When we found out we were pregnant on a January morning, excitement and joy filled our home immediately. We were going to have a baby! But, I must admit that by the end of the first week knowing I was pregnant, I was feeling incredibly overwhelmed.
There is so much to plan and do, and decisions to make over the next 9 months. Two of the first big ones being:
One of the most important things to consider early on is where you want to give birth. By first determining this, you can make sure you are receiving prenatal care from providers who deliver at your chosen place.
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Today, I want to help your feel more prepared as you investigate prenatal care options and hospitals for birth.
Let’s learn about:
It is important to explore options in your area and make an educated choice about where you want to deliver your baby. The goal is to have you feeling confident, comfortable and well-taken care of during your prenatal care, labor and delivery, and recovery.
The first place to start is proximity. You don’t necessarily need to choose the hospital closest to you on a map. But, you should have an idea of where different hospitals, birth centers and women’s health centers are in relation to you. This will help you narrow down your choices.
Once you have determined realistically where and how far you are willing to travel to prenatal appointments, and ultimately for birth, you can start learning more about these places.
Once you have a list of places nearby that interest you, get your google on! You can explore their websites to get an idea of what their facilities offer in terms of amenities, midwives, doctors, and pain/labor interventions and strategies.
When deciding, remember that you are never locked into your choice until you have been admitted for labor and delivery. While receiving prenatal care from the providers associated with your hospital is generally preferred, if you begin to feel uncomfortable or unhappy with your care you can switch at ANY point in your pregnancy.
Additionally, because complications may arise or your pregnancy risks may change, it is smart to explore a variety of birthing options so that you can make an educated switch should your personal needs change.
Think, will this birth place help me attain my birth wishes?
Be sure to investigate if the hospital or birthing center is going to be able to adequately and safely reach your needs and promote your birth wishes. For example, some hospitals and delivery teams are known for promoting VBAC (vaginal birth after C-section) while others discourage it. Some hospitals specialize in births of multiples, etc.
Some hospitals are quicker to suggest pain interventions while others have different philosophies. Some hospitals even offer water births should this be what you are looking for.
Usually this information can be found online. This can be a good source of information to help you narrow down your list and decide where you want to go tour.
Additionally, I found it useful to research specific hospital stats while also comparing nationwide stats on the whole for hospitals versus birth centers.
When you begin to do research about possible birth places the numbers that you want to most pay attention to are:
At the bottom of this article you will find a list of resources for websites that will help you look up nationwide hospital statistics such as rates of C-sections by hospital.
You will also find a list of search term advice. These will help you find rates of other interventions and birth stats within hospitals in your specific location.
While I hope to provide some helpful advice in terms of your care, you should always consider your own unique needs in making your decision. Some of these include (but are not limited to):
On the flip-side, if you are considered “low-risk” and are not expecting any complications, then this may also influence your decision. It would allow you to choose a smaller hospital or have less concern with a higher ‘level’ NICU (neo-natal intensive care unit). You can see more about this in point 6 below.
Understanding your options when it comes to maternity care and ultimately your delivery begins with the provider that you choose. You will need to decide if you want to deliver with a Certified Nurse Midwife or Doctor.
Something that one of my midwives explained to me is that prenatal care and pregnancy in general in our country is looked at as a “medical condition” but in most other parts of the world is not viewed this way.
Caring for the expecting mother emotionally is viewed as equally important in many other countries and cultures. This is a hallmark of midwifery prenatal care.
As an expectant mother you are not ill, and in low-risk pregnancies we can trust our bodies to grow and develop our babies with relatively minimal monitoring.
Delivering with a doctor is not something I can speak about from personal experience, but it can also result in a positive birth.
With N, I decided that I wanted to deliver with a midwife and would absolutely make this decision again if my future pregnancies are considered low-risk. I decided this because my wishes were to deliver with minimal pain interventions (which ultimately did not happen).
I was hoping to build a relationship with the women who would ultimately deliver my baby. This is not to say that I couldn’t have found these things in a doctor, but midwifery care is more known for this.
In my personal experience, I was receiving care from a midwifery group that included five midwives, and I got to know them all very well by the time I was ready to deliver. This meant that no matter which midwife was on duty when I went to the hospital, I would be greeted with a familiar face who knew us, and our birth wishes. For me, this was important.
Hospital deliveries account for 98% of births across the United States. They are a must for women with high-risk pregnancies.
You can deliver with a doctor OR a certified nurse midwife in a hospital setting:
The benefits of delivering in a hospital are:
Newborn nurseries are leveled from 1-4 with the following descriptions (see sources for more information):
If you have a high-risk pregnancy, it will be mandatory to delivery at a hospital with a Level 3 or Level 4 NICU. The care needed from a level 4 NICU would most likely be something you would know about prior to birth.
If you are concerned about being separated from your baby, even with a low-risk pregnancy, then delivering at a hospital with at least a level 3 NICU will mean that the odds of being separated from baby will be extremely low.
My thought process on the matter:
This was something that weighed heavily on my decision about where to give birth. I ultimately did not choose the hospital with the highest level of NICU in proximity to my home. I was fortunate that nothing went wrong.
