Choosing the right birth setting can be one of the most significant decisions for expecting mamas!
Growing up, I always admired my mom's choice to have all four of her children at home. Her experiences deeply influenced my perspective on childbirth.
However, when it came time to deliver my first child, I felt drawn to the intimacy of home birth, but my husband, Alexander, preferred the security and medical resources available in a hospital setting.
In this blog I want to talk about the pros and cons of both home and hospital births, diving into the emotional, practical, and medical factors that influence each choice, aiming to provide insight and support to other couples navigating this intimate decision!
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First Step: Research
Deciding between a home birth and a hospital birth requires thorough research and personal reflection. If you're considering a hospital birth, it's never too early to start researching the hospitals in your vicinity (and covered by your insurance if you have it).
Look into their maternity units, specifically examining the availability of midwifery-led units, if you desire a setting that supports a more natural birth experience within a medical environment.
Reviews and ratings from other parents can provide insight into the quality of care, cleanliness, and overall birth experiences provided by these institutions. Additionally, many hospitals offer tours of their maternity wards, which can be incredibly helpful in making your decision. For my hospital birth, we interviewed two different midwifery units. Our second interview was definitely the winner, but I'm glad that I started with options.
On the other hand, if you're leaning towards home birth, I suggest starting by researching and interviewing midwives who specialize in home birth within your area.
Look for certified and experienced professionals with excellent reviews and a good track record. Talking to other moms who have had home births can also offer valuable insights and firsthand accounts of their experiences. They can provide details about the benefits and challenges, helping you set realistic expectations and prepare adequately. I think we personally interviewed about five midwives.
The difference between working with a midwife for a home birth and a hospital birth is that you'll be working solely with that midwife, so you definitely want to like them! On top of that, other considerations could be insurance coverage, cost, etc., which might look different for a hospital birth that is typically recognized and covered by a lot of insurance.
I found out I was pregnant with my second at four weeks, and it took us 16 weeks to solidify our midwife care and homebirth plan. Whether you choose a hospital or home birth, the key is to ensure that the environment and the healthcare professionals align with your birth plan, comfort level, and medical needs. Definitely spend as much time as necessary to get the team around you that you want!
Prenatal Appointments
Appointments with an OB/GYN versus a midwife often differ significantly in style, duration, and the nature of care provided.
Typically, appointments with an OB/GYN are more medically focused and may be shorter, usually lasting about 15 to 20 minutes. These sessions often concentrate on the clinical aspects of pregnancy, monitoring the physical health of the mother and the fetus through medical tests and screenings.
One difference I noticed is midwife appointments tend to be longer, often lasting about 60 minutes, allowing for a more holistic and personalized approach to prenatal care.
Midwives usually spend more time discussing the mother's emotional well-being, offering nutritional advice, and preparing the mother for the labor and delivery process. They often provide more in-depth, individualized advice and build a nurturing relationship, encouraging mothers to discuss their fears, preferences, and expectations.
This approach can lead to a more comprehensive care experience that covers both the physical and emotional aspects of pregnancy and childbirth.
Since we had midwives for both of my births, with a hospital birth and a homebirth, my prenatal appointments were in-depth, more personalized, and holistic-driven. I NEVER felt rushed through my appointment. When we saw the midwife unit in the hospital, I will say that we did have to wait in a waiting room like we would a typical appointment, but when we saw our individual midwife for my home birth, we never waited! It was GREAT. Also, Addy was able to get involved in a lot of my prenatal appointments with Dax, which was SO special.
Preparing Your Birth Plan
Preparing a birth plan for a hospital birth versus a home birth involves considering different factors and environments, each with its unique protocols and possibilities.
For a hospital birth, your birth plan should detail your preferences within the context of the hospital's policies. It’s important to include your wishes regarding pain relief options, such as epidurals or natural pain management techniques, the use of interventions like labor induction or continuous fetal monitoring, and your preferences for handling different labor scenarios.
Additionally, you might specify who you want present during delivery and your plans for immediate postpartum care, such as skin-to-skin contact and breastfeeding initiation. Researching the hospital’s standard practices will help align your expectations and incorporate any necessary compromises in your plan.
Another critical part of a hospital birth plan is making sure your team is aware of what interventions you will want for you newborn, following birth - like vaccinations, eye ointment, vitamin k, etc.
On the other hand, preparing a birth plan for a home birth often allows for greater flexibility and personalization.
This plan should detail the setup of your home to create a comfortable, safe birthing environment, your preferences for pain management with fewer medical interventions available, and the roles of everyone present, including the midwife, a doula, and family members. It is crucial to outline a clear transfer plan to a hospital in case of emergencies.
