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nikipedia's avatar

What are your thoughts on hospital births vs. home or birthing center births?

Asked by nikipedia (27333 points ) November 19th, 2012

I have followed this debate for a while and the more I read about it the less certain I am of either position. The US has a very high rate of birth interventions (induction, epidural, c-section), which you would think would reduce infant and maternal mortality, but in fact we have relatively high mortality rates for a first world country.

Studies have shown that for low-risk pregnancies, out-of-hospital births attended by a Certified Nurse Midwife (CNM), who have masters-level medical training, tend to have comparable outcomes to those in a hospital. Also, these tend to be less expensive and more comfortable birth experiences.

What are your thoughts? Is it simply not worth the risk to try to labor outside of a hospital? Or is it worth it to have a better experience, since the risk does not actually appear to be elevated (under certain circumstances)? Have you had a good or bad experience with either type of birth?

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14 Answers

bob_'s avatar

A hospital just seems like the safest route.

Then again, like you say healthcare in the US is outrageously expensive… so, yeah, I don’t know.

Mariah's avatar

For me personally, I would want to be in a setting where there are people prepared to handle whatever could go wrong.

SpatzieLover's avatar

There was a time prior to being pregnant that I thought home birth would be a beautiful thing.
Then I got pregnant, and my mindset changed halfway through.

In my state, there have been a lot of infant deaths & a lot of midwives claiming to be certified that aren’t associated with at home births.

These are older stats from my state, but they paint a bad picture for home-birthing.

marinelife's avatar

I have mixed feelings. I know people who have gone both routes.

Kardamom's avatar

Even if you have what appears to be a relatively un-complicated or low risk birth, complications can arise. If I was having an un-expected emergency situation, I would want to be in a hospital, not have to be transported to a hospital.

Sunny2's avatar

Hospitals are the best place to be in an emergency. If you are absolutely certain there would be no complications, have the baby somewhere else. I believe women have given birth at the side of a field being plowed. It’s one of the choices women may make, as long as they legally have charge of their own bodies.

SuperMouse's avatar

My third pregnancy was uneventful, because of my age at the time (36) we had an amnio and knew he was healthy with all the right numbers of chromosomes and no other issues. I had two other very easy pregnancies and relatively easy deliveries.

A friend of mine was pregnant with her third at the same time under pretty much the same circumstances (even down to our age). She opted against all the fetal testing and a delivery at home with a certified nurse midwife. She had a wonderful experience having the baby in her bathtub and had a happy, healthy little boy.

I was due a couple of months later and when I went into labor everything was great. He was right on time, a great size, and I was moving right along. Then about ten hours into labor my water broke and the baby dropped. When he dropped he seemed to have pinched the cord or something because his heart rate slowed to almost a complete stop – and didn’t come back up. The doctor who was there to deliver the baby happened to be in the room when this happened, he also happened to have a c-section scheduled for another patient within the hour so a room was all set up. He had us in that room and the baby was out within six minutes. He said that is the fastest he has ever delivered a baby. My son wasn’t breathing and was intubated immediately. Within a minute or so though he started breathing on his own. All we could do was wait and see if he was going to have any brain damage. He is ten now and by some miracle there was no brain damage and he is perfectly healthy.

I know that if I had opted to give birth at home my son definitely would have had brain damage and might not have survived at all. Up to the point where he went into distress everything was perfectly fine. There were no warning signs until his heart pretty much stopped beating. From that day forward I stopped thinking that a home birth was a good idea. I understand that statistics show that home birth is just as safe as giving birth in a hospital, but emergencies can and do happen and I don’t think it is worth the risk. I also think that doctors and especially maternity nurses are usually willing to make every effort to adhere to the mother’s birthing plan and help the birth be a positive experience for mother and baby.

filmfann's avatar

My wife has 3 children. Only one didn’t have to go straight into the incubator. The other two stayed in the hospital for a week or more.

wundayatta's avatar

I live across the street from not one, but two midwives. If anyone knows the risks, you would think they do. And one of them had a home birth. The other had her children long before I ended up on the street.

I think if you have good medical care, a home birth has every chance of leading to a good outcome. You can make an informed decision, when the time comes, as to whether to go to the birthing suite or to stay home.

We had our children with midwives in the hospital. Technically, the first one was in the birthing suite. But it was in a hospital and just across the street from the hospital birthing center, with surgeries in case they were necessary.

I am totally supportive of people who want to have their children at home. We didn’t do that, and I don’t think either of us desired to do so. But it’s up to your level of comfort, I would say. There’s not reason why a home birth couldn’t be perfectly safe. But then, there are always the uncommon occurrences. You’re probably a little bit safer in the hospital.

augustlan's avatar

I was initially interested in having my kids at a birthing center near the hospital. It was a very home-like environment, and it seemed appealing. As it turned out, all three of my pregnancies were high-risk, so it wasn’t an option. My first birth was with an OB-GYN at the hospital, and I was not pleased with his methods. The other two births were with a mid-wife at the hospital, and I was much happier with her methods. My third child needed oxygen immediately after birth and a warming bed for several hours afterward, so I was awfully glad to have been in the hospital.

All in all, I’d choose to be in a hospital and have a mid-wife, if at all possible.

harple's avatar

I’m halfway through my pregnancy now, and this is a decision I have to make. I have 3 options where I am: homebirth, a mid-wife led maternity unit, or a hospital. As it’s my first I’ve automatically ruled out homebirth, but can’t decide between the maternity unit or the hospital. If anything goes wrong at the maternity unit there will be an ambulance on hand to whisk me to the hospital, but obviously if anything goes wrong and I’m already at the hospital that would be better. The environment in the mat unit is much more homely apparently (much like @augustlan is describing) and I’m drawn towards that… but I hear so many horror stories of tricky births. Hey ho. We don’t need to decide just yet, and we will get to go look round all the places too. And you never know, the decision may be taken out of my hands anyway when it comes down to it.

Seek's avatar

I love the birthing center thing.

When I was pregnant with my son, I had slated the water-birth in the birthing center thing. It’s was totally set. My midwives (I had two) had a combined 40 years experience in midwifery, and they were both trauma nurses as well. The birth center was a beautiful log cabin on a lake, surrounded by oak trees, but we knew the one Big Closet had everything needed for an emergency. The hospital was a five minute drive, max, in case of placenta privia or something equally drastic.

Unfortunately, my son was post-dates – went a whole 42 weeks without even a Braxton-Hicks contraction. I ended up spending three days in the hospital having labor induced.

It was an altogether horrible experience. Enough to turn me off of ever having another child, just to prevent having another hospital birth.

Cupcake's avatar

I am now considered high-risk with any future pregnancies, so non-hospital births are out of the question for me. That said, I think they are great for some… but you can never know prospectively if you are in that group. Hospitals are doing great things these days to allow mom’s to actually make and follow their birth plan. I spent a good amount of time in the tub in labor in the hospital this last time.

In terms of our infant mortality… we’re talking apples and oranges here. If a baby is born in the US with an APGAR score of >=1, they are considered alive. Even if they have NO chance of living. Even if they are 20 weeks gestation and 300 grams. Even if they could legally have been aborted. They are considered alive. The US definition of a live birth is the reason for our seemingly relatively high infant mortality.

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