any interventions during labor. Most midwives will carry oxygen and some will carry Pitocin. A few will carry IV liquids. Those will be used in case of emergency or not at all.

Outcomes

Contrary to what many believe, planned home births attended by qualified midwives have excellent outcomes. The “planned” and “qualified midwife” parts of that are important.

Some of the scary statistics people refer to about home births are skewed by including women who weren’t planning on birthing at home but accidentally did, women who had known medical conditions that meant that they should have given birth in a hospital, or women who give birth at home without a qualified midwife.

With those statistics taken out of the picture, the outcomes are promising.

Three big myths circle about home birth outcomes, and I address all three in Home Birth Myths: Busted. To summarize…

1. The risk of the mother or baby dying is lower or at least no higher at home than in the hospital,

2. Hospital transfers aren’t super common and most are not because of emergencies, and

3. Negative outcomes happen LESS often at home than in the hospital.

(To be clear, you’ll also experience these positive outcomes at birth centers.)

TL;DR

So how do hospital births and home births compare? Let’s look at them side by side.

Hospital Birth vs Home Birth: The 3 Cs

In the hospital, you’ll be cared for by a doctor or a nurse-midwife who likely views birth as a medical event that needs to be closely monitored and treated. At home, you’ll be cared for by a midwife who views birth as a normal process and you’ll be able to labor however you choose.

Home births are more convenient than hospitals in the sense of not having to travel and having all your own belongings available without having to pack a bag. Plus, you won’t have to fill out paperwork in the middle of labor.

Generally, a home birth is the cheapest option. That said, if you have good insurance and you’ve already met your deductible, a hospital birth may be cheaper for you.

Pain Management and More

Your pain management options will be very different between hospitals and home. At the hospital, you’ll have medications available to lessen or numb the sensations. At home, it will be up to you to know and practice natural coping methods.

In the hospital, you’ll most likely be limited to 2-3 people at your birth. At home, you can have as many people there as you want.

The atmosphere at a hospital is medical and sterile, with machines, noises, and strangers. Your home is your space, comfortable and familiar, and can be set up and decorated however you want.

In a hospital, you are far more likely to experience medical intervention than you would at home. And usually the outcomes at home are much better, for mom and baby.

In The End

After all that, what I really want you to know is that where you give birth matters! Where you give birth can radically change your birth experience. And I want you to have a wonderful birth!

With everything you’ve learned in this blog post, I hope you feel ready to make a truly informed choice.

Until next time,

Allison

P.S. If you want to learn how birth centers compare to hospitals, check out Hospital vs Birth Center: What’s the Difference, Really?.

Wondering if a home birth is a good choice for you?

My FREE guide will help you know exactly what to ask yourself and what to consider before choosing a home birth so that you can make the decision with complete confidence. Download yours now!

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