Home birth plans often emphasize creating a calm atmosphere, so you might include preferences for lighting, music, and the use of water pools for labor. Additionally, discussing post-birth procedures in advance, such as handling the placenta and newborn examinations at home, is essential. In both scenarios, the key is open communication with your healthcare provider to ensure that your birth plan respects your wishes while preparing you for any unforeseen changes.
For me, I wanted to have a low intervention, natural labor for both of my births (and I did)! Obviously, an epidural wasn't an option for my home birth, but I also considered what pain relief options I wanted in both situations. This included the role of my husband and doula, midwife, water, essential oils, etc.
For both of my births, I've used this Birth Plan Template to create the birth plan that reflected the birth that I wanted and desired! You can consider all the options for pain relief, monitoring, procedures before, during, and after birth, options for care for you and baby postpartum and SO much more. This template has been INCREDIBLY helpful for me and I hope it is for you too!
Labor
Laboring at home for a home birth versus in a hospital setting presents distinct experiences influenced by the environment and the approach to care. Laboring in a hospital involves several logistical and procedural steps that can add layers of stress and discomfort - it did for me, even though I was admitted into the midwife unit.
Upon arrival at the hospital, you will typically go through a triage process to assess your labor stage, which might include regular checks for dilation and fetal monitoring. This can be INCREDIBLY uncomfortable if you are in active labor. While I was in labor with Addy, I was in full-blown contractions, and they were asking me to lay on my back so they could check my dilation. I almost couldn't answer when they asked because of how active my contractions were.
When the midwife looked, she saw Addy's hair! There was honestly no need for the check; I knew I was incredibly close to pushing.
It's important to note that the very act of traveling to the hospital while in labor can intensify discomfort and anxiety, potentially prolonging the labor process.
In my first labor, by the time we decided to get into the car to travel to the hospital, we had to drive 45 MINUTES. Laboring in the car was SO uncomfortable, and when we arrived at the hospital, we had to park and wait to be rung in (and THEN go through the whole triage process)! Honestly, this was probably one of the worst parts of the hospital birth for me.
Also, hospitals operate on protocols that can lead to more frequent interventions and less personal autonomy. This was not a problem for me, thankfully, as I had a very clear birth plan and a doula and husband who advocated for me. Both of these aspects allowed me to feel confident while laboring at the hospital.
I also knew ahead of time (because of our initial interviews) what these protocols were and what interventions were "routine." With the help of my doula and husband, I had a very relaxed atmosphere that I felt very in control of in order to have a beautiful birth with my daughter.
In contrast, the labor process tends to be more relaxed and less medically regimented in a home birth scenario.
One of the significant advantages is the elimination of the need to travel during labor, which, as I mentioned, sucked. Instead of navigating to the hospital, dealing with traffic, and the potential discomfort of moving while experiencing contractions, you remain in a familiar, comforting environment.
I was able to labor in my bedroom, with my husband (and daughter) supporting me. I didn't have to stress about when contractions were picking up pace, if I had bags packed, etc.
Home births typically involve fewer intrusive procedures; for instance, dilation checks are done less frequently, if at all, respecting the natural pacing of your body. This setup tends to reduce stress and promote a calmer birthing experience.
My midwife did not check me at all during my labor with Dax - we just followed my body's lead! Your midwife comes to you equipped to provide personalized care, which allows for a more intimate and less clinical/rigid experience.
Birthing at home also allows you to move freely in your own space, eat and drink as you wish, and adjust your surroundings to suit your comfort needs, all of which can lead to a more positive labor and delivery experience!
Golden Hour
The "golden hour" after birth is a critical period for both mother and baby to promote bonding, initiate breastfeeding, and establish a connection. The environment in which this hour is spent can significantly influence the experience, and there are stark contrasts between having this time in a hospital setting versus at home.
In a hospital, the golden hour can sometimes be interrupted by medical procedures and the environment's disruptions. For instance, after delivery, there may be a need to move from the labor room to a postpartum room, which can disrupt the initial moments of bonding. Hospitals, while equipped to offer medical care, often have protocols that can delay immediate and uninterrupted contact, such as weighing, measuring, and bathing your baby, which might be prioritized before skin-to-skin contact.
The presence of various medical personnel coming in and out of the room can make the setting feel less private and serene.
If you want this time to be prioritized in your hospital birth, it definitely can be! Just make sure to include it in your birth plan and have your husband and/or doula advocate for you to get this time (as long as you and baby are healthy post-delivery).
A home birth allows for an undisturbed golden hour (if you and baby are healthy, of course), where you can enjoy immediate and continuous contact with your newborn in the comfort and privacy of your own home.
After a home delivery, there is no need to move locations; you can nestle into her own bed or remain in a birthing tub as long as you feel comfortable. This flexibility supports such a peaceful atmosphere and really helps with establishing an immediate bond without the stress of being handled or moved. In the home setting, interventions are minimal, and procedures such as weighing the baby can typically wait, emphasizing the importance of those first undisturbed moments for breastfeeding and bonding!
