Home birth vs. birth center

[sarahr]

So I'm not pregnant yet, so I know I'm planning way ahead, but I'd love some feedback.

The midwife group I'm planning on using does both home births and births at their birth center and I can't decide which one I want to do. The advantage of a home birth, of course, is that I don't need to go anywhere and that I could look into renting a birth tub. The advantage of the birth center is that the mess stays out of my house, I don't need to be responsible for preparing anything other than myself, and they have some resources I don't (like a big jacuzzi tub).

Anything I'm forgetting? Which would you choose?

[jennyfah]

Don't underestimate the luxury of not having to go anywhere when you're in labor! (Though I suppose it depends greatly on how far the birth center is from your home.) I have a friend who recently had a VBAC at a birth center 45 minutes from her house, and they made a rather intense and badly-timed drive in snowy weather when she was in transition. Not fun!

Also, most midwives I know will clean up nicely after the birth, so you and your DP should not have to worry about cleaning---some midwives even do the dishes and fold laundry. We used a fishy pool for our home water birth and it was great.

Best wishes,
Jen

[dogmom327]

Originally Posted by jennyfah

Don't underestimate the luxury of not having to go anywhere when you're in labor!

:

I think there's a significant psychological difference too. Being on my own turf meant I was comfortable. I know where my bathroom is, I know how my bed feels, etc. Also, there's something about knowing that all your birth attendants are guests in your house who could be asked to leave (not that I would of course) but I think that helps. I felt more in control which allowed me to relinquish some control when the time came.

Don't worry about the mess. Between the MW, DH and my best friend, I never saw the mess and I'm told it wasn't a big deal.

One more potential issue. At least when I looked at a birth center (in another state), their transfer rules were much more strict (so much higher chance of transfer) than if I birthed at home. Many birth centers around the country are under increased scrutiny and may not have as much flexibility. I don't know how that translates if your MW works for a BC too but it might be worth asking their transfer rates for HB vs. BC.

[MegBoz]

Originally Posted by dogmom327

I think there's a significant psychological difference too. Being on my own turf meant I was comfortable.
...I felt more in control

Exactly!! I had planned a hospital birth because the only FSBC in my area is nearly an hour drive away - the other direction from my work, so like 1.5 hour from work for prenatals. I didn't want to deal with that, plus my MWs & hospital actually are mother-friendly.

Anyway, I accidentally ended up all the way through transiton at home! Went much more quickly than I expected!! (Less than 5 hours since the first ctrx I ever felt.)

I cannot imagine the intensity of transition anywhere but home. Just, emotionally, the comfort of MY room, MY bed.

HB MWs are accostomed to cleaning up the mess, so I just wouldn't worry about that at all. I'd rent a tub & just sacrifice the jacuzzi jets. I'm going to plan an HB for whenever we conceive #2.

[fruitfulmomma]

Don't underestimate the luxury of not having to go anywhere when you're in labor!

I had a non-emergency transport to the hospital during my second labor and it was excruciating. Unless you plan on going in early labor and/or have other reasons for wanting the birth center this reason alone would make me think twice about it.

I really don't think it is all that messy. We use a waterproof liner (a cheap shower curtain) on the bed and a set of sheets I don't mind getting messy and then have lots of disposable pads around the birthing area. My last birth (3rd homebirth) was the messiest and all we had to do was change the sheets because my water didn't break until she was being born and it kind of exploded all over the midwife. But most of it went on the chux pads. So then we just had the sheets and some towels to wash. That was it.

I did love the tub in the hospital when my 3rd baby was born and I would love to have room for a birthing tub. (If I am still having babies when we build our house it will definitely have a tub big enough to birth in.) But I have dealt without it. The shower works pretty well too.

[pixiepunk]

i had my first at a birth center, the other two at home. giving birth at the birth center was like giving birth at someone else's house comfortable and nice, but not my familiar surroundings, not my comfy pillow, etc. and with 3 birthing suites it was an absolute miracle that we were there by ourselves - most people will have to deal with the sights and sounds of others who are laboring just like you would in a hospital, if someone gets there first you might not even get the suite you want (assuming there are multiple suits - most birth centers have at least 2).

and yeah, definitely don't underestimate the luxury of being able to make everyone come to you! the midwives clean up all the mess, i was never aware of any of it. and when i was done i was in my own bed with my family and i didn't have to go anywhere. at the birth center they wanted me out in 6-8 hours - though they let me stay 12 because there was no one else in labor and it was the middle of the night so they let us sleep. but had it been a busy night, i might've been sent packing at 3am to get in the car and drive 45 minutes home.

after we had our birth center birth DH and i couldn't understand why on earth we had thought it was a good idea to go to them instead of having them come to us! in fact, i don't know if there are any CPM's in your area, or if you'd be comfortable with that option, but my last pregnancy was the best because my midwife came to me for all my prenatals. i didn't have to go anywhere. we'd chat and have a cup of tea and watch my older kids play and measure my belly while i laid on the living room couch

[ShwarmaQueen]

Although I don't have the option of a BC here in Houston (being a VBAC), I just can't see the benefit to having to pay more to go somewhere else to birth (except a hospital if need be). It's not like the birthcenters are better equipped than a HBMW for emergencies...oxygen, pitocin, etc. is all standard anyways. Plus, you won't have to worry about "Is it really labor?" and all that drama...you can just keep in touch with your MW and she'll come when it's time.

