Birthing center vs. home birth?

[ammiga]

For my first birth, I had a natural birth in the hospital with a MW. I really liked the MW I used, but hated just about everything related to the hospital. I vowed to never have another hospital birth, unless absolutely medically necessary.

When I got pregnant this time, I decided to give birth at a local birthing center, and I am in love with the staff. It is a very calming house, and everything seems to be what I imagined my birth to be. Until I started reading this board...

Now I am remembering other parts of my birth that I wasn't so fond of (outside of the hospital issues). I didn't like rushing to the hospital, and I didn't like how quickly I needed to leave and being rushed out. The hospital broke my dd's leg immediately after birth, so I needed to leave to get her to a specialist the day after she was born (she was born in the middle of the night). I also hated listening to the screaming from other birthing women.

While I know it would be different in some ways, I still feel like I will have that part of the experience at the birthing center. I might need to rush out the door and race to the birthing center (I had a VERY fast labor last time), I check out of the birthing center and head home 4-8 hours after I deliver, and there are no guarantees that another client of the birthing center won't go into labor at the same time that I do.

The birthing center will also do home births, with the same midwives. So, what I'm trying to figure out is what the differences are between birthing at home and birthing at the center. I feel safe and comfortable giving birth at home, I just never really thought about it until a few weeks ago when I started looking at this board. I also feel safe and comfortable giving birth at the center, I just don't like the traveling, the rush, and the chance of listening to another woman in labor and the lack of privacy that gives me.

Sorry this got so long! Can anyone give me some insight, personal experience, or resources to look into? The more I think about a home birth, the more I like it, I just want to make sure I'm not missing anything. Dh is totally on board with whatever makes me the most comfortable.

[dannic]

I"ll tell you about my experiences:

My first birth was at a FSBC; I was checked every hour and during a few contrax. I pushed on my back, I had to leave. (These are things that bothered me in hindsight, not in the moment.) I didn't even realize that many protocals weren't really necessary or part of a natural birth.

Second birth occurred en route to the BC because my mw didn't believe I was in active labor and wanted to shower before meeting me there--DH caught baby in our truck.

It wasn't until I had my third at home that I realized how managed my first birth was...I think BC have certain regs too. My appts with my hb mw were longer and more informed. I love my appts! My HB happened at my pace on my timeframe. I was never checked and I called the shots. I didn't have to leave in labor to get anywhere and I didn't have to leave after birth to go home

I am having my 2nd hb in Aug. I hope to never leave home for birth again.
(just my .02 cents)

[dogmom327]

I've only had two HB but considered a BC. The reasons I personally wouldn't consider a birth center:

--It's no safer, there are no real equipment advantages, etc.

--I can't fathom getting in the car during hard labor. I'm one of those people that by the time I get to the point I'd go in, I'm in transition and will give birth in 1-2 hours. I can't imagine sitting in the car in that much pain!

--Underlying having things happen in my home is a sense of control. It's my house so what I say ultimately goes. Not that I've ever needed to play that card but somehow knowing it's there helps.

--Everything and everyone came to me. My labor wasn't disturbed.

--In the end I climbed into my own bed, used my own bathroom and only had to go as far as the couch over the next week. No getting things together to leave and head home.

--In some places (but not all) birth centers are much more closely monitored/regulated than are HB. When I was first pregnant and living in a different state the local BC had a high transfer rate because the bar for a required transfer was much lower because they were under a lot of scrutiny.

[To-Fu]

For me, if there's no advantage to using a birth center over birthing at home, I wouldn't even consider it.

Is there a reason you think the birth center might be better for you somehow?

For me, being at home is key to my ability to be able to relax. I don't want to be interrupted in the middle of labor to have to go somewhere else and try to get back into The Zone. I don't want my labor to be disturbed in any way.

I know all the food in my house and can eat it as I please.

When it's all over, I can get in to my own bed, dig out my own comfy clothes, and do what I want.

Ultimately, I guess I want to be in control of my birthing environment. I think that's kind of animalistic and normal. Even at the end of pregnancy, I become like a bear in a cave.

It's a very individual decision, but the above is why I need to birth at home and am not interested in birthing at a birth center. It might be different if I lived in a tiny apartment or with roommates or something, but I don't.

[mbhf]

Originally Posted by dogmom327

I've only had two HB but considered a BC. The reasons I personally wouldn't consider a birth center:

--It's no safer, there are no real equipment advantages, etc.

--I can't fathom getting in the car during hard labor. I'm one of those people that by the time I get to the point I'd go in, I'm in transition and will give birth in 1-2 hours. I can't imagine sitting in the car in that much pain!

