A Comparison of Birthing Settings: Home, Hospital and Birthing Center Births

Written by Erin Odom, Contributing Writer

With all this talk of birthing babies around here at Keeper of the Home, I asked Stephanie if I could compare three common birth settings: home, hospital and birthing center births.*

Whereas a home birth may seem the most natural choice for natural mamas, all three settings have their pros and cons and should be compared, evaluated and prayed through thoroughly before making a decision on where to birth your baby. 

Image by eyeliam

Home Birth

The most natural setting of all three, a home birth is the ideal environment for mothers who want complete privacy and control of their birthing experience.

Pros:

  • All of the comforts of home are available (own bed, bathtub, food, etc.)
  • Complete freedom for birthing position (kneeling, squatting, all fours, in or out of water, etc.)
  • Ambience of choice (Candles anyone? No fire codes to violate here!)
  • No restrictions on birth witnesses–from your hubby to your grandma to your toddler
  • No time constraints (Often, a hospital sets a time limit on how long they will allow a woman to labor–usually 12 to 24 hours–before interventions.)
  • Privacy: No medical team of doctors and nurses running in and out of the room
  • Much lower cost than other birth settings
  • Best bet for a completely natural birth: The setting itself, well, sets itself up for this!

Image by eyeliam

Cons:

  • If an emergency arises (which is rare), you must leave and be transported to a hospital.
  • If you have other young children and no one to help you take care of them for a few days, resting may prove difficult, although if you have help, resting in the comfort of your own home is best (and actually more restful). (Hopefully, most people have help!)
  • Even though the cost is lower, some insurance companies do not cover home births. You must weigh whether or not your family can afford the out-of-pocket expense of the home birth versus what your insurance will cover in another setting.

Why have a home birth?

If you desire privacy and complete birthing freedom, a home birth may be your best option.

Image by intruso4

Reasons not to have a home birth:

  • If you are a high-risk pregnancy: Midwives are trained to access your risk factors, and some even have back-up doctors that will evaluate their patients as well if anything is in question. If either the mother or unborn child has any known serious medical conditions, a homebirth may not be a good choice. 
  • If you or your husband are fearful about it: One emotion that can hinder a natural birth is fear. If you are fearful in your setting, no matter how natural it is, you will be less likely to achieve an unmedicated birth. Although studies have shown home birth to be safe, only you know whether or not you feel comfortable in this setting.
  • If homebirths are illegal in your state, you may want to seriously consider the pros and cons of breaking the law. Some states allow unassisted births but not births with certified professional midwives (I know–where’s the logic in that?). Know the law, pray through your decision, and stick to your convictions in the matter. (And if you don’t like the law…do your best to try to change it by writing your state representatives with the research that shows the safety of home birth!)

Home Birth Stories: Babykin’s Birth Story @Creative Christian MamaZachary’s Story @Raising Leaves , Landon’s Story @The Joys & Woes of Motherhood, My Son was Born in a Kiddie Pool @Venison for Dinner, Caden’s Birth Story and Johanna’s Birth Story @ Keeper of the Home.

Image used with permission by Intentional by Grace

Birthing Center

If you desire a homelike setting away from home, a birthing center may be the place for you.

Pros:

  • Homelike: Most have good-sized beds (not hospital beds) and tubs and are attractively decorated. 
  • Some medical interventions are available–if needed. 
  • Most are housed near (or even attached) to a hospital in case an emergency arises.
  • More freedom than in a hospital setting (for changing positions, etc.)
  • Less expensive than a hospital birth
  • High chance of achieving a natural birth
  • Go home the same day as birth

Image used with permission by Intentional by Grace

Cons:

  • You must travel to birth center (Bumpy ride during contractions!).
  • If not accredited, your insurance may not cover it.
  • Going home the same day may be a pro but it can also be a con if you do not have anyone at home to help care for you and the baby.

Why have a birthing center birth?

If you are fearful of a home birth but want a home-like setting, a birthing center may be the perfect setting for you. 

Reasons not to have a birthing center birth:

  • You are a high-risk pregnancy.
  • You want to spend the night in your birth setting.
  • Your insurance does not cover it, and you cannot afford to pay out of pocket.

Birthing Center Stories: Samuel’s Story @Intentional by Grace (pics above!)

Hospital Birth

Is it possible to achieve a natural birth in a hospital setting? Absolutely! But, be warned, it does take more work. What do I mean by that?

Let me explain. I’ve had two hospital births. Granted, they were in two different hospitals, in two different states, but I didn’t prepare at all for my first birth. I had grown up hearing stories of my mother’s quick and easy natural births…and I just assumed I would be the same way. Was I ever wrong!

I was able to deliver vaginally–but after 16 hours of being confined to a bed, pumped with pitocin, hooked up to a catheter–and with an epidural in my back (after hallucinating on another pain medication). No, my first birth was anything but natural.

I studied and prepared for a natural labor my entire second pregnancy….and I achieved just that. But it took preparing myself for opposition (most hospitals are not accustomed to natural labors), using a midwife, hiring a doula and the support of my husband and a massage therapist friend.

But I did have a wonderful experience (I labored at home except for the last 4 hours, spent much of the time at the hospital in the hot shower, and I even got to pull her out myself and let her do the breast crawl!). I’m now preparing for my third birth in that same hospital with the same midwife and same doula.

