Comparing Home Birth to
Hospital and Birth Center Birth
Compiled by Beth Overton.

The act of having a baby is a moment of great strength & passion. Where and how you choose to give birth can either enhance the life experience or diminish it. Please take advantage of this overview of the differences between home birth and hospital birth. While you read, remember that our so-called modern method of “legs-in-the-stirrups-up-on-a-table” birth in hospitals comes from a point in history when Louis XIV commanded that a “viewing table” be constructed so he could better see the birth of one of his mistress’s children. Of course since he was the king, it became the thing “au courant” to do among the elite and eventually made its way into the accepted norm.

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Advantages of Home Birth: Statistics show that home birth is as safe or safer than hospital birth for low-risk women with adequate prenatal care and a qualified attendant. At home, a woman can labor and birth in privacy and comfort of the familiar surroundings of her own home, surrounded by loved ones, in whatever positions and attire she finds most comfortable. The laboring woman maintains control over everything impacting her labor and birth. Meeting her needs is the only focus of all those present. Nothing is done without consent. Labor is allowed to progress normally, without interference and unnecessary interventions. Studies show that the risk of infection is reduced for both the mother and baby. During labor the woman is encouraged to eat, drink, walk, change position, make noise, shower, bathe, etc. Care-givers are invited guests in the birthing woman’s home. She can have anyone she desires present: family, friends, children, etc. Her care providers (midwife and birth assistant) do not go home because their shifts have ended. They also don’t take the day off because they planned something else or because it is a holiday. The birthing mother doesn’t have to worry about when to go to the hospital since her care providers come to her. Continuous one-on-one care is given by the midwife, providing ongoing assessment of the baby’s and mother’s condition throughout the birth process and postpartum period. Her care provider knows her well and she knows her care provider. They have established a trust relationship. Women are supported throughout the hard work of labor, and empowered to realize their magnificent potential from such a powerful life changing event. Bonding is enhanced and includes everyone who has contact with the baby, including relatives and neighbors. Breast feeding is facilitated by the baby remaining with the mother.	Disadvantages of Home Birth: Clients must assume a greater responsibility for their own health: physical, mental, and spiritual. This requires active ongoing participation in decision- making in all aspects of their care, and a willingness to accept the consequences of those choices and decisions. Since the hospital is currently the socially accepted location of birth, choosing otherwise may result in negative judgments and lack of support. Cesarean section, forceps deliveries and a neonatologist are not available at home. Transport to the hospital is necessary for these and other medical interventions. Personal arrangements must be made for postpartum care, such as meals, housekeeping, child care, etc. The cost of home birth may not be covered by the client’s insurance.
Advantages of a Hospital Birth: Many mothers feel safest laboring at a hospital. It is the safest environment for the mother at risk of medical complications during labor. It is the only option available should a cesarean be necessary. Immediate pediatric attention is available should the newborn need immediate medical care. It has round-the-clock help for the mother and baby.	Disadvantages of a Hospital Birth: The parents are not on “home ground” and do not have the same control. Hospitals can seem impersonal and intimidating. The father is less likely to be actively involved in a hospital setting, and may feel like an “outsider.” Some routine separation of the mother and baby is almost unavoidable. The birth is usually managed by experts trained in pathology, not normal births. The mother is at a significantly higher risk of having an unnecessary cesarean section. The risk of complications or infections caused by medical interference to the mother and baby is greater among mothers who deliver in hospitals rather than with the help of a qualified midwife in their own home. Less privacy is available. Most hospitals do not allow the mother much rest.
Advantages of a Birth Center Birth: The facility is usually only provided for pregnancy and birth events. In a birth center, pregnancy is considered a natural and healthy process. During pregnancy and birth women are encouraged to show responsibility for their own health care. It provides an alternative to parents not comfortable with home birth, yet who are not wanting to give birth in a hospital. It has many of the same advantages as home birth, such as greater parental control, non-interventive obstetrical care, freedom to eat and move during labor, and to give birth in any position, and to have family and friends attend the birth. It offers personalized care at a much lower cost than traditional hospitals. In most centers, parents can meet the entire staff prior to the birth. The rate of cesarean and forceps deliveries is less than hospitals. The discharge time after birth is normally measured in hours not days.	Disadvantages of a Birth Center Birth: Rigid screening criteria often eliminate healthy mothers (i.e., VBAC [Vaginal Birth After Cesarean], mothers over 35). The mother is still moved to the birth center during labor, and still labors away from the home environment. Many have rigid rules concerning transporting of the mother to the hospital (i.e., prolonged labor, ruptured membranes). There are usually no pediatricians on staff if the baby has special needs. The mother cannot remain at the birth center for a two or three day rest; discharge is usually within 4 to 24 hours after birth.

Compiled by Beth Overton. Used by permission.