Pregnancy: Prenatal Care and Tests (cont.)
Places to deliver your baby
Many women have strong views about where and how they'd like to deliver their
babies. In general, women can choose to deliver at a hospital, birth center, or
at home. You will need to contact your health insurance provider to find out
what options are available. Also, find out if the doctor or midwife you are
considering can deliver your baby in the place you want to give birth.
Hospitals are a good choice for women with health
problems, pregnancy complications, or those who are at risk for problems
during labor and delivery. Hospitals offer the most advanced medical
equipment and highly trained doctors for pregnant women and their babies. In
a hospital, doctors can do a cesarean delivery if you or your baby is in
danger during labor. Women can get
or many other pain relief options. Also, more and more hospitals now offer
on-site birth centers, which aim to offer a style of care similar to
standalone birth centers.
Questions to ask when choosing a hospital:
- Is it close to your home?
- Is a doctor who can give pain relief, such as an epidural, at the
hospital 24-hours a day?
- Do you like the feel of the labor and delivery rooms?
- Are private rooms available?
- How many support people can you invite into the room with you?
- Does it have a neonatal intensive care unit (NICU) in case of
serious problems with the baby?
- Can the baby stay in the room with you?
- Does the hospital have the staff and set-up to support
- Does it have an on-site birth center?
Birth or birthing centers give women a "homey"
environment in which to labor and give birth. They try to make labor and
delivery a natural and personal process by doing away with most high-tech
equipment and routine procedures. So, you will not automatically be hooked
up to an IV. Likewise, you won't have an electronic fetal monitor around
your belly the whole time. Instead, the midwife or nurse will check in on
your baby from time to time with a handheld machine. Once the baby is born,
all exams and care will occur in your room. Usually certified
nurse-midwives, not obstetricians, deliver babies at birth centers. Healthy
women who are at low risk for problems during pregnancy, labor, and delivery
may choose to deliver at a birth center.
Women can not receive epidurals at a birth center, although some pain
medicines may be available. If a cesarean delivery becomes necessary, women
must be moved to a hospital for the procedure. After delivery, babies with
problems can receive basic emergency care while being moved to a hospital.
Many birthing centers have showers or tubs in their rooms for laboring
women. They also tend to have comforts of home like large beds and rocking
chairs. In general, birth centers allow more people in the delivery room
than do hospitals.
Birth centers can be inside of hospitals, a part of a hospital or
completely separate facilities. If you want to deliver at a birth center,
make sure it meets the standards of the Accreditation Association for
Ambulatory Health Care, The Joint Commission, or the American Association of
Birth Centers. Accredited birth centers must have doctors who can work at a
nearby hospital in case of problems with the mom or baby. Also, make sure
the birth center has the staff and set-up to support.
Homebirth is an option for healthy pregnant women with
no risk factors for complications during pregnancy, labor or delivery. It is
also important women have a strong after-care support system at home. Some
certified nurse midwives and doctors will deliver babies at home. Many
health insurance companies do not cover the cost of care for homebirths. So
check with your plan if you'd like to deliver at home.
Homebirths are common in many countries in Europe. But in the United
States, planned homebirths are not supported by the American Congress of
Obstetricians and Gynecologists (ACOG). ACOG states that hospitals are the
safest place to deliver a baby. In case of an emergency, says ACOG, a
hospital's equipment and highly trained doctors can provide the best care
for a woman and her baby.
If you are thinking about a homebirth, you need to weigh the pros and
cons. The main advantage is that you will be able to experience labor and
delivery in the privacy and comfort of your own home. Since there will be no
routine medical procedures, you will have control of your experience.
The main disadvantage of a homebirth is that in case of a problem, you
and the baby will not have immediate hospital/medical care. It will have to
wait until you are transferred to the hospital. Plus, women who deliver at
home have no options for pain relief.
To ensure your safety and that of your baby, you must have a highly
trained and experienced midwife along with a fail-safe back-up plan. You
will need fast, reliable transportation to a hospital. If you live far away
from a hospital, homebirth may not be the best choice. Your midwife must be
experienced and have the necessary skills and supplies to start emergency
care for you and your baby if need be. Your midwife should also have access
to a doctor 24 hours a day.