See also: How to Have Natural Childbirth in the Hospital

Image by aleheredia

Pros:

  • Any and all medical interventions needed in case of an emergency.
  • Can stay overnight and rest. (But this can also be a huge con if you hate hospitals!)
  • NICUs available if there is a problem with the baby.
  • Insurances typically always cover hospital births.

Cons:

  • You must travel to the hosptial.
  • Depending on the facility, hospitals are usually much more restrictive on birth positions.
  • The ambience is not home like in the least.
  • Limited privacy (especially during delivery).
  • Least likely setting to achieve a natural labor, as interventions can often be pushed (even when unnecessary).
  • Must stay overnight (or longer) for observation. And tests on your baby may be required (Although you can sometimes decline tests and especially vaccines, such as the Hep B and Vitamin K shots.)
  • The food is usually bad (HFCS in your yogurt, anyone?).
Image by tkobosz

So why am I personally having a hospital birth?

1. My husband does not currently feel comfortable with homebirths. I am to be submissive to him. For that reason, I haven’t even given it much thought.

2. My insurance doesn’t cover other settings. (And we did look into a brand new birthing center in our county, but, sadly, it won’t be accredited until 3 months after our birth, so our insurance won’t cover it either.)

3. Homebirths with CPMs are illegal in my state. (And there are no CNMs in our area that deliver in homes.)

I found these resources to be incredibly helpful while preparing for childbirth:

Hospital Birth Stories: Labor & Delivery the Quick, Easy, Cheap & Healthy Way, my own hospital birth story, Emily’s story

*Although I only have firsthand knowledge of hospital births, I spent hours of research on various birth settings (including interviews with women who had birthed in all different settings and both hospital and homebirth midwives) for an article I wrote about the uproar of the arrest of a midwife in my state in the spring of 2011. I used much of that research in writing this post.

What birth setting did you choose: home, hospital or a birthing center? Why did you choose that birth setting?

Top Image by cpopp77

About Erin O

Erin is a follower of Jesus, wife to Will and mommy to three little redheaded girls (born in 2008, 2010 and 2012). She is a life-long, professional dreamer and recovering overwhelmed homemaker. Her mission is to encourage, educate and empower her readers at The Humbled Homemaker to live a grace-filled, natural life. She is the author of a 200+-page eBook all about cloth diapering-- Confessions of a Cloth Diaper Convert: A Simple, Comprehensive Guide to Using Cloth Diapers.

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Comments

  1. We had our first child in the hospital and our second at home. We are expecting our third anytime now and are planning another home birth. We live in Canada so finding midwives is a little easier (as most provinces have midwifery care covered as basic health care). We did not have to find specific midwives for homebirth, as all the midwives in our province offer homebirth as an option. We also didn’t have to worry about insurance. It seemed like an easy decision for us at the time and wish we would have had my son at home too!

    We loved our homebirth and would not plan to have a baby any other way now that we have done it. Both my husband and I were both comfortable with the homebirth and knew it was the right choice for our family.

  2. Thank you so much for all the information! My husband and I are planning to start trying for our first child in the next few months, and we’ve been doing a ton of research on all the options. It’s helpful to see all the information together, since we kind of feel like we’ve been swimming in an ocean of options and opinions and research. :)

  3. This is a great post. Things are different though where I live (Canada). Here are the differences: No matter where I give birth, there is “no cost” since its covered by our provincial health plan (so in a way there is the cost through taxes but we pay that anyways). I can choose (providing I can get in with one) a midwife or a doctor. Midwives are, however, limited, not in all areas, or are so popular that its hard to get in with one. Also, there are no birth centers, although there is talk of trying to get them going. I think there may be one in western Canada…but I’m not sure. There aren’t any at all here.

    There is currently one midwife in my area, but there wasn’t any with my second child (within 2 hours driving). I am using the midwife (probably a homebirth if its works out) for this upcoming birth, providing that she is still here, since she has to leave a few days after my due date. Otherwise I will use a naturally-minded doctor I’ve already met with at the hospital.

    For my first I had a midwife at the hospital, as I lived too far from the hospital during winter time for the midwives to consider a homebirth. For my second, I had her in the local hospital with a doctor (and a doula who we did pay for). I thought the experience would be worse than it was…actually…it was a really good experience. I went into it thinking I’d have to “fight” more for my rights but I was really respected in what I wanted to do, and they pretty much left me alone with my husband and doula for the most part. I had a natural birth there, as there was no need for any interventions and everything was normal. I could deliver any way I wanted to (I did hands and knees as it worked best at the time for me) and I could basically choose to do whatever I wanted. I didn’t have any time constraints either, even though they knew my labour lasted 23 hours. I didn’t have much issues with privacy really either. I brought my own food and they let me store it in the fridge no problem. They respected my birth plan and didn’t push me to do anything. My only issue was with breastfeeding after the baby was born, as they pushed using a bottle since I had issues (we went on to happily breastfeed without using a supplements despite their warnings that it wasn’t going to work).

    The doctor was willing to have me leave earlier than I did, and this time, the doctor has agreed to 4-6 hours as long as everything is fine. The only thing is I have to come back the next day for the heel prick test and hearing test unlike the midwives who do that at home.

    Its going to be interesting to see what happens as I am due soon…could be any day now!

    • Wow! It sounds like you have a great hospital, Nola! Thank you for sharing your experiences!

    • This is why I love living in Canada! We have it so good here compared to those in other parts of the world (or continent).

