One of the most significant factors in determining how you give birth is  choosing the place to give birth

Where you give birth has a greater influence on your risk of having caesarean birth than your age, weight, or overall health. It can influence breastfeeding success. You often inadvertently choose your birthing place when you choose your pregnancy care provider, as you will likely birth where your provider practices.

Hospital births

Hospital birthing facilities vary widely. Some offer care provided by midwives as well as physicians. Most offer pain medications, epidural anesthesia and cesarean birth.

Birth centers

Birth centers can be on a hospital campus, or in a home-like facility where midwifery care is provided to healthy women not at risk for pregnancy or birth complications. Narcotics and epidurals aren’t available for pain management. People people who choose birth centers often do so for a more natural childbirth. Birth centers are often located close to hospitals should urgent care be needed. Home birth occurs in your own home perhaps with a midwife or other support people including doulas.

Ask about rates of procedures. Assess your risks with your provider about where they will support you during labor and birth:

What is the cesarean rate? The ideal rate for cesarean should be between 10-15%. The cesarean average in the U.S. is about 32%.

If you’re choosing an out-of-hospital birth, ask about their rate of transfer to hospital? Ask for the most common reasons women are transferred to the hospital, and how transfers are accomplished.

Ask about birth practices

Ask about movement in labor and birth. Research shows that when women are free to move during labor, they have shorter labors and lower rates of cesarean birth. In hospitals that require continuous fetal monitoring, you may be required to labor and birth in bed.

Can you eat and drink during labor? Some hospitals limit all laboring women to clear liquids or only ice chips. While this may be appropriate in high-risk pregnancies, for other labouring women, this can be physically and emotionally stressful. You need energy for the work of labor.

What coping options are available? Most hospitals offer epidural and IV narcotics; they may also have showers or birthing tubs, sterile water papules and nitrous oxide. Can you bring a yoga ball, aromatherapy, TENS units, or dim the lighting?

Ask about policies

What is the policy on visitors and doulas? Labor support to help you feel safe in a labor matters. Can your partner be there? Family members? Especially during pandemic, ask if you can bring your own doula for support.

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Paris Maloof-Bury, CNM, RNC-OB, IBCLC is a certified nurse-midwife and lactation consultant at Sutter Health in Davis, CA.

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