Birthing centers and home births: the basics

Changes to hospital protocols in the wake of COVID-19 and general safety concerns related to the pandemic have widened the conversation around birth options. If you are pregnant or even planning a pregnancy, you are likely considering more possibilities than you were before. Birth centers and home births are receiving a huge increase in attention and consideration by couples. To help you to plan the most empowering birth experience we are giving a breakdown of the basics of what each offers to the labor experience, why each option may be right for you, and how to move forward with your research.

What is a birthing center? 

A freestanding birthing center is designed around providing a less-clinical setting that feels more like having an at-home experience. One can simply look at a room in such a center to see the difference between this option and a hospital. A typical room in a birth center will be spacious and include a queen or double bed, jacuzzi tub, cozy furniture, a television, and possibly a kitchen.

Centers are licensed by state medical departments. Births are supervised by a licensed midwife who is “backed-up” by an OB. If a medical intervention becomes necessary mothers are transferred to a hospital. A 2013 study by the Journal of Midwifery and Woman’s Health showed a rate of 1% of birth center labors not ending with the baby delivered at the center.

In short, the primary difference between a hospital and a birthing center is presumably greater comfort along with the avoidance of interventions. This includes separation of mother and healthy baby, eye drops, medication offerings, inductions, immediate cord-cutting, fetal monitoring, limiting the number of people to witness the birth, limiting what food the laboring mother can consume, and time requirements for staying at the hospital after your baby arrives. An emphasis is also put on the autonomy of the delivering woman and couple.

Why should I consider a birthing center? 

Birthing centers are a great option if your pregnancy is considered low-risk and your birth preferences lean heavily toward having an unmedicated experience. Most birth centers don’t provide epidurals but specialize in other pain relief options. Hypnobirthing, massage, and hydrotherapy are some techniques that may be available. Many throughout the country also offer nitrous oxide.

How do I find the right birthing center for me? 

If you are interested in using a birth center, start by asking for referrals from your doctor or parent groups. Then, find other local options to compare by visiting the American Association of Birth Centers. 

What is a home birth? 

Home birth is a labor and delivery experience that takes place entirely in a woman’s home. It is often supervised by a licensed midwife with the support of a partner, parent, or doula. Home birth has grown in popularity over the past decades as more information has been made available about a woman’s ability to deliver.

Why should I consider a home birth? 

If your pregnancy is considered low risk and your preferences include a non-medicated birth, laboring at home may be an option to consider. Some families are also selecting home during the pandemic as it limits exposure of the mother, baby, and birth team.

Is it safe? What if something happens? 

Most home births are supervised by a licensed midwife (LM) who works closely with you throughout your entire pregnancy. LMs arrive equipped with knowledge and experience in all types of labors but also with oxygen, IVs, sterilization supplies, ultrasonic stethoscopes, and other medical equipment. In the event that a medical intervention is required, a woman will be transferred to a hospital.

How do I plan for a home birth? 

The first step in preparing for a home birth is to find a midwife to work with. As with locating a birth center, we recommend first asking for referrals from those you know and trust. Then, select others to consult with through registries such as the American College of Nurse-Midwives. Local searches may return more results depending on the area. Once you have a shortlist of providers, meet with each before making a final decision.

More resources for considering a birth center or home birth:

A Doula’s Perspective on Homebirth 

Hypnobirthing for Pregnancy, Delivery, and Postpartum 

The Birth Hour: Home Birth Stories 

Behind the Scenes at a Birthing Center