When You Have a Choice – Homebirth or Birth Center?

November 1, 2018

If you have a choice of birthing at a birth center or at home but are having a hard time deciding, this list of questions may help you and your partner decide what is right for your family. Where you live is likely a factor, and both of these options may not be available to you depending on your state laws and insurance coverage.


Birthing in a Birth Center

1. Do they charge more, or less, to birth there?

This can go either way. Discounts are sometimes given if a couple is willing to come to the birth center, but some midwives charge more money (even over $1000) to birth at the birth center.

2. How long will you be allowed/encouraged to stay at the birth center? Under what conditions might you stay longer? Who is watching after mom and baby in the immediate postpartum period?

It’s pretty typical to be out of the birth center within 3-6 hours. Are you OK with that? Does the midwife stay with you, or someone else? What is their training and expertise?

3. Who and where is their emergency backup?

Often, birth centers are located near their emergency backup, but not always. You need to ask. If you need to transfer, will your insurance cover their backup hospital and/or care provider? It’s not unheard of for couples to pay for their birth twice.

4. Do you have your own space to labor? What if someone else is in labor at the same time? What about your family? Will they be sharing space?

How do you feel about the possibility of sharing space, even if you are in separate rooms? Will you feel self-conscious if you are vocal? Do you each have your own bathroom, too? A lot of women like to labor at length in the bathroom…

5. Speaking of family… Are siblings welcome? Or just tolerated?

If you are wanting your other children at your birth, take a Birth Boot Camp Sibling Birth Prep class, or even just pick up a workbook. You won’t regret it. Has your child(ren) met the midwife and toured the facilities with you? If not, make sure that happens before the big day.

Birthing at Home

Many of the same questions apply, but there are some other things to consider.

1. If an emergency were to arise, where is the closest hospital? Are they friendly towards homebirthers and your midwife? How does your midwife feel towards them? Is it her usual backup? Is she familiar with their protocols, or will you be met with uncertainty and hostility?

Under normal circumstances and great preparation, there is likely no need to transfer, but the fear of the unknown can play into your emotional relaxation. Knowing the answers to these questions is important.

2. Who does the cleanup?

Some midwives clean everything up, down to draining the tub and putting fresh sheets on the bed, but other midwives do nothing. This is a good thing to know so there aren’t angry feelings because of unmet expectations.

3. If your labor is on the long side, does your midwife have space to rest? Are you feeding her meals and snacks?

If you are birthing at the birth center, she will have her own space and food. Discuss this with her at your home visit. You both will be glad you did.

4. Are you the type of person that is going to be stressed out about cleaning beforehand? Is this going to be how you spend your early labor – cleaning? If things aren’t cleaned up, are you going to have a hard time relaxing with “visitors” in your house?

You know yourself better than anyone. This may become an issue if labor comes on fast and furious and there is no time to straighten up. Once the baby comes, mom may be trying to clean before the midwives are out the door, instead of bonding with her baby. Will this be a stressor you can’t ignore?

5. This isn’t really a question, but more of a comment. Many people (especially dads) take comfort in driving somewhere. Truth is, generally, in a home birth, the midwife is just bringing everything to you.

In most cases, there really isn’t much difference except those things listed here. They are important, however, and they should all be carefully and thoughtfully considered and answered.

Whether you are birthing at home or a birth center, consider taking the Birth Boot Camp class designed specifically for couples having an out-of-hospital birth. Click here for details.

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