Labor & Delivery Special

A guide to your childbirth choices.

OPTION 2: Independent childbirth center

“Home birth was actually my first choice, but my husband was really concerned about what people would think. I knew I couldn’t do it unless he was completely onboard, so the birth center seemed like the next best choice.” —Laurie, a corporate planner and mother of two in Dallas, T.X.

“As a new mom, you need to recover and take care of your baby, so if you don’t have close family or friends who will be there [at your home] for you, you’re probably better off delivering in a hospital, where you will have nurses to help you out.” —Gayle, a Chiropractor and mother of two in Los Angeles

Who chooses it > Women who want to deliver naturally with a midwife, without interventions, but don’t want a home birth. The “best of both worlds” option.

What you get > A more relaxed, homelike atmosphere than a hospital, yet closer physically and emotionally to the safety net of a hospital.

What you give up > While an independent (freestanding) birthing center is more “mom-centric” than a hospital, protocols must still be followed. Some centers have M.D.’s on staff as medical directors, but care is generally provided by midwives. Medical interventions such as  epidurals are unavailable, and you are sent home a few hours after delivery.

What you need to know > A freestanding center should be accredited by the American Association of Birth Centers (AABC; birthcenters.org). Only the lowest-risk pregnancies are welcome. You will need to meet several strict requirements; if you “risk out” at any point or have prolonged labor, you will be transferred to a nearby hospital.

OPTION 3: Midwife-attended natural birth in a hospital

“The most important thing for me was to have a midwife because I wanted a holistic approach to childbirth, but I still liked the idea of being in a medical setting in case something went wrong.” —Dawn, a public relations director and mother of two in Oak Park, Ill.

“When I checked into the hospital, I had to spend a mandatory one hour on the monitor before I could be moved to the birth center, and I didn’t like it at all. I was itchy and uncomfortable, and all I wanted to do was walk around.” —Jennie, a literary agent and mother of two in North Salem, N.Y.

Who chooses it > Women who prefer the low-tech, handson, low-intervention, drug-free philosophy of a midwife but do not want to deliver in any place other than a hospital. Giving birth with a midwife at an in-hospital (nonindependent) birthing center is the most supportive hospital setting for completing a natural labor (you go through labor and give birth in the same room). In some hospitals, midwives can deliver babies in the delivery room.

What you get > A compromise between hospital safety and a midwife’s natural, personalized approach; in-hospital birthing centers are a good option for women in the 16 states that do not have any AABC-licensed independent birth centers.

What you give up > You’ll likely be at least temporarily hooked up to an IV and an electronic fetal monitor, and you will have to follow hospital rules about eating and drinking and the number of other people allowed in the room.

What you need to know > Prepare by taking a natural-birth class, such as Bradley or HypnoBirthing, and make sure your little corner of the hospital is as conducive as possible to staying drug- and intervention-free. Have your partner or doula practice running interference with doctors for you.