Choosing Where To Deliver - Pregnancy

In general, your choice of where you deliver will be linked to your care provider. The majority of physicians take care of women in a hospital setting, where most birth in the US take place. Midwives also take care of women in a hospital setting, although they also deliver babies in birthing center.

Hospital birth

There are three potential advantages to choosing deliver in a hospital. First, if you are among the 30-40 percent of women over 35 who require a cesarean delivery, there will be no need for you to be moved from home or the birthing center. Although most cesarean deliveries are not urgent, in which case the delay will not cause you or your baby any harm, in an obstetric emergencies, time can be of the essence. The second advantage is that you will have more pain control options. Although many first time mothers wish to avoid epidural analgesia, you may not know what type of pain relief you want until you are actually in labor. If you are highly motivate to avoid an epidural analgesia, freestanding birthing centers and home birth are geared toward supporting you with out pain medicine. A third advantage is that a hospital birth may be safer if you have significant medical problems such as diabetes or blood pressure problems, which may affect you or your baby. It is also safest to deliver in a hospital if you've' had a cesarean section previously, because of the small risk of the uterus rupturing.

Birthing center or home birth

If you are having a normal, healthy pregnancy, the risk to you and your baby of delivering in an alternative setting is low. For women who have strong preferences about the use of oxytocin or continuous fetal monitoring delivery at a birthing center may increase their chances of avoiding these interventions, In addition, because epidural analgesia is not usually available you are likely to receive more intensive labor support for your pain. While some believe that delivering in a frec standing birthing center will reduce your likelihood of a cesarean delivery or episiotomy, your care giver's practice style is probably a more important determinant than where you deliver.

Getting The Most From Your Prenatal Care

The most important principle in choosing a care provider is to find someone you feel comfortable with. Ask questions early on about things that are important to you for example, the rates of episiotomy, cesarean delivery, and forceps or vacuum delivery. When thinking about your care giver's cesarean delivery rate, be aware that interpreting cesarean delivery rates is very complicated, even for statistical experts. Physicians who care for higher risk patients are likely to have very high cesarean delivery rates, which are explained by the high· risk nature of their patient population. However, in low-risk patients, recent studies suggest that either too high or too low cesarean delivery rates may indicate a problem.

Your care provider's philosophy about pain control in labor is also important. Unless you share his or her view, avoid a care provider who has strong feelings about what type of pain control you should select in labor.

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