--Underlying having things happen in my home is a sense of control. It's my house so what I say ultimately goes. Not that I've ever needed to play that card but somehow knowing it's there helps.

--Everything and everyone came to me. My labor wasn't disturbed.

--In the end I climbed into my own bed, used my own bathroom and only had to go as far as the couch over the next week. No getting things together to leave and head home.

--In some places (but not all) birth centers are much more closely monitored/regulated than are HB. When I was first pregnant and living in a different state the local BC had a high transfer rate because the bar for a required transfer was much lower because they were under a lot of scrutiny.

Yes to all of this. I can't think of any reason I would choose a birth center, though I know several women who have and have been happy with their decision. I don't just want to avoid a hospital for my births, I want to stay in my own home.

[JorgieGirl]

I agree with pp.

Midwives coming to your home bring the equivalent of a free standing birth centre. So, you are no 'safer' at a BC. Plus, just by being at home you have a lower risk of infection. So it seems the advantage would be homebirth, if that is what you are comfortable with.

[Nicole730]

I had a hospital birth with my first. No major problems at all.

I chose homebirth the second time because midwives would have all the same equipment at home, so a birth center was not any safer. And because I am so much more comfortable at home.

[*MamaJen*]

My midwife described birth centers as "homebirths you drive to."
I think of birthing centers as a great option if something is wrong with your own home, say, if you have toxic roommates or you're in the middle of a big construction project or something. Or maybe your home is too far from a hospital. And some insurance policies will pay more for a birth center than for a homebirth. And also, some women really want to leave their house to birth, or their partners might be emotionally okay with a birth center but not a homebirth.
Those are all totally valid reasons to pick a birth center. But if you're happy and comfortable in your home, I'd totally just birth there. You're in your environment which I think makes a big difference in how you cope with labor, and I think it's also more psychologically empowering to be in your own space. you don't have to get in the car and drive during labor, you know where your fuzzy socks are, you get to crawl into your own bed and nurse right away. Also, some birth centers are less tolerant of things like longer labors.
In your situation, it really sounds like a homebirth is a great option. I'm sure a birth center would be good too, but it would just sort of be making everything more complicated than it needs to be.

[Cersha]

For me, the only reason why we are choosing the free standing birth center over home is that the insurance company refuses to pay for home, but will pay for the FSBC 100%. So, there really isn't an option.

[faeriecurls]

There are only 3 reasons we are not having a HB

The hospital that almost all HBs would transfer to is in danger of closing.

The nearest hospital to us scares the crap out of me (I have already done their maternity tour and was stared at like I had three heads when I asked ANYTHING)

Our apartment is very small and our walls are super thin.

I hope to have different circumstances for number 2 so we can have a HB.

Your situation sounds like a HB would be perfect for you.

[Gladiolus]

For my second (first was in a hospital - never again unless it's an emergency), we went to a birth center but were planning a HB with the midwives. From what I gathered, they *loved* doing HBs and I was really excited that this was a possibility since our insurance lined up.
However, when my labor started - there was another woman in labor/recently PP that couldn't be released yet so they had us drive to the BC (and I was in transition - it was a very fast labor, involuntarily pushing in the car - I really thought I might birth in the car) and I put that car ride (about 20 minutes) right up there with "never again unless it's an emergency". So you might want to see what their standard practices are if there is another woman in labor - would they ask you to come to the BC anyway? Or are there enough midwives that one would still come to your home?
This time, I'm planning a HB with a HB midwife and it's just far exceeded my hopes and expectations. Our appointments are in my home, for at least an hour... much more personal than I got with our BC.

[Belle]

In addition to what everybody else already said. For us a FSBC would have cost about twice as much as a home birth. Because we would have had both the midwives' fee and the facility fee. So for us, cost was a factor. And not driving in labor. My homebirthed baby was born an hour after our midwives arrived. I was starting to feel pushy when they got there. If we'd done a BC birth we might not have made it in time. Also, my dog was a real comfort to me. I think they'd have frowned on us bringing an 70lb big hairy beast into their BC.

[SwanMom]

I had a home birth and loved it, except for the fact that I wanted my out-of-town family to be there, but not at my birth. For that reason, I'm considering a birth center (about 2 minutes from my house) this time. I also like the idea of leaving my boys happily playing at home with their auntie if my labor is long (like it was last time). I don't think I'll be able to labor as well with them around 'cause I might try to tend to their needs?

But I really can't decide because I love the thought of not going anywhere, of being on my own turf, and of birthing in my own home.

sigh.

I guess my boys could go with auntie to a hotel if need be.