    • I don’t know of any birth centers out in Western Canada (at least, I’ve never heard of one in BC- maybe there’s one in Alberta?). The options are pretty much hospital (with choice of doctor or midwife) or home with midwife. There are definitely more midwives where I live, in the greater Vancouver area, but I know that they are pretty sparse in most other parts of the province. I would assume most of the major Canadian cities have a good number, but that most rural areas are limited. Even here, where there are plenty in my city, you have to call pretty quickly to make sure you get in with someone, unless you are a repeat client (and then you usually get in automatically).

      And I do have to comment that although I’ve had my last 3 births at home (and they were fantastic), my first one was a homebirth-turned-hospital-transfer. I definitely did have interventions (some my midwife wanted, others she helped me to advocate against until they truly seemed necessary). The experience, while hard and disappointing, was actually still somewhat better than I thought it might be. I think that midwives in our area have worked very hard to forge relationships and gain the respect of the local OB/GYNs and that helps to make all the difference.

  4. I had two natural births in the hospital. Both were very different experiences – the first I was sent up to L&D at my 40 week appt because I was dilated to 5cm. The only intervention I had was the doctor breaking my water. My second child, I labored at home and made it to the hospital exactly 1 hour before she was born. It would’ve been sooner, probably, if the triage nurses had moved a bit faster at 4:50 in the morning. :) It was hard for them to believe I was ready to push since my water hadn’t broken yet…which it did just 15 minutes before my daughter arrived!

    I read Henci Goer’s book and would’ve been open to considering a home birth, but my husband was not. So I read “Natural Childbirth the Bradley Way” and basically coached myself thru labor both times. I knew that if my husband was trying to coach me, I’d get frustrated with him. Ha!

    I think you must know yourself before you can determine which birth experience you really want. We were comfortable in the hospital because it made him more relaxed to know the doctors and nurses were nearby. I was more relaxed because he was relaxed. Neither experience was my “dream birth,” but I don’t think it’s quite realistic to expect to have a “dream birth” because there are so many unknowns and things that no one but God can control. Both were good experiences, though different. Both my children were born safe, healthy, and we were well cared-for. That’s the important part.

  5. I second the book “The Thinking Woman’s Guide to a Better Birth” by Henci Goer. This was actually my husband’s favorite book about birth. :) He was not just jumping for joy about a home birth, but after doing some reading and research, he was completely on board. We’ve had two very different home births – the first was over 24 hours, and I know I would have had a c-section if we’d been in the hospital. The 2nd wad about 6 hours, and the midwife almost didn’t make it in time. I think the most important thing to remember about birth is to make sure you are making informed decisions – whatever that looks like for you. Don’t just let things happen when you can have a say in it. That’s one thing I loved about The Thinking Woman’s Guide – she shares the information and helps you come to decisions that are right for you. Also, her information about how every intervention increases the risk for more interventions and emergencies was very helpful and eye-opening. Love hearing about everyone’s births!

  6. RaisingCropsandBabies says:

    I had a homebirth with my first that went wrong. :( 30 hours of back labor, 4-1/2 hours of pushing, severe shoulder dystocia resulting in a birth injury for my son (and a broken tailbone and tearing all the way for me). I had some red flags during my labor, but hindsight is 20/20. I’m thankful my son is alive and the midwife was able to save his life, but I’ll never put another child through that again! He’s had to have surgeries, splints, and he’ll be in therapy indefinitely. I’m grateful that God intervened in saving his life the day he was born and I trust in His choosing not to intervene with his injury.

    My last 3 kiddos have been c-sections. Talk about two extremely different worlds!!!! haha. They were born healthy and breathing and it’s such a blessing to have healthy babies! I think I took that forgranted before I had my first child… like it was a “right” when in reality it is very much a blessing.

    C-sections vs. homebirths are very different. Recovery from the first is much harder (and is getting harder and more complicated with each one), but I would rather have surgery than anymore of my babies. I have learned that the birth of your baby is going to be special to you no matter how you give birth. I just had to get used to the fact that it’s different than I ever envisioned. I do get sad from time to time that I’ll never get to have another labor again, but such is life sometimes. While birth is “natural”, things in nature don’t always go perfectly. My husband is a farmer and he has to pull lambs and calves a few times a year and sometimes they die. Things in nature are imperfect because we live in a flawed world. So while birth is natural, so is death and/or trauma. Giving birth one way or the other doesn’t guarentee a certain outcome. My two cents. Sorry if that sounds grim. :/

    I still support homebirths for low risk women. It’s all about risks vs. benefit and your decision after comparing/praying/etc.

    • Wow–thank you so much for sharing your story! It is full of godly wisdom! I believe God ordains all our days–and that even includes our births–no matter how they happen! I think it’s so important for high-risk women to weigh the risks. I am thankful for all options!

  7. We have had 6 hospital births, 1 home birth, and will be having our second home birth in May. After having experienced both types of births, I would not go back to the hospital unless the birth required more intervention. My home birth was wonderful. The pain level was a lot lower. My husband didn’t even believe that it was time to push because I wasn’t in amount of pain I am usually in at that stage. Our baby was born in the middle of the night while the kids slept. They had no idea what was going on, we didn’t need to call anyone to watch them and we didn’t have to rush off to the hospital. If we had needed to wait for someone to come before leaving for the hospital, I probably would have delivered on the side of the road. My labor was less than 2 hours and the midwife made it with 10 minutes to spare. With this next one, my husband is being coached by the midwife in case she doesn’t make it. Having babies at home is more relaxing than having hospital staff fussing over you. No 5am nurse visits. No nurses coming in and telling you the baby can’t sleep in bed with you. Midwives also aren’t overly expensive. My midwife charged about $3200 for all my visits, delivery, and 6wk post partum visit. Compared to copays and deductibles we have had in the past, we’ve paid almost that much.

