Hospital, Birthing Center, Home Birth: What You Need to Know

Updated 19 Dec 2024

Counting down the days to your newborn’s arrival can be an exciting experience, and at the same time, a bit frightening, especially for new parents. One thing you can do to ease your anxiety is to think about the type of birth experience you want to have and explore the options available to you. Whether you give birth in the comfort of your home or with the convenience of modern medicine nearby is a very personal decision. 

These days, parents have several options when it comes to childbirth, but you may have to consider certain restrictions on your choices, including

• What your medical insurance will cover
• Where your healthcare provider practices
• Where you live and what facilities are nearby
• Whether your pregnancy is at high risk for complications

Let’s take a look at some different birthing options and consider which one may be best for you.

Hospital Birth: The Most Popular Choice In the US

In the United States, the vast majority (98.4%) of women give birth in hospitals. For those who have a high risk of medical complications or are attempting vaginal birth after a cesarean delivery (VBAC), a hospital is the safest – and perhaps only – birthing option. Hospital labor and delivery settings are more procedural-based and clinical and are monitored by multiple regulatory agencies. Fortunately, many hospitals now provide a variety of birthing options that make the birthing experience far more comfortable. 

What Happens During a Traditional Hospital Birth?

Traditionally, a hospital birth experience may have you laboring and delivering in one room, recovering in another, and then finally moving to a private or semi-private room. Your infant may stay in the hospital nursery and be brought to you for feedings. Every hospital has different policies and procedures in place so be sure to ask what you should expect.

These days, many hospitals have moved toward a model of family-centered maternity care (sometimes called “woman-centered care” or “patient-centered care”). According to the International Childbirth Education Association, this care model focuses on the following themes:

• Birth is a natural, healthy process for most women.
• Care should be individualized and respectful.
• Decision-making should be a collaborative effort between the pregnant person and their healthcare providers.
• Education should reflect current, evidence-based knowledge.
• Information should be shared freely between the pregnant person and each of her healthcare providers.
• Mothers and babies should stay together (rooming in).

Hospitals following this care model often offer soothingly decorated private rooms equipped for the entire labor, delivery, and recovery experience. Your support partner is allowed to stay with you for the entire process, and your newborn is allowed to room in as well.

Many hospitals also offer additional options that create a better overall birthing experience, including the following:

• Certified nurse midwives on staff
• Options for natural birth without medicated intervention
• Lactation consultants
• Childbirth classes
• Birthing stools, balls, tubs, and other birthing aids
• The choice to allow family and friends to be present during the birth

What to Think About When Considering a Hospital Birth

Tour the hospital well in advance of your due date to get a feel for the environment. Ask about their accommodations and policies. Begin thinking about what issues might help you feel at ease and what might feel uncomfortable.

• Ask about their episiotomy and C-section rates.
• Understand that while the facility will try to honor your preferences, your safety will be paramount in a hospital setting. This means your healthcare provider may recommend interventions you’d rather not have if they feel it is in the interest of your or your baby’s health.
• Ultimately, you’ll have to abide by the hospital’s policies and rules.
• Expect a lot of activity in your room as staff pops in and out to monitor you and your baby.

Birthing Centers

In the United States, 0.52 percent of women give birth in freestanding birthing centers. Birthing centers were developed by midwives, recreating a “home-like” childbirth experience, but with additional support staff and a more comprehensive range of supplies readily available. Birthing centers are designed to care for low-risk pregnancies, whereas hospitals are equipped to care for patients that have low- to high-risk pregnancies. Usually, a certified nurse midwife will deliver your baby. Birthing centers have transport agreements in place with a nearby hospital in case any emergencies arise during the labor or delivery process. Many offer childbirth classes and lactation support as well.

How Does a Birthing Center Differ From a Hospital?

Birthing centers can offer a more home-like experience where your needs and desires come first. You’ll have a private room with little to no limitations on what you can eat, drink, or wear. With fewer risk factors, birth centers also tend to have fewer visitor restrictions than hospitals. Many have birthing tubs that allow a laboring person to relax or have a water birth. Birthing centers also offer more holistic and alternative methods of pain intervention, whereas a hospital will have more pharmacological options.

What to Think About When Considering a Birthing Center

Attend the birthing center’s orientation so you can learn about their policies and procedures, as well as meet the staff. 

• Inquire about their emergency plan, which hospital they are affiliated with, and how far away it is.
• Inquire about the center’s hospital transfer rate and the circumstances that make transfers necessary.
• Learn about their backup physicians or obstetricians.
• Remember that anesthesia will be unavailable at a birth center.
• Look into the staff’s certifications and licensing.
• Ensure the facility is licensed (if your state requires it) and accredited by the Commission for the Accreditation of Birth Centers.
• A freestanding birth center is less likely to be covered by insurance than a hospital so verify your coverage beforehand.

Home Births

Fewer than 1 percent of women in the United States give birth at home. Most home births are planned, although about 15 percent are unplanned. A person may choose to give birth in their own home for several reasons:

• A wish to have the baby without medical intervention, such as pain medication, labor augmentation, labor induction, or fetal heart rate monitoring
• The desire for a more relaxed, home environment with family 
• Discontent with the hospital setting
• More freedom of choice throughout the labor and delivery experience
• Lack of transportation
• Less expense
• Religious or cultural reasons

Are Home Births As Safe As Hospital Births?

If you are interested in home birth, weigh the risks and benefits carefully. According to the American College of Obstetricians and Gynecologists (ACOG), while the overall risk is low, studies show that the risk of infant death is two times higher when giving birth at home. ACOG believes that hospitals and birthing centers are the safest settings for giving birth. However, many women have healthy babies at home.

What to Think About When Considering a Home Birth

If you’re considering a home birth, it’s critical to weigh the risks and benefits. While many women give birth at home with no complications, research suggests that planned home births are associated with a higher risk of infant death and seizures than planned hospital births. A number of factors may minimize the risks of these complications, including having assistance from a certified nurse midwife, access to a practicing obstetric doctor, and a plan for emergency transport to the nearest hospital.

The American College of Obstetricians and Gynecologists strongly advises against planned home birth in any of the following situations:

• Pregnancy with multiple babies
• Fetal malpresentation (the baby doesn't settle into a position that allows for a headfirst delivery)
• A prior C-section delivery

Bear in mind that potentially life-threatening problems can occur during labor and delivery with no warning. In those instances, the hospital transfer for you or your baby could delay care and endanger your life. Understand the risks and benefits of a home birth before you choose where to deliver.

The Bottom Line on Hospital Birth vs. Birthing Center vs. Home Birth

Only you can determine what's best for you and your newborn. Consult your healthcare provider, as well as experienced family and friends. Evaluate all the possibilities so you can select a comfortable, safe place to meet your new bundle of joy.