This was one of the BEST parts of my home birth. Getting right into my own bed felt SO good and comforting - I can't describe it!
My midwives stayed at my house for about 3 hours post-birth. They were very hands-off but did ensure I was well taken care of and eventually performed the necessary procedures like weighing Dax.
Overall, the afterbirth experience for both of my births was pretty night and day in differences. I got the "golden hour" with both. Still, my hospital birth was filled with pressure to deliver my placenta (pitocin and eventual forceful removal), poking and prodding of both Addy and me, and a fair rush to move from the labor room to a postpartum room.
After my homebirth, we delivered my placenta when I felt the urge to, the midwife did not touch me or Dax until I wanted to leave the tub and move to my bed and all procedures waited until I was ready for them!
The First Night
The first night after giving birth is an unforgettable experience, filled with a mix of emotions and physical challenges. The setting in which this occurs—whether in a hospital or at home—can significantly influence the nature of this initial night with a newborn.
In a hospital setting, the first night after birth is often FILLED with frequent interruptions. Nurses may come in at various hours to check on the health of you and your baby, administer medications, or assist with breastfeeding. The environment can be noisy, with sounds from medical equipment, other patients, and hospital announcements contributing to a less restful atmosphere. While the availability of medical care and support staff can provide reassurance, the clinical setting can sometimes feel impersonal, overwhelming, and honestly annoying.
The first night at home after a home birth offers a VERY different experience.
At home, you and your family can enjoy privacy and continuity in your surroundings. After the birth, you can move freely within your own space, like transitioning from a birthing pool to your own bed at your leisure.
The comfort of familiar surroundings can significantly ease the physical recovery process and foster a calming environment for both you and your newborn. Without the constant interruptions typical in a hospital, your family can settle into your new routine more naturally, allowing for more restful sleep and intimate bonding time.
Your midwife or doula might still be available for support, but their interventions are usually less intrusive and tailored to provide a gentle transition for the newborn into the world.
For me, this was such a HUGE difference. I remember my first night in the hospital being ROUGH - I cried about wanting to just go home. I couldn't get any sleep with all the nurses and doctors coming in. I was exhausted from birth and could not get sufficient sleep due to all the interruptions and, honestly, just the super unfamiliar environment.
With Dax, after my home birth, once the midwives left, we had the entire first day and night alone as a family, and we could sleep when we needed to, were uninterrupted in breastfeeding, etc. It was SO MUCH MORE relaxing. It definitely helped that Dax was my second as I already had an idea of what to expect in feeding and caring for a newborn, so I did not have any nerves being alone that first day & night.
Get Prepared!
My New Mom Bundle is your ultimate resource as you prepare for your little one - whether it's your first, second, or third! It's packed with comprehensive guides and detailed PDFs, covering everything you need to know, from prenatal care to postpartum recovery.
Whether you're preparing your baby cart, organizing your diaper bag, deciding between a home and hospital birth, and SO much more, my checklists and guides have you covered! I have personally used every single one of these checklists.
The bundle includes valuable insights and practical tips to ensure you're fully prepared for every aspect of motherhood! Embrace this exciting journey with confidence, knowing you have the best tools at your fingertips to navigate the wonderful world of being a new mom.
Important Considerations
As I'm sure you can tell from everything I've already discussed, I definitely lean towards having a home birth. For me, it was a much better experience overall, from pregnancy to postpartum. But I still LOVED my first birth with my daughter in the hospital. I was able to have the birth I wanted in both scenarios; they just looked and felt different overall.
Choosing between a hospital birth and a home birth is a deeply personal decision that should align with your health needs, personal beliefs, and comfort level. Each option offers its own set of benefits and considerations that must be weighed carefully.
Hospital births provide the reassurance of immediate medical intervention and advanced technological support, which can be crucial for those with high-risk pregnancies or for those who find comfort in the presence of medical professionals and emergency services.
On the other hand, home birth might appeal more to those seeking a natural birth experience in a familiar and comfortable environment, where hospital protocols do not dictate the pace of labor, and the presence of loved ones can be more freely accommodated.
Ultimately, the decision should be made based on a thorough understanding of your own health, the risks involved, and the setting in which you will feel most supported and secure. It is essential to consult with healthcare professionals, discuss with your partner, and possibly speak with other mothers who have experienced both scenarios. Consider all factors, from the practicalities of travel and hospital policies to the desired atmosphere and support system you envision for your labor and delivery.
Remember, the choice of where to give birth should empower you and reflect your wishes for one of the most significant experiences of your life. By making an informed decision, you ensure that you are setting the stage for a birth experience that resonates with your personal philosophy and provides the best care for you and your baby!
I wish you nothing but the best in your pregnancy and birth, no matter what you choose.
Always,
Jess
L E T ' S B E F R I E N D S!
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