Birthing at home versus in a birth center?

[KLM99]

I had my first at home and it was absolutely wonderful. I'm going through the process of deciding where to have my second (I have tons of time to decide, but would like schedule my first appointment in the coming weeks). We have a few great birth centers in the area, but I wondered - safety-wise, are birth centers really that different from homebirths? If I was concerned about needing to transport from a homebirth, would the transfer happen any more quickly in a birth center? Do they have additional supplies at the birth center that you wouldn't have at home? Thanks!

[dogmom327]

When I interviewed a local birth center (different city than now), I was surprised to find that they didn't have any extra equipment, etc. than the home birth MW. That decided it for me. Why get in the car and go someplace I might not be as comfortable when the whole set up could come to me?

[AlexisT]

The transfer might be quicker, depending on the BC and their arrangements.

FSBCs have logistical advantages for some women, but they don't have any great safety advantage per se. (Obviously, comparing individual BCs and midwives might result in a different conclusion.)

[Arwyn]

They'd only be safer if they were much closer to a hospital than you are (say, if your house was more than 30 minutes away from one, and they were less than 5). Other than that, nope. One could argue they're less safe (homebirth=no risk of car crash ), but there's nothing making a FSBC safer in general.

[*MamaJen*]

I've heard birth centers described as home births you have to drive to. Typically they have the same supplies that a midwife would carry. And the transfer likely wouldn't be notably faster.
Birth centers can be great options for people who have logistical problems giving birth at home, or who just want to be out of the house for birth. But typically I'd say home is easier.

[JennTheMomma]

I haven't gave birth at home, but I did use a birthing center, and I personally loved it. The bed was a lot more comfy then my bed . I think you should talk to the birthing center and take a tour. Birthing centers can be different from state to state, and even from town to town.

[meganmarie]

Its mostly about the logistics, as I understand it. We don't have any freestanding birth centers in NJ so I am jealous of you having more than one to consider! Anyway, my sis delivered in one outside Philadelphia in PA that is literally across the street from the hospital. In that scenario it made some sense to me - if you wanted the extra security of a quicker hospital transfer, that would be the case.

The only other advantage of the birth center vs. home would be having everything on hand - labor tubs, birth balls, waterproof pads on the mattress or whatever - not having to arrange for that stuff to be in your house. But that's kind of offset by having to get in the car during labor!

Don't know if this is good or bad, but the BC my sis used was staffed by a whole practice of midwives - you had prenatals at the BC with any one of them, and then one of them would be on call the day you went into labor. With a HB midwife you'd likely know she would be the one.

Some insurance may cover a birth center but not a homebirth? Not sure about this...but worth asking about.

[KLM99]

Thanks for all the input! I don't think any of the centers around here are much closer to a hospital so it sounds like safety-wise they might not be that different from a homebirth. It would make sense to have one connected to a hospital or something, but I don't think we have that option. Hm...I think I'll tour the birth centers just to see, but it sounds like it might be a homebirth versus hospital birth decision for me rather than homebirth v. birth center v. hospital. Makes my decision 1/3 easier anyway! Thanks again.

[Turquesa]

OP, I second and third everything posted here. I had a birth center birth for my first and am planning on a home birth for my second. Good luck with your decision!

Also, just a tinge off-topic . . .

Originally Posted by meganmarie

The only other advantage of the birth center vs. home would be having everything on hand - labor tubs, birth balls, waterproof pads on the mattress or whatever - not having to arrange for that stuff to be in your house. But that's kind of offset by having to get in the car during labor!

Dontcha love how we “birth junkies” get to sound like spoiled brats about this? I mean, here we are making our decisions—“Do I want to have my baby in the comfort of my home and avoid a treacherous car ride, or do I want access to the center’s birth balls and soaker tub?” All the while, most of the world is making their decisions—“If I don’t have my baby by week 39 like my OB wants, should I agree to the membrane sweep or go straight for the pitocin?”

If mainstream, low-risk, hospital-birthing mamas knew what a safe and wonderful alternative we’re all taking advantage of, hospitals might lose most of their low-risk maternity patients.

[Mamabeakley]

Birth centers that are right accross the street from a hospital tend to have higher transfer rates (not all do, I'm sure, but the ones near me do). Probably on the theory of "because it's there".

[dogmom327]

One more thought...sometimes birth centers are more likely to transfer you to the hospital for things that a HB MW would handle at home. This can be due to licensing requirements or increased scrutiny. I know where I used to live, the BC was much more likely to transfer for even the smallest things because the OB's in the area hated them and they were under a lot of scrutiny from the state.

[kathan12904]

Especially if you've already had a wonderful homebirth, why go someplace else to birth? Although I think birth centers are breaking ground in the battle to take back birth, I don't believe they are safer than home. The two most important factors that make home birth safer than hospital ie: being more comfortable in your "den" which leads to faster, easier labors and that your home is colonized with bacteria that your baby already has the antibodies for unlike hospitals where the bacteria is strange and extra potent/antibiotic resistant, are not present in birth center births. I definitely think a birth center is a safer place to birth than the hospital, but why leave your home which is perfect for it?

[callieollie]

I had both my kids at FSBS. I had great experiences, but very different ones. The first BC was across from a hospital and has a high transfer rate (I actually transferred due to exhaustion on my part). My second birth I chose to drive an hour to a different BC rather than have a homebirth because I hated my house! We were actually in the process of moving out of it and it was a small, cramped, not homey house that I was happy to leave! The BC had these AWESOME whirlpool tubs and comfy beds and I actually liked going there and enjoying everything they had to offer. It was almost like going to a fancy hotel on vacation to have a baby! That said, the drive was horrible (it was an hour drive and my labor was only 3 1/2 hours total so I felt like I spent most of the time packing the car and driving). Next time around I have the option of another FSBC that is only about 10 minutes from our new house or homebirthing with those same midwives or some other homebirth midwives that come highly recommended. I haven't decided what I'll do yet when that times comes.