[DahliaRW]

The not having to get in the car during labor is a HUGE plus. Also, not having to put a screaming newborn in a car seat and drive home a few hours after birth is a huge plus. The level of emergency equiptment is the same. And at least at my birth the MW did all the major clean up, so it was no big deal to me. I actually liked getting my birth supplies all together and organized. It gave me something to do while I waited.

[Italiamom]

Something to consider would be whether home is actually "home" to you. I currently live in an apartment, which I hate. I have a tiny hot water heater, my neighbors are noisy, I loathe being here. While I love the idea of a homebirth, I chose to go with a birth center because for me the benefits of not having to be in my apartment outweigh the comforts of "home." My birth center has plenty of hot water, big tubs, and no music/barking/stereo/car noises. I can deal with other laboring ladies, but I'm not sure how I would handle the howling of my downstairs neighbor's dog, or how my neighbors would handle my howling!

That said, I know several ladies who had great home births in their apartments. But they were very happy with where they were living. I certainly wouldn't let mess be a deterring factor in chosing or not chosing a home birth. Go with the place that makes you feel the best...

[Hallielynn01]

I've done both, and I would take a homebirth any day of the BC birth (not that there was anything wrong with the BC) I lOVED not having to go anywhere during labor, be in my own shower, (we didn't do a waterbirth this time) be able to get on my computer in early labor for distraction, have my lovely doggies with me the whole time, get my snacks and drinks and such, be able to be in my babies room during labor, I liked that, and not have to go home after the birth, I think that was better than not driving in labor for me! And there was no mess, the midwives handled everything, I birthed on the bed this time, and they literally scooped the sheet and all chux etc up and put it into one big bag and there was a clean fresh sheet already on the bed from the instructions I had. They did this while I was in the shower rinsing off and trying to pee! (a requirement for them to leave) I came out to a clean bed, my soft pillows and a warm fresh born baby!

[NokomisThree]

We chose a birthing center for 2 main reasons. First, our home is 35 minutes from the nearest hospital. And although I knew there was almost no chance of needing it, we erred on the side of caution. Second, we have well water. And I'm not talking about nice, sweet, upstate NY well water. I'm talking nasty, iron filled, rotten egg smelling FL well water. I don't take baths here and had no desire to have a tub filled with rotten eggs to labor in.

That beings said, if we do it again, i would have the baby at home. Things went fast for us too and next time I do not want to be in the car at ANYTIME during labor. The car ride was the worst. Worse then a rotten egg bath? Yes, yes I think it was.

[Munki'sMom]

Stay at home!!!!! NO place like home

[Burnindinner]

I had a similar option. I chose home for a couple of reasons - the atmosphere at the BC was "fine", but it still had tile floors, a drop ceiling. There were 3 birthing rooms, so odds were high we wouldn't be the only people there. The sitting area was a common room, so my family would have been around other families. You had to bring all your own food anyway. I would have had a 15-20 minute drive. I would have had to go home again.

I loved being at home because: someone else set up and cleaned up. All my prenatal care was at home too. My family was there, also in the room, stayed for a week and cooked/cleaned.

[D'sMama]

Another vote for home! It's all I've done, but I would NOT want to go anywhere in labor or after the birth!

I loved being able to hang out in my comfy clothes, baking, setting up my bed, etc. The mess was no biggie, and I even hemorrhaged! We put a big sheet of plastic around the mattress and draped it down the side of the bed and onto the rug, then covered that with an old sheet I didn't mind losing. All of that worked out well because I ended up birthing while kneeling by the side of the bed and then bleeding all over the old sheet. Once the bleeding stopped, I got in the shower, came out and DH and the MW had stripped the bloody sheet and plastic away, put chux pads down on my nice sheets, put a load of laundry in the wash, and brought me food. I just had to get in my cozy bed and nurse my sweet baby! For the next three days, I hibernated - stayed in bed with DS, and DH brought all my meals up to me. It was awesome!

[super mamabug]

I had my last birth in a fsbc. I agree about assessing whether home is home to you. I lived in an apartment with my husband, mother and son, oh yeah and a MAJOR roach infestation. There is no way I would have given birth there. That being said, the only part of my labor that was difficult was the drive, the rest was easy. Plus DH couldn't relax until we got to our birthing place. We are planning a home birth this time and I am so excited to not have to worry about, "is this it?" or "get the bags in the car" etc. I just get to relax and have my baby when it happens, no worries. Everyone come and take care of me!

