One of the most intimate, raw and life-changing events of any woman’s life is the birth of her baby. In today’s culture, the overwhelming majority of pregnant women say they are planning for a natural birth, but far less than half will achieve it.
Which is why we’re talking all about home birth vs. birth centers today. Choosing to give birth outside of a hospital increases your likelihood of a natural birth significantly. What’s more, birthing with a midwife at home or in a birth center results in a more personalized and positive birth experience for momma and baby.
But how do you choose which is right for you? Let’s take a look at the pros and cons of home births vs. birth centers to help you decide.
Both of these birthing options mean receiving care from a midwife, no epidurals, an emphasis on natural pain management techniques and greater control over care for the birthing momma. What’s different is potential access to medical professionals if needed, setting, and cost.
Well, momma, below we’ll take a look at the specifics of having a baby in a birthing center and having a home birth and finish with some questions to help you make the difficult decision of where to have your natural birth.
Should you give birth at a birth center?
For the momma experiencing a low-risk pregnancy that is hoping to have a labor and birth that won’t fall victim to the cascade of interventions so common in hospital settings, birth centers are a wonderful option.
They can provide a sense of a security to mommas that are feeling anxious about giving birth in their own homes while still allowing the birthing family to call the shots and experience a birth that trusts in the body’s natural process.
What is a birth center?
A birth center is a stand-alone pregnancy and birth facility that is staffed by birthing and healthcare professionals. A birth center is designed to give a home-like feeling to pregnant women and their families. Birth centers are currently regulated and licensed in 41 states here in the United States.
Who can give birth in a birth center?
If you are interested in having your baby at a birth center, you will need to be prescreened. Typically, only women experiencing low-risk singleton pregnancies are permitted. This is because of the lack of access to the immediate medical interventions that may be necessary in higher-risk, complicated pregnancies and deliveries.
Who attends birth center births?
Birth center births are typically attended by midwives, and many facilities have both Certified Nurse Midwives (CNM) and Certified Professional Midwives (CPM) on staff. For women that are feeling anxious about home birth, this can be a huge pro for birth centers. This is because CNMs have a medical background and a master’s degree in nursing midwifery.
This differs from CPMs (which are the midwives that most commonly attend home births) who, while licensed under rigorous and lengthy coursework and apprenticeships, don’t have the same medical background. Having access to CNMs is a perceived pro for many women who choose to have their baby at a birth center. When it comes to home birth, it is highly unusual to find a CNM to attend your birth.
In addition to midwives, you will find nurses at birth centers and many have nutritionists, pediatricians, lactation consultants and even consulting OB/GYNs on staff.
Some birth centers are connected to hospitals which allow for quick access to medical interventions should they be necessary. Birth centers may vary when it comes to who they have on staff, so be sure to do your research when looking into birth centers in your area.
What are the pros of having a baby at a birth center?
Giving birth at a birth center has a lot of pros compared to birthing in a hospital, and even some of the same pros that a home birth offers. Above all, birth centers allow mommas to give birth naturally in a supportive home-like setting. Births in a birth center are unmedicated, personalized and utilize natural pain management strategies.
Birth centers share many of the hallmarks of the midwifery model of care, including caring for the whole woman, looking at birth as a natural event rather than a medical event, and allowing the birthing momma to play a leading role in decisions related to her care.
Some of the standout pros of having a baby in a birth center include:
- Experience family-centered care
- Home-like birthing rooms typically equipped with queen-sized beds, laboring tubs, and showers, birthing pools for water birth, couches, low lighting, etc.
- Access to natural pain-coping tools such as birthing balls, birthing stools, birthing bars, large tubs, hydrotherapy showers etc.
- Discharged within a few hours of baby being born (vs. a 2-3 day hospital stay)
- Freedom to labor and push in whatever positions feel most comfortable
- Hands-on attention and support from your midwife
- Ability to eat and drink as you feel necessary during your labor
- Extended visits and personalized prenatal and postpartum care
- Very low rates of C-section and other medical interventions
- Covered by more and more insurance plans
- Well versed in how to handle emergency situations, should they arise
- Water births are usually available
What are the cons of having a baby at birth center?
- If your birthing center is connected to a hospital, you may experience the same rates of intervention as a typical hospital because of their required protocol
- Not all women and pregnancies qualify for birth centers because you need to be low-risk
- You may need a hospital transfer anyway
- Fast discharge after birth (usually within 4-6 hours) may be a con for some mommas
- No access to epidurals may be a perceived con for some mommas
A few birth center stats:
- Around 15% of all women laboring in a birth center will transfer to a hospital, but only 2.4% of these will be emergency transfers
- The rate of C-section is only 4% in women planning birth center births
- Cost is up to 50% less than an uncomplicated birth in a hospital setting
- More than half of all birth centers provide childbirth education, home visits, and newborn examinations
(source)
Should you give birth at home?
Deciding between a home birth and birth center can be difficult for many mommas. Mommas weighing the pros and cons between these two birth options typically have similar goals. They want to have a natural birth where they feel in control and at ease.
These two birth experiences share many of the same pros. However, a home birth is often perceived as the most intimate and natural birthing experience by many mommas. This is because you are in your own home, there is no change of location once labor begins, and you truly just trust your body to do what it was perfectly designed to do.
What is a home birth?
A home birth, or more accurately a “planned home birth”, is intentionally planning and preparing throughout your pregnancy to give birth in your own home with a midwife in attendance.