  8. My hubby was actually the one who wanted a home birth, and I was the one who was afraid. He’s one of 12 kids, 8 of whom were born @ home. No midwife- just Dad delivering. He said they always knew when his Mom was having a baby because his Dads truck wouldn’t leave for work so they would stay home from school and watch cartoons on T.V. Eventually his Dad would emerge from the bedroom with a little bundle and introduce them to their new little brother or sister. It was only @ the hospital that his Mom ever had problems. So he was totally fine with home birth and actually preferred it. I think I would have liked it also, but I had a nagging feeling with my first that we should be @ the hospital because I was going to need a c-section (which hubby scoffed at ” Doctors perform way more surgeries than they need to because they are afraid of getting sued. There is nothing wrong with you”) Which was true, I had a picture perfect pregnancy. But at the hospital after only 2 hours of labor and 9cm dilated I was wheeled into the operating room, due to 2 factors. One was my sons heartrate kept dropping with each contraction down do 30-35 bpm. He just could not handle the stress of the labor. And his arm had gotten stuck above his head and he couldn’t drop. My hips are apparently too small to deliver the head and arm together. Thankfully the surgery went well and we were blessed with a 9lb baby boy.
    For my 2nd I really wanted a VBAC, and I was a great candidate, but the hospital where we live was not allowing that procedure at the time due to restrictions with their insurance carrier. If I really wanted one I had 2 options. I could either drive tot he closest hospital that offered it. (3 hours away, so fat chance after my 2 hr labor the first time. And what if something happens again?) Or before they would admit me I could sign a waiver that basically said I was knowingly requesting a procedure they didn’t offer, so if anything went wrong I understood I had brought it on myself, and they were under no obligation to intervene. Which meant if I needed an anesthesiologist even if there was one on the floor, they weren’t required to come treat me if they didn’t feel like it. Same for nurses, surgeons etc. I was not about to go to a hospital and not be treated. That’s why you’re IN the hospital! So I ended up scheduling c-section #2. And later #3.
    I definitely believe that all three options are viable and best in certain situations. You need to trust what your gut is telling you (my MIL’s gut told her to not go back to the hospital because that’s where she almost died. Mine told me the exact opposite.) Childbirth may be natural, but it can also be very dangerous and the only thing that matters is that both mom and baby come through safely.

  9. Nice article, but I don’t agree with what you said about emergencies being rare. About half of my mommy friends have had birth-related complications that required immediate intervention. I think a home birth is beautiful and would be great, but honestly I feel it’s also selfish on the mom’s behalf to want to be comfortable. Think of how much is being risked? What if there was a serious problem and the baby was deprived of oxygen for too long or mom bled out? Delivering a child is serious business, something I think should be responsibly done at a hospital. I’m sure this is going to get people hating me, but it’s just my two cents.

    • Ashlee, I completely understand where you’re coming from, and in my comment below explained how I don’t find the risk of my life (or my baby’s) worth the home birth experience. However, I think it’s important to respect everyone who does decide on a home birth. I don’t think it’s selfish, as long as they are making informed decisions and doing their research before hand. From what I have read in my own research, most home birth midwives are well trained in types of complications, and will err on the side of caution for the sake of the mother and baby.

    • Thanks for your input! I do have a question–were your friends in hospitals or at home? Many times “emergencies” in the hospital are just caution on the part of doctors. I would have thought the same, but my reasearch showed again & again the safety of home birth. My CNM said that most home births are uncomplicated. The problem is that when complications do arise, they are usually serious. Many people think hospital birth is even more complicated because of so many unnecessary interventions. I don’t have my notes handy, but when I researched all this last year, the USA c-section rate was something like 30-40% where worldwide it was 10-15%. The World Health Organization says it should be around 10-15%. C-sections can be much riskier than vaginal births & although I believe they are life-saving, I believe they happen far too often.

      • Erin, your research is impeccable! Thanks for providing such good information. The truth is, there ARE risks associated with birth, but ALL birth settings contain risks. Giving birth in a hospital presents it’s own risks, as does birth in a birth center or at home. The important thing is to do the research and make informed decisions. Hospital = safest, home = risky is just not true.

    • There are several recent and very thorough studies done in BC comparing maternal and infant mortality and morbidity. The findings showed that the differences in rates of complications are negligible in low risk women.

      I agree the safety of both mom and baby are of utmost importance. A beautiful birth means nothing, if harm comes to either of them. Having a competent midwife is key (in BC midwives are regulated so there is some security there), as is being a good candidate for home birth (healthy woman who has had a healthy, uncomplicated pregnancy).

  10. Kathleen K says:

    We were very blessed to have all three of our babies in a hospital that supported natural birth. For all three, we had a doula who is also an ob nurse–and since she was in the room with us, the rest of the nursing staff left us alone. I appreciated the 48 hour stay the first time. The next 2, I was ready to go home that day. (Too many interruptions during night and bad food!).