[Veritaserum]

Home. Car during labor doesn't sound fun to me. The mess is really non-existent. My mw and her assistants clean up everything.

[Quindin]

HOMEBIRTH, no question about it!!

I had 3 hospital births, 1 birth center birth and then a homebirth.
As wonderful as we thought the birth center birth was compared to the hospital births, a homebirth is sooooooo much better!

The birth center had a jacuzzi. We don't. And you know what - I did not miss it AT ALL! Being in my own home, my own bed, not having to drive anywhere, being able to call in my children whenever I wanted... nothing compares to that!!

It was so wonderful snuggling with my baby in my OWN bed right after birth, and knowing I did not have to go anywhere if I did not feel like it! I hated having to drive home with my brand new baby and my tired body after giving birth in the birth center.

And mess? The midwife recommended we used some old shower curtains to protect the carpets, but when it was all done they cleaned up everything for us!

[marrymeflyfree]

I haven't had my HB yet (coming in September!), but I'll tell you what I liked/dislike about the birth center experience with my first.

Homebirth wasn't a good option for us at that time...the house we were renting was really just not ideal for it for many reasons, and I don't think we'd have had as great an experience had we opted for it then. This time around is much different, and I will be very comfortable birthing here. You really can birth just about anywhere, sure, but being in an environment where you're totally comfortable really does make a difference.

I lucked out in that I didn't have to drive down there during labor...after having experienced it, I can honestly say that this would have blown big monkey chunks. Our BC was an hour's drive away, and I'm really grateful that my labor was started with castor oil after we were already there! Hard to guess how it would have played out, of course, but I think just being in one place when it all started helped me stay mentally on top of the contractions. No worries, plenty of room to move about as needed/no confining car and seat belt, bathroom right there, etc, etc.

I liked the fact that I didn't have to do anything to prepare my house for birth. Just get ready for the kid, and you're done! The flip side, however, is that at the BC you only have what you've brought. Hubby had to go out twice for food for us...we forgot the camera...I brought this herbal heat wrap thing for my back, but realized that the fuzzy hot water bottle I'd left at home would have been nicer, and so on and so forth. And the worst part...I've got really long hair, and didn't have a freaking hair elastic thingy! I had to make do with a plain old rubber band from the BC's office - not comfy, and my hair was shredded from it due to all the movement, being wet from the tub, etc. A small thing really, but it annoyed me to no end!

I felt a little rushed when leaving after the birth as well. We could stay up to 12 hours postpartum...while the staff there was pretty great, there was a subtle push at the end to get us out the door. The drive home was fine, but it was *pouring* rain out and we were trying to get home before my parents got to our house. Long story about that, but they came much sooner than they were supposed to...there were some issues, and I think I'd have had more control over that if we'd just been at home.

What I liked, though, was the comfort in knowing that nothing would be missing or out of place for the midwife. They attend births there all the time, know exactly where everything is, have every last tool there that they'd need, no chance that something will be missing or forgotten.

Also, my birth was MESSY. In and out of the tub, a HUGE amount of amniotic fluid, and a postpartum hemorrhage - it was so bad that I kind of apologized for the mess! Of course they just laughed me off, but I was glad that it wasn't my carpet, my sheets, my mattress, etc. (Of course there are ways to protect the room, but still...!)

I liked the fact that there was also a nurse there assisting the midwife and helping us with our newborn...and that the in-house LC and another midwife stopped by twice to get us off to a good start with breastfeeding.

Those are all relatively minor comfort issues, but the last thing is more important and it does weigh on my mind a bit. After that birth, my placenta was really wonky and I had a ton of bleeding. I had IM and IV pitocin, and IV and (for the week pp) oral methergen to control it. A hospital transfer via ambulance was considered, another midwife was called in at 1am to assist...there was a teeny bit of drama. It was all handled very well in the end, but I would not have had the option of the IV meds with a homebirth. I'll never know if IM pitocin or other measures alone might have been enough had I been at home, but if it hadn't....well that would not be good!

Soo, in a nutshell, I think there are pros and cons to both scenarios. But really what it boils down to is this: healthy mom, healthy baby, happy experience, happy family. I had that with my BC birth, and I'm certain I'll have that with my HB too!

[Talula Fairie]

Nothing is worse than being in a car when you're in labor. Ugh.

And I heard, nothing is better than being able to climb into your own bed after you give birth and snuggle with your newborn

Also I agree with the PPs, being on your own turf will make you more comfortable, may even decrease pain.

[Lula's Mom]

Originally Posted by marrymeflyfree

I would not have had the option of the IV meds with a homebirth.

Are you sure your midwife wouldn't have brought them along for a homebirth as well? For my first birth I had IV antibiotics for GBS in labor, and IV fluids afterward for pp hemorrhage. She was a CNM, though, so maybe that makes a difference. Just thought it was worth mentioning, in case the OP were to think that it's never possible to have the IV available at home.