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Birthplace Options – Understanding the Pros and Cons
December 21, 2016 8:00 am | by

As a Doula, one question I am asked repeatedly is, “what are my birthplace options?”. Many of my clients are first time parents, but there are some who have given birth before and want to know what choices they have.

Birthplace Options

There are pros and cons to all places for birth. Regardless where you choose to give birth, it is important to be aware of these pros and cons so you can make an informed and educated decision.

Hospital Birth

This is the most common place for people to give birth in the United States. OBGYNs and CNMs (Certified Nurse Midwives) attend births at hospitals.


  • Immediate access to surgical care for birth.
  • Constant monitoring of the birthing person and baby.
  • Access to pain medications.
  • Nurse care to assist with immediate postpartum.
  • Possible access to lactation support.
  • Food is provided by hospital staff.
  • Access to oxygen for birthing person and baby.
  • Access to Pitocin and other drugs used to control hemorrhage.
  • Insurance typically covers hospital birth completely.


  • Driving to the hospital in labor.
  • Hospital protocols may not give options for eating and drinking during labor.
  • Necessary IV line placed and constant or intermittent monitoring.
  • Lack of ability to move outside of the birthing room.
  • Possible lack of shower or tub.
  • Staff may not be supportive of unmedicated birth.
  • Hospital or doctor practice protocols may not support unmedicated birth.
  • Increased risk of interventions such as, AROM (artificial rupture of membranes), vaginal exams, IUPC (intrauterine pressure catheter), Internal Fetal Monitor, enema, shaving, betadine wash, and cesarean birth are just a few.(1)
  • You’ll need to bring any of the personal items you want in delivery with you. Pack your bag!

Birth Center

There are several types of Birth Centers in the United States. The two most commonly seen are Free Standing Birth Centers; a birth center that is not located near or on hospital grounds, and a Hospital or OBGYN Birth Center; one that is located on the hospital campus, in the hospital, or in a doctor’s office adjacent to the hospital.


  • Ability to move, eat, and drink during labor.
  • Substantially fewer interventions.
  • Access to birthing tubs.
  • Birthing rooms look more like bedrooms and are very comfortable.
  • Encouragement to stay home as long as possible.
  • Intermittent fetal monitoring with doppler or fetoscope.
  • Access to evidence-based care.
  • No routine IV placement.
  • Access to oxygen for birthing person and baby.
  • Access to Pitocin and other drugs used to control hemorrhage.
  • Discharged within 12 hours of baby’s birth. This varies depending on the birth center. Most discharge 4-8 hours after birth.
  • Very low intervention rate.


  • No access to emergency surgery.
  • No access to pain medication except lidocaine for suturing tears.
  • Necessary to bring your own food and drinks.
  • Needing to drive somewhere during labor.
  • If transfer to hospital is needed, an ambulance ride or wheelchair ride across the street or to a different part of the hospital will be needed.
  • Insurance may not cover birth center services.

Home Birth

This is an option for those who are a low risk during pregnancy. Home births are attended by Certified Professional Midwives CPM, Certified Lay Midwives CLM, Direct Entry Midwives DEM, and in some states, Certified Nurse Midwives CNMs.


  • Midwifery care is typically more in-depth than that of an OB. They take more time with clients and get to know the whole family. It is a more holistic approach to maternity care.
  • No restrictions on movement, eating, drinking, or laboring in water.
  • More autonomy in birth decisions.
  • Those using midwifery care receive education from their midwives and are often required to take childbirth, breastfeeding, and newborn care classes.
  • Not needing to leave during labor.
  • Ability to labor in your home, surrounded by your smells and comforts.
  • Access to oxygen for birthing person and baby.
  • Access to Pitocin and other drugs used to control hemorrhage.
  • Intermittent monitoring with doppler or fetoscope.
  • Access to evidence-based care.
  • Midwives clean everything up post birth.
  • Very low intervention rate.
  • Recovery in your own home.


  • No access to emergency surgery.
  • No access to pain medications, except lidocaine for suturing tears.
  • Partner will need to do uterine massage after midwives leave.
  • If an emergency transfer is necessary, it will be done via ambulance.
  • Insurance may not pay for home birth services.

As is evidenced, there are pros and cons for whatever birthplace you choose. However, if you are low risk and want an unmedicated birth, a birth center or home birth may be the best option for you.

References: 1. Evidenced Based Birth, Rebecca Dekker,

Do you have a question for the doula that you’d like her to consider answering in a future column? Leave it in a comment below or email

About the Author

Kim is a birth and postpartum doula in Austin, Texas. She is the Mom to 6 children and has experienced both cesarean birth and home birth. She is a champion for VBAC's and postpartum support. In her free time (ha!) she likes to knit, sew, read, write, and take long walks with her podcasts. You can find her on Instagram at @kimborchert.


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