Choosing a Place of Birth

Hospital? Home? Birth Center? Get the rundown on the pros and cons of each, and decide what’s right for you.

Women have babies safely in all kinds of settings. What turns out to be the right choice for one family may not be right for another. Which choice is the right one for you? Here are some of the main pros and cons for each setting to help you decide.

Keep in mind that each hospital, birth center, doctor, and midwife will have different practices and approaches. To find out what the usual practice is, and what your options are, at the place of birth you’re considering, ask! See our pages on choosing a caregiver and questions to ask your caregiver. Your doula can help you with all of this!

Hospital Positive	Hospital Negative
Immediate access to medical care for mother and baby in case of emergency Immediate access to drugs for pain relief The mother may feel safer in a hospital Costs most likely to be covered by insurance	More likely to have routine interventions during labor and birth Increased risk of mother or baby picking up an infection The mother may feel anxious in a hospital environment
Birth Center Positive	Birth Center Negative
May be closely affiliated with a hospital that can offer very fast access to medical care for mother and baby in case of emergency (this varies) Easy access to drugs for pain relief May have a more “homey,” less clinical atmosphere than a hospital The mother may feel safer at a birth center	Some birth centers may not offer access to all forms of medical pain relief Some birth centers may have high rates of routine intervention, similar to many hospitals May not be appropriate for high-risk conditions Costs may not be covered by insurance
Home Positive	Home Negative
Medically proven to be as safe or safer than birth in hospital, for most women The mother is familiar with her environment and has complete privacy and control The mother may feel safer at home No need to travel in labor or after the birth Lowest risk of infection Lowest risk of routine interventions	Birth attendants have to travel to you Limited access to drugs for labor Mother or other family members may feel anxious about home birth May not be appropriate for high-risk conditions Mother must travel in the event of serious complications Costs may not be covered by insurance

What About Limited Options?

It may be that the area you live in does not provide all the options we talk about here. Perhaps there are no birthing centers, or only one hospital. Perhaps your insurance only covers certain practitioners.

Having limited choices can make it more challenging for you. Firstly, do your own research. Just because someone else tells you that you would be considered high risk for a birthing center, or that homebirth is not allowed in your area, this is not necessarily the case. If there is a health department that covers your region, they should be able to tell you what is allowed and what is not. If there is a birthing center near you, the best way to find out what their policies are is to call them and ask them directly.

If you really are limited in your choices, you will need to decide how important the place of birth is for you. Sometimes women choose to have their baby at home rather than go to a hospital where they will not know their doctor, or where active management and high rates of intervention are the norm.

You may be able to negotiate with your caregiver to have personalized care that s right for you. You can find out which policies are fixed and which are more flexible by asking the right questions. Ultimately, you always have the right to refuse any treatment - however, labor is not the best time to be negotiating on this!

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