Comparing Birth Options: The Pros and Cons of Hospital, Birth Center and Home Births

Many women don’t think twice about giving birth in a hospital as it has been our society’s norm for the last decade. I didn’t even know I had other options when I had my first baby thirteen years ago. However, something shifted inside of me after my second hospital birth and I wanted to experience something different. I wanted a birth that I felt more in control of and empowered by.

I’ve now had two births at a hospital, two at a birth center, and two at home. I’ve had amazing experiences in every setting and firmly believe that having great support at any location is the key factor to a positive experience wherever the birth takes place. Having a doula present is a great source of additional support, no matter where or how you chose to give birth.

Hospital

I was 16 years old when I birthed my first baby, who I placed in an open adoption. Without a doubt, a hospital was the best choice for me at that time because I was dealing with so much emotionally. The nurses and my personal support system were beyond amazing and made me feel comfortable in every way. I loved my epidural birth the first time. However, during my next birth, while nearly identical in every way except for a different hospital and staff, the difference in my care led me to reconsider my options for future pregnancies.

Pros

  • Lots of extra supplies to bring home (blankets, pacifiers, pads, diapers, baby brush, etc.)

  • Quick access to medical care when needed

  • Available for most any type of birth you desire—from all-natural to VBAC or c-section

  • No cleanup after birth

  • Insurance covers more expenses

  • Pain medication is available if desired

  • Lactation consultants available on-call

  • Meals delivered to you three times a day

  • The amazing adjustable bed

  • Easier to restrict guests after birth so you can rest

  • Onsite access to pediatrician, hearing testing, etc. 

Cons

  • Sterile atmosphere can stall or affect laboring

  • You may not know the person catching your baby, and you might only see them for a few minutes

  • Different nurses rotating through your stay

  • Hospital food may not taste awesome

  • Medical intervention is often encouraged and can be hard to refuse

  • Nurses coming in and out, interrupting needed rest

  • Water birth not an option in most hospitals

  • Being attached to an IV during labor

  • No solid food allowed during labor at some hospitals

Birth Center

My midwife affectionately describes a birth center as being “Like a home birth— just not at your home.” A birth center was our personal stepping stone to home births in subsequent pregnancies. My first experience at a birth center was also my first experience of laboring on my own terms, following my body, and actually wanting to feel everything that was going on. I wanted to listen to my body and know what to do based on what it was saying, instead of having a doctor tell me what to do. The high I felt overcoming each contraction was unlike anything I felt with my epidural births! The change to midwifery care was also a game changer for me, as I felt like a friend instead of just a chart.

Pros

  • Homey environment is familiar since your prenatal visits are there as well

  • Water births are available

  • You know the person who will help catch your baby

  • Midwife care tends to be more personal, with longer prenatal visits and a constant presence during labor

  • You’re encouraged to eat and drink throughout labor

  • No uncomfortable IV or belly monitors during labor

  • Your birth plan is easily accommodated (pushing in different positions, immediate skin-to-skin contact, no eye ointment, etc.)

  • The staff sets up and cleans up

  • Large beds available for family bonding and snuggles

  • You can have a birth party if you want with friends and family to witness the birth, or you can choose an intimate, quiet birth

  • Easy to save your placenta for encapsulation

Cons

  • Excruciating car ride when in active labor

  • You interrupt your beauty rest a few hours after labor to go home

  • Insurance may not cover expenses, but it still can end up cheaper

  • May have to transport to hospital if an emergency arises (this happens on average around 4% of the time)

  • Women with high-risk pregnancies may not be able to give birth at a birthing center

Home Birth

Chosing a home birth was a natural progression for us after our amazing birth center experience. We figured if we could stay at home and use our same trusted midwife, why not? It ended up being cheaper than our birth center bills, and being able to stay home the entire time was a huge plus. For one baby, I birthed in a blow up birthing pool on my bedroom floor. For another, I birthed in my garden tub. I was able to give birth however I felt comfortable and have the exact people I wanted there—after all it was my house and my terms—with my midwife as a guide.

Pros

All the pros of the birth center pros plus:

  • Your own well-known birthing space 

  • No concern of birthing in the car on the way

  • Many supplies can be re-used for future babies

  • It’s enjoyable to freak out your neighbors while walking the streets at odd hours and stopping every few minutes to sway

  • No need to pack a bag

  • Crawl into your own bed and stay there for days

  • Often prenatal and postnatal visits are in your own home—perfect for the lazy person or homebody like me.

  • You can be as loud as you need in labor with no fear of disturbing others, or hearing other moms

Cons

  • The crazy look people give you when you tell them you’ll be birthing at home

  • Having to keep your home meticulously clean the last weeks of pregnancy, since you never know when guests and baby will arrive!

  • Insurance may not cover expenses—but you can file for reimbursement

  • Birth kit supplies and ultrasounds are an additional expense to the midwife’s services

  • For high risk pregnancies, home birth isn’t advised

  • If an emergency arises, transport to hospital will be needed

You do what’s best for you! These options are each worth exploring. Consider each possibility as you figure out what you truly want, then seek out the best provider and support people for your birth. Talking with other moms who have experienced birth in a particular setting or with providers can also be a great resource as you make your decision.

Leah became a mom at 19 years old and standing short at 4 foot 11, she is now a mother of almost 5 and a birth mother in an open adoption. Not letting age or size stop her, she's conquering her dreams while being surrounded with yogurt smeared walls and mountains of laundry. You can find more from Leah on her blog, The Grace Bond.

Related articles