Choice of birthplace: Which type of birth setting is best for you?

Women who are considering pregnancy or are currently pregnant have three potential birth settings to choose from: birth center, hospital, or home. It is important to ask questions of the facility where you plan to give birth to gather information about whether the approach to care fits your wants and needs.

A free-standing birth center is a facility often run by midwives that provides full-scope care for healthy women during their pregnancy and childbirth. The Brooklyn Birthing Center and Morris Heights Health Center are two existing options for women in NYC. Birthing centers:

• Are a home-like environment that caters to low-risk pregnant women and their families
• Are just as safe as delivering in a hospital for low-risk women
• Offer non-pharmacologic pain relief and comfort measures in addition to limited pharmacologic pain relief options
• Are licensed, regulated and accredited just like hospitals. They go through a rigorious quality assurance process and must meet certain standards to be in operation.
• Are covered by Medicaid and many insurance companies if they meet accreditation and licensing standards in their state.
• Are part of a collaborative healthcare system. Agreements exist between midwives, physicians, and emergency services to quickly transfer your care to a hospital if a need for an elevated level of care arises during pregnancy or childbirth

Women laboring at a birth center may expect:

• The option of having multiple and chosen support persons present during the birth
• A midwife with whom she has developed a relationship present during the birth
• The opportunity to change positions and utilize tools such as birthing stools, tubs, and balls during labor.
• Greater freedom to eat and drink as tolerated throughout the labor
• A short recovery period at the birth center after the birth with early discharge to home

See an example of what care can be like in a birth center by watching the short video below. The Birth Center is an accredited facility serving the community in Bryn Mawr, PA:

The majority of women in the U.S. give birth in a hospital.  Midwives and physicians often work with women who give birth in a hospital.  A hospital is the safest place for birth if complications or desire for epidural are anticipated.  In the hospital:

• There is immediate access to emergency care for high-risk pregnancies
• The option of a broad spectrum of pain relief options during childbirth including epidural analgesia
• Women often have continuous electronic fetal monitoring and less freedom to assume comfortable positions throughout labor and birth
• There are often policies discourage oral intake of food and fluids after admission
• There are often limited visitors allowed during labor and birth

Many hospitals in New York offer midwifery services including The Mount Sinai Hospital, NYU Langone Medical Center, St Luke's-Roosevelt, and Beth Israel Medical Center. Maimonides Medical Center and Woodhull Medical Center in Brooklyn also have very active midwifery services affiliated with the hospitals.

Birth at home is also an option for women in NYC. Planned home births should always be under the supervision on a skilled birth attendant, who is usually a midwife. Women who give birth at home may expect:

• A lot of flexibility for laboring in different positions
• Alternative pain control and a commitment to medication-free birth
• The midwife to discuss plans for transfer to a hospital that can accommodate you in the event of an emergency
• The comfort of their own home, familiar surroundings and the presence of whomever they wish during the birth

The Coalition for Improvement of Maternity Services has an educational pamphlet available here to help guide you through the process of asking questions at your intended birthplace.