  11. Excellent post, Erin! I’m sure all the mamas out there are very appreciative of all the research you put into it. Thanks so much for including Babykin’s birth story! :-)

  12. What a wonderful post–thank you for educating the public about a lot of the pros and cons of the different types of births!

    I had 2 c-sections with my first two babies (neither was emergency, but I was led to believe, at that time, that they were necessary). The next 4 babies were born at home, with various degrees of comfort with each, but I will say that the care from my midwife was beyond excellent. The midwife greatly encourages nutrition and natural ways to deal with some of the issues that I had, including varicose veins, anemia, and others. My labors ranged from 12 hours (too fast for me) to 65 hours (long, but worth it in the end). I loved being able to labor in the shower or tub as my need arose. I loved that we could have whatever type music or prayers playing in the background during the labor and birth. I loved that my husband caught 3 of the babies (with the midwives’ hands underneath, of course). I loved having only oil lamps for light (the midwives used flashlights when needed). I loved that my daughter was able to cut the cord for her little sister’s birth. I loved having my toddler snuggle up in bed with me just hours after his baby brother’s birth and be able to nurse for comfort. I loved not having to fight with docs and nurses about vacs, circumcision, or birth position. I loved being able to eat and drink whatever and whenever I wanted. I loved having my children and hubby there for support when I needed. But there are two sides to every coin, as well, and for some the “cons” are dealbreakers. I had one birth when I had a toddler who wasn’t familiar with the help I had, and screamed throughout my entire transition period, and I cried the entire time. I’ve had homebirths where relatives and friends thought I had it all together and didn’t help at all, and the older children and husband had a heavy burden to bear. With my last birth I had to emergency transfer to the hospital after 60-some hours of labor, and since I had no backup plan (after 4 homebirths I didn’t even think I needed one), my children ended up staying the night with a friends’ mother whom I’d never met, making for a very stressful time for me and my husband at the hospital. I had no backup doctor, and the doc on call at the time was not someone I felt comfortable with. My had to make last-minute decisions about pediatricians, tests, and procedures that I hadn’t thought about in years, with no way to research on-the-spot.
    I was very blessed to have 4 babies at home, naturally, but I know full well that it may not be God’s plan for every mom.
    My next baby (#8–due here in a few months) will be a hospital planned c-section, due to extreme medical complications with my last birth and this pregnancy. The hospital I’m delivering at would allow a waterbirth (if I were having a baby naturally), and is very friendly concerning breastfeeding, decisions on vacs, bringing your own food, etc, etc, and I believe I would be comfortable having a natural birth in this particular hospital if it were possible. I’m saddened, but not despairing, at the thought of another c-section, as I know it’s God’s will for our particular family. Under my doc’s direction (whose mom and grandmother were both midwives), I will have a birth plan at the hospital, so Godwilling there will be no stressors from the various decisions we’ve made about the care of our little boy. I do know that being prepared for as much as possible is very helpful for alleviating stress and fear during pregnancy, and especially during labor, and I pray that my story will help someone else in making a prayerful decision on how best to prepare for the birth their own little one.

    • Wow–Alanna!! You have so much wisdom to share! Praise God for the many varied experiences He has given you!!! Blessings on your next birth & thanks for sharing!

      On another note–any tips for varicose veins besides support hose? I have them. :(

      • Thank you, Erin, for your kind words and encouragement. Here are a few things that have had varying degrees of success for me and my varicosities:

        –V-2 supporter (this worked well for my previous 3 pregnancies, and can be found on amazon). I found that if I alleviated the pain from the veins in my “upper regions” then the leg veins didn’t hurt as much.
        –Trilight Health’s “circulatone” A mixture of herbs that worked for even the first part of this pregnancy.
        http://www.trilighthealth.com/Pregnancy/Mother-s-Choice-Pregnancy-Line/Circulatone-Circulation-Support-p188.html
        –staying off my feet with my feet elevated. I’ll admit this is much easier since we homeschool and I now have teenagers to help with the little ones, but being a “type A” personality, this is even hard for me now. I did get a counter-height stool for the kitchen, and it helps me to be able to sit while preparing meals.
        –Prayer and discernment. According my my docs, my veins are not really dangerous, just cosmetic, even though I’ve developed some blood clots in my feet in recent months. The pain is very real, however, and not just “in my head”. I’ve had to pray often and ask God to set for me priorities in caring for my family. I’ve had to lower my standards on some things, and in others God has shown me ways to improve my mothering skills and my children’s skills to help make things easier on everyone. This may be as little as making it easy for toddlers to get their own snacks (with supervision, of course), or as much as teaching a teen how to cook spaghetti sauce from scratch.
        I’ve not had good experiences with compression hose, and this time my SPD (symphysis pubic dysfunction) makes them impossible to wear, so I can’t comment on them one way or the other.

        I pray this info helps you and/or others–sometimes it’s very lonely being in pain with no way to alleviate all of it, but we’re tremendously blessed to get a baby out of the deal–and know that Our Lord gives us these “crosses” to bring us closer to Him.

  13. Great article! Love the straight-forward comparison! We have had 2 unmedicated births in the hospital with a wonderfully supportive OB. We’re planning our third birth (in July) for a free-standing birth center. I love my midwife and am excited to not have to fight quite so much for what I want.

    However, I have a partial placenta previa and will not be able to deliver vaginally if it doesn’t resolve itself. I am at peace knowing God will put us right where we need to be.