Home births are typically attended by a Certified Professional Midwife (CPM) who you will need to interview and choose early in your pregnancy. She will provide all of your prenatal care and help you prepare for birth.
A home birth requires that you play a very active role in decisions regarding your care and birth experience. You will also be responsible for preparing your home and birth space, gathering supplies, and assembling any other parts of your birth team.
What are the pros of home birth compared to a birth center?
While it’s true that giving birth in a birth center or at home are both wonderful ways to achieve your goal of a natural birth, there are some pros that are unique to the home birth experience. This is why so many mommas who’ve birthed in a birth center in the past decide to plan a home birth for subsequent pregnancies.
Some of the amazing pros of home birth:
- You’ll experience the ultimate sense of control over your birth experience. You get to call all the shots, prepare the space, gather the supplies, and be involved in every step of the process along the way
- You will have one-on-one attention from your midwife throughout your entire labor and delivery because you’re the only one birthing in your home
- Your birth will be in a familiar and intimate environment that you’ve carefully curated and prepared for this special day
- You don’t have to think about any logistics regarding when to head to a birthing facility, traveling, or being away from home
- Your first moments with your new baby will be in your own home, in your bed
- Extremely low rates of C-section and medical interventions
- Very low rates of emergency hospital transfers (0-5%)
What are the cons of home birth compared to a birth center?
- Home birth is simply not as accepted by mainstream culture
- In the rare event of an emergency, a hospital transfer may be necessary
- You likely will be delivering with a CPM. CPMs are licensed and highly trained in childbirth, but are not technically medical professionals which is a perceived con for some mommas
- Like birth centers, some women are not able to have home births
- Home births are typically not covered by insurance
- Having to prepare your home, gather supplies and do much of the birth planning is a con for some women
How much does a home birth cost?
Giving birth at home means hiring your own midwife and purchasing any supplies necessary for birth. And unfortunately, most insurance plans in the US don’t currently cover home birth. However, don’t let this info get you down! Home birth is still a cheaper option than a hospital birth with insurance for many families.
The cost of home birth varies significantly depending on where you live, but in general, is between $2000-$4000. When you plan a home birth, you usually purchase a ‘package’ from your midwife that is a fixed price for all of your prenatal care, the birth, and postpartum care.
A few home birth stats:
- Hospital transfer for first time mommas having planned home birth can be as high as 40%, though research shows that between 0-5% of these transfers are considered “emergency”
- Significantly lower likelihood of induction compared to hospital births (1.5% vs. 30%)
- Significantly lower rates of C-section compared to hospital births (5% vs. 25%)
Home birth vs. Birth center: Questions to help you decide which is right for you
When it comes to choosing where to give birth, there is no right or wrong answer. Every woman’s preference will vary, and every birth and pregnancy is unique. The same momma might even birth in different locations for each of her babies!
That being said, Childbirth Connection did a systematic review of the best available research to determine what factors are most important for a positive birth experience:
- Having good support from care providers
- Having high-quality relationships with care providers
- Being involved in decision-making surrounding your care
- Having high expectations for your own birth experience, regardless of location
With these four key components to a satisfying birth, you’ll need to look within and talk with your partner to determine the best location for your birth.
Here are some questions to help you decide between a home birth or birth center:
- Will being in my own home put me at ease or cause unnecessary anxiety?
- Will laboring in a space that is not completely private cause me to tense up or feel anxious?
- How do I feel about preparing my own birthing space and gathering birth supplies?
- What does my partner think about the idea of home birth?
- Does the input of my family and friends matter to me when it comes to where I decide to give birth?
- Does the type of midwife at my birth matter to me?
- Have I made my own list of pros and cons for birth centers vs. home birth?
- How will I feel about being on my own pretty quickly after birth in my own home?
- Where is my home located in relation to the hospital? How far would the birth center be from the hospital?
- Would my birth center have an attending OB/GYN in the event of an emergency? Would this put me at greater ease?
- Are the birth centers nearest to me licensed or accredited?
- In which location will I feel the most empowered, comfortable and confident?
- Is this my first birth and does that affect my decision about where I want to birth?
- Check out our article, Is Home Birth Right For You? 11 Questions to Ask Yourself, for a further self-assessment
Now that you’ve done some self-reflection in regards to where you want to give birth, what steps can you take to explore both options? If you are truly on the fence between a home birth and a birth center my best advice is to pursue both possibilities!
Here are some things you can do:
- Read birth stories from home birth and birth center mommas
- Hop onto some local forums or Facebook groups of local “crunchy mommas” and find out what people are saying about local home birth midwives and birthing centers
- Do a little more research about home birth and birth centers to get educated on the two options
- Conduct some home birth midwife interviews to get an idea of what the process of home birth will be like from prenatal care up to delivery and beyond
- Schedule tours at birth centers near to you and have a consultation with one of the midwives on staff
Ready to decide, momma?
Now that you’ve had a chance to look at the pros and cons of home birth vs. birth center, and used these self-reflection questions to get your mind going, you’re much better prepared to make a choice.
At the end of the day, this is your birth, momma! So do what feels right to you. And remember, you can always change your mind as your pregnancy progresses if you have a sudden change of heart.
To get even more education on the topic of home birth and make the most informed decisions for your birth, be sure to check out our entire home birth section as well as the Natural Home Momma Pinterest Page for the best info out there!