  14. I have had one birth centerl birth and two homebirths so far. I had my first in the birth center because I wanted a midwife, a natural birth and I hated hospitals, but wasn’t totally comfortable with a homebirth with my first child. If something went wrong I wanted to be near a hospital in case of transfer. The midwife made us pre-register at a hospital within 15 minutes of them in case of a transfer. (she said it takes 15 minutes to set up for a c-section, so if a woman needed one it would be ready when she arrived) They were very warm, friendly and professional and I would probably do it over again in a heartbeat for a first. Everything went well except my son was blue and needed oxygen. (They had all that stuff right there-no issues) It was expensive for us as we were self-pay. By number two, I was totally comfortable with a home birth. Everything went well except well except my daughter was a face presentation(ouch!) and born not breathing. A puff of air and she was screaming like a banshee! I switched midwives for number three-one that I had met while working with my first homebirth midwife. She had been at over 1000 births! My third was my easiest baby with only 2 hours of active labor and I got to catch her!!! My advice is to go with a midwife you are comfortable with and has lots of experience. I could really tell the difference between the less experienced midwife and the one who had been to LOTS of births. :) Make sure you have a ‘Plan B’ for if you need to go to the hospital and have an emergency bag packed. A midwife is trained to know when to make a transfer.

    The midwife births were only about 10% of the cost of my birth center birth and were covered totally by the the Christian Health share ministry we are with- Samaritan Ministries. They are a great alternative for Christians to health insurance!
    I think that hospitals are the best place to have your baby if you are high risk or uncomfortable with the idea of a homebirth. I believe in giving birth where you are comfortable and safe! (I am not a fan of unassisted homebirths!-unless, of course, you are married to an OB ;))

    • Sounds like you had great experiences! Your second midwife sounds wonderful! I should check into the Christian health insurance. We have our insurance through my hubby’s job & it seems premiums keep going up every year!

      • If you do mention my name- Brooke Church. They give a referral discount! I’d be singing their praises anyway, though. They are awesome. :) A family of any size is $320 a month. It is less for couples with no children,singles and those under age 25. I called to add our new baby and the man I talked to recognized the name of the town I lived in and said he went to school with a girl from here. :) Turned out to be someone my husband grew up with! They make is so easy to call and ask questions because they are so friendly!

  15. I’ve had 3 hospital births and am planning my 3rd home birth in about 6 weeks. I could never go back to the hospital setting after experiencing birth at home! (Unless I have complications, of course!) For those whose husbands are uncomfortable with HB, (and I think most/all are initially!) remember that most of that comes from lack of information and misunderstanding. When I felt lead to HB during my 4th pregnancy my husband was initially STRONGLY against it. I let him know I’d follow his lead, but asked if I could read some things to him and share a couple articles. After reading parts of “The Thinking Woman’s Guide to Better Birth,” among others, he did a total 180. Now he’d never let me set foot in a hospital unless I was in medical danger. ;)

    Also, our insurance doesn’t/hasn’t covered HB, but we have a high deductible and would be paying a lot out of pocket for a hospital birth anyway. And my husband has always bartered with our midwives to pay the remaining costs. Most HB midwives are happy to barter and/or set up long-term payment plans.

    Where there’s a will there’s a way! If you’re facing obstacles to a Homebirth, I encourage you to pray and look for solutions. I think it is truly the most peaceful, respectful, family-honoring way to bring a new child into the world. =]

  16. We are due in July with Baby #1. I was interested in considering homebirth, but my sweet husband turned a shade of pale and gave a pretty firm no. I’ve also been unable to find homebirth midwives in our area.

    I was recommended to a lovely birth center (more comfy than my home!) with CNM who have admitting privileges at the nearby hospital. The CMNs work out of the same office as OB/GYNs who are covered by our insurance, so we have insurance coverage for all of our prenatal and delivery care.

    A hospital was not an initial consideration for us – my friends who have delivered at the local hospital have liked their OBs, but have still had unpleasant experiences – who wants someone rushing in during labor to discuss how you’re going to make your final payments, or wants a doc scheduling a c-section just because the baby looks a little big, even after three uncomplicated deliveries?

    I’m grateful for my option at the birth center – even with the 45 minute car ride!

    • Congrats on your pregnancy, Amanda! I am due in August with #3! It sounds like you have found a wonderful place to birth! I am excited for you! I wish I had prepared myself more before my first birth!

  17. Our first three babies were born at home. I’d never considered homebirth until my husband asked me, “Do you think you would want to have the baby at home?” We interviewed a midwife and both liked her so much that we’ve hired her for all four of my pregnancies!

    We had planned for our fourth baby to be born at home as well. But something happened and the baby just wasn’t coming. I’d never not been able to handle contractions during labor, but this time the pain was worse and different. Our midwife told us that we should go to the hospital while everyone was still OK. So, we transferred to the hospital and within 10 minutes of arriving our youngest son was born. We never found out what made his birth different. A nurse friend who was at the hospital with us said that so many people were praying and maybe God just miraculously took care of whatever was wrong. I tend to agree!

    I was disappointed that I did not have my youngest at home, but regardless of setting, we were just thankful that we had another healthy baby. :-)

  18. I enjoyed this post. It is definitely important for each family to evaluate the best birth setting for them, given their feelings, circumstances, etc. Beautiful births happen in all kinds of settings. It is important to note, though, that most home birth midwives carry all the same emergency equipment available in a birth center, so aside from a mother feeling more at ease in another setting or possibly being closer to a hospital, if mom is rural, there aren’t any safety benefits to being at a birth center since all the same emergency equipment is normally available. If in a state where CPM’s are illegal, the only other consideration is that transfer to a hospital in emergency may be met with hostility and less-than-ideal care because of staff attitudes towards home birthing families. Also, even in states where it is illegal for CPM’s to practice, it is not illegal for parents to hire one, so it is more the midwife taking the legal risk than the parents, and many midwives feel called to do what the do by the Lord, another consideration. For parents who want a faith-based care provider first and foremost, that can be a serious plus. Even if parents don’t want to use aCPM due to the law, they can almost always find a CNM. For instance, in the Charlotte metro, some parents work with Karen Benfield. On the cost issue, often times home births with a CPM or CNM are reimbursable as an out-of-network birth, or using hsa or fsa funds, even in states where CPM’s cannot practice. My own births have been reimbursed this way, as well as doula services. In addition, many midwives are more than willing to work out payment plans, barter arrangements, trades, and to do oro bono work when called for. This takes care of the cost equation for most families. I say all this not to say that everyone should have a home birth, but that if you want to have one, there is almost always a way to make it happen. Starting with accurate and thorough information is 90% of the battle on that front

    • Thank you for all the great info., Allison!! Almost all the homebirth mothers & midwives I interviewed we’re Christians, and it is neat to see their servant hearts in fulfilling their call! It seems we both live in NC? I have been sad that so many negative stories make the news, while there are hundreds are positive stories out there! My CNM (who I saw yesterday!) is in support of homebirth in NC but she said no one wants to take responsibility for the very few negative outcomes (like if a baby dies in an emergency room). I really hope/pray CPMs will be allowed to practice in NC soon! It doesn’t make sense that they are legal in all our neighboring states but not in NC!

      • Yes, I hope our bill goes through soon so that CPM’s can practice without fear in this state. I mentioned the CNM home birth midwife because a lot of area women don’t even know it is an option. Unfortunately, the midwifery community is sometimes divided and CPM’s and CNM’s are not always united. Both types of home birth midwives are important and differently qualified, with CPM’s being the only midwives trained specifically for the home environment and CNM’s having broader medical training. Families deserve the option to choose the care provider that suits them best. What works for one family is going to be different than what works for another.

        • I didn’t realize Karen is a CNM serving the Charlotte area! When I was researching this last year, the only practice in the state that offered this was one near Winston. What practice is Karen with? Yes, it seems there is some opposition (at least in NC) among CNMs & CPMs.

          • Yes, Karen has been offering midwifery services for more than 20 years as a direct entry midwife who was also a RN — both in FL and in NC. About three years ago, she completed her CNM. She is fully reimbursed by NC Medicaid, which is neat for people who prefer that. She operates out of her own practice, BirthTender Midwifery. I found her facebook page if you want to look: https://www.facebook.com/BirthTender?sk=info

            I’ve heard good things from clients of hers. Of course, she won’t be a fit for every family. Some families specifically feel more comfortable with the training, etc, of a CPM and there are also lots of excellent options for CPM’s in the area (can’t wait until the day when I can officially name names and recommend them publicly, too). But, for families that do prefer CNM’s for home birth, she is a good option.

            Also, because she works with a supervising OB, she is sometimes more limited in which VBAC’s she will take and some women may risk out that wouldn’t necessarily risk out with a CPM. But, it’s good to know that there is an option out there for CNM attended home birth in the Charlotte area.

  19. I applaud your decision to have a hospital birth. I had 1 homebirth (Dr and midwife attended) and 4 hospital births. Each was different and ranged in comfort, psychological distress, complications and Dr. attitudes. I have yet to write my homebirth/hospital birth stories, but will eventually. Suffice it to say, I make room for each to decide as they feel led, but I do see some major deficits in the home-birth situation and feel that if you find a good Dr. who understands your positions/choices, and will support that, a hospital birth can be the safest for your child. I realized I never wanted to regret not being near enough to emergency services in case they were needed. That’s just me – but having witnessed a stillbirth in Africa, I really saw how fragile newborn life is – you have about a 10 minute window to sustain life in an emergency. That’s often not long enough to hop in a car and get somewhere.

    • Wow–what an experience in Africa! Did that help confirm your decision for hospital births after your first homebirth? I agree that I believe with the right education & support, you can have a wonderful experience in a hospital (I did!). Many of my friends who choose homebirth have done so after horrific hospital experiences. Some women even experiece something called “birth rape.” Although my first hospital experiece wasn’t ideal, it wasn’t traumatic or horrible, so I had no reason to consider other venues since I knew I had simply lacked the support & education I needed.

  20. Great article! I had a wonderful home birth this last August. I would never want to do it any other way if I had the choice. It was so great, not having to travel while experiencing contractions.

    It’s interesting to hear that so many husbands are opposed to home births. I got that a lot from my friends, too. I wish men could be more educated in how safe home birth is. I also wish more men had confidence and trust in the power of a woman’s body.

  21. Excellent post and very informative! I had both babies at the hospital. I had lots of pregnancy complications and my husband and I did not feel a peace about having a home birth. We had an excellent Christian doctor who delivered both. We were told to expect a still birth and had a room full waiting to assist. Plus, they made me lie flat on my back with legs in stirrups while I pushed for 3 hours due to a mess up with the epidural {a very difficult and emotional way to birth} I am a natural girl but gave in to epidurals and had problems with it with my first. Then my back felt like it was going to break when I was pregnant with my 2nd one. I was more in control with my 2nd birth in the same setting and it was better. I was able to walk with a walking epidural, sit up, and only had us plus doctor and nurse. Pushed 2 times. Thank you for all the great information. If we were blessed with more, we would probably still have a hospital birth, but in a natural way. I have personal friends with horror stories and paralysis from epidurals in the last couple of years.

  22. Great post! I’ve personally had all five of my children in the hospital, because I had preeclampsia with the first and that birth ended up in a c-section. I had the same wonderful doctor for all of my pregnancies, and after my first c-section, she recommended c-sections for the rest.

    My first two c-section experiences were pretty terrible! The last 3 were very good, and I loved being able to stay in the hospital for 3-4 days after each birth to have time to recover and spend time with just me and the baby. I wouldn’t change that for anything. :-)

    The only big downside was that the hospital food isn’t very good.

    • I agree, the hospital food is horrible. Fortunately, our hospital has a mini fridge in every room so the patients can bring in their own food if they want. :) It also allows laboring mothers a chance to eat as long as there are no signs of complications for c-sections.

      • A mini fridge in the room would be so nice! I ate some during my second labor (not allowed anything but ice chips during my first!), but I was still famished afterwards. I felt like it was the workout of my life! Haha! I was so hungry that I kept requesting more food! I didn’t read ingredients labels until breakfast the next morning…and was grossed out! We may have to see about bringing some good food ourselves this time around!

    • I agree about resting in the hospitals with the new baby! I enjoy those days before I have to come home & be “mom” again!

      • I’ll see how it is this time around, but during my last hospital birth the food was actually pretty good. It was almost like ordering room service and the quality of the food was surprisingly good. I’m already planning to order chicken quesadillas after our little boy is born, one of my favorite dishes I ordered after my daughter’s birth.

  23. Love this post – so thorough and knowledgeable! I had 2 natural births in a hospital, so I know it’s possible. I am another whose husband is not comfortable with a home birth, so we didn’t go that route (plus not sure about the legalities in my state – never researched it because I knew my DH would never go for it). Also, the closest birthing center is too far away for his ease of mind (about 45 min, potentially more with bad traffic). So I went with midwives who deliver in our local hospital. I was pleased both times – the midwives run the show when it’s their patient and they are allowed to bypass all the hospital’s normal procedures. The nurses know how the midwives want it done, so they don’t insist on things like hooking you up to a monitor the whole time and the like. Also my hospital is very relaxed about the vaccines. In fact, my pediatrician just tells the hospital that he prefers to give the vaccine in his office, and they go with that.

  24. Erin, this is an excellent post….one of the best you’ve ever written. Thanks for outlining all these choices. My husband says he’ll never be comfortable with home births either – so your husband is not alone. :-)

  25. I think this is a great article outlining all three options and putting the emphasis on what is best for each family. I personally gave birth to my first son in the hospital with the care of midwives. They were wonderful and all the nurses encouraged a natural birth. When I gave them my birth plan, one had commented on how she wished more patients had the same desire. I had back labor with my son, and after 18 hours of non-stop excruciating back pain, I did decide on the epidural, so I could rest before pushing. My little boy never did get into the proper position (transverse), even after my midwives allowed me to push for 5 hours trying every position in the book! We had a c-section, and it was all in the Lord’s plan as it probably saved my life being in the OR when I hemorrhaged.

    I was blessed to find a hospital that took my every wish seriously, did not make me feel guilty about any decisions, and I look forward to delivering our next child in the same hospital this August. Despite what happened, all OB’s I talked with agreed that midwife care is still better, and all the nurses, midwives, and doctors are 110% behind a VBAC this time around. Because of the unforseen severe hemorrhage in my first delivery, I will never deliver at home. For me, the risk of losing my life (now that I know first hand how real it is) just isn’t worth it. I would be so stressed out the whole time and probably prohibit labor from progressing!

    • Wow, Sara–thank you for sharing your amazing story! I had all back labor with my first–one reason I ended up getting the epidural that time as well (but it was long before the pushing stage!). I had a combo of both back and front with my second, and both my girls came out sunny-side up! Your midwives sound amazing–5 hours of pushing! WOW! I only pushed 2 hours with my first and 1.5 with my second, and I thought that was a long time!

      I am so glad to hear they are letting you try for a VBAC in August! (I am due in August, too!) I pray it goes well! It is also so good to hear the OBs fully support midwife care!! It sounds like the C-section did help save your life! One of my friends hemmoraged after her birth a week before my second. It was in my same hospital with my same midwife–and made me a little nervous!

      Blessings on the rest of your pregnancy!

      • Congratulations on your pregnancy! I could just imagine how nervous I would have been if someone I knew had a birth experience like mine just before my due date! I’m grateful the Lord did not give me foresight to that.

        I feel so encouraged with the support I’m receiving for my VBAC. The hospital I will be at has one of the highest rates for successful VBAC’s in the US, and I pray God will allow me to add to that number!

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  2. [...] you are debating a homebirth this article has great unbiased information on homebirth, hospital birth, and birthing center births.  Posted by sistersplayinghouse at 10:35 [...]

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