Because my pregnancy was low-risk and because of my knowledge of my own pregnancy, the benefits of a smaller, quieter hospital, which only had a level 2 nursery, outweighed the risks involved.
My experience with a Level 2 Nursery
I researched my options with my husband and we decided that given everything we knew about my pregnancy and the likelihood of us needing a level 3 or 4 NICU, we felt comfortable with our choice.
However, had N suffered complications from pooping while still inside of me (see my Birth Story for more details), she would have been moved to the bigger hospital close by to receive care from a higher level NICU. We would have been separated.
To be honest, I think I will still opt to deliver my future children at our smaller, local hospital, but I wanted to share my experience to help you better understand and inform your own decision.
Everything mentioned about birthing in a hospital is true for an in-hospital birth center. What is different about an in-hospital birth center?
An in-hospital birthing center will not be less likely to provide interventions. It will also not have the lower intervention and cesarean rates associated with free-standing birth centers.
My experience at an “in-hospital” birth center
I delivered at an in-hospital birthing center. The benefit for me was that I was able to receive medical interventions that I would not have been afforded at a free-standing birthing center.
My birth also would have likely been moved to a hospital had I started at a free-standing birth center because N pooped in utero.
An in-hospital birthing center is a nice in-between because should any complications arise, you will not have to re-locate and may not need to be separated from baby.
Free-standing birth centers are less common in the United States, but their popularity is rising and more and more as these facilities are becoming available.
Drawbacks to delivering in a birth center:
Looking for more information about pain management options, interventions and creating a birth plan in order to inform your decision about where to birth? Learn more in Trina’s birth plan article.
Now that you know the 8 things to consider, you can narrow down your provider and birth place choices. Once you have your short list, it’s tour time!
One of the best things you can do when making your decision is taking an in-person tour of birthing options near your home. During a tour you will get a feel for the hospital or center.
Whether the floor looks shiny and fancy is not all that important, what’s really going to make for a great birth experience is the overall culture of the birthing facility.
If the tour does not include this, then definitely ask to see labor rooms, delivery rooms and postpartum rooms. You want to be able to envision yourself in all aspects of your birth.
When you see the postpartum room consider how your partner will fit into your recovery and learning about how to care for your new baby. Some places have postpartum rooms with double or queen-sized beds. This probably indicates more emphasis on including the partner in the post-birth care of your newborn.
Some hospitals promote and emphasize having your newborn room-in and others put more emphasis on their nursery
These are all legitimate things to consider because you want to be set up for success and know what you need to bring in your hospital bag. You need to think about what feels important to you.
Another good thing to ask is if the postpartum care room is different should you be recovering from a c-section or vaginal birth. It is important to be able to envision yourself in either space should your birth not go as planned.
Next, make sure that you ask about:
Learn about breastfeeding support available:
Find out about the lactation consultants on staff and how often they make their rounds. Will visits with the lactation consultants be covered under your postpartum stay or be billed separately to insurance (this is something to consider taking up with the insurance company).
Most hospitals provide:
It is a good idea to ask so that you know what to bring and what you can expect to have access to there, although I still always recommend bringing your own preferred products, just in case.
What about food?
Another important thing to understand is the meal policy and what is covered under insurance so that you know if your partner will need to bring food. Usually the post-partum care only includes meals for the mother. Some hospitals offer a celebratory ‘dinner’ which includes a meal for both parents.
You want to have an idea of when visiting hours are, policies about who can stay over in the room, policies about older siblings and outside food as well. These are all important things to know about for planning and preparing purposes. These things may influence your ultimate decision if you are down to two choices
Lastly, Don’t Forget to ask about
General philosophies and practices the hospital has in terms of newborn care, interventions and birth philosophies. For example, some hospitals may routinely practice skin-to-skin while others you will need to be more vocal about your wishes.
Looking for help with this?
Make your hospital tour so much more organized and productive by using the planning worksheets and checklists in our Nesting Planner.
Talk to other moms
If you are involved in a pre-natal yoga or fitness class, find women who are already mothers and ask them about their experiences. You can even ask the instructor what she knows about different facilities near you.
Ask potential pediatricians
Talk to pediatricians or pediatric nurses about the hospitals that they have worked with or what they have heard.
Learn about the experiences of family and friends
Ask family members and friends who have given birth about their experiences in various settings. Even if the other moms in your life didn’t necessarily birth in your community they may be able to help you decide to deliver with a doctor or midwife, at a hospital or birth center, or help you decide what level of nursery care makes you feel most comfortable.
Read birth stories
Hearing the stories of other people can always help you better understand your choices. Definitely read my birth story and Trina's as a reference point too.
With this guide, you are ready to make an informed decision about the best place for your unique and special birth. You are equipped with foundational knowledge about your provider and location options. Your next steps are to:
As your pregnancy progresses, you’ll be doing a lot of planning and preparing. This is only the beginning! You’ll be making a registry, planning your shower, designing your nursery, preparing for birth and more!
Why not enroll in our free Bump Smart e-mail series? Each week you’ll receive an e-mail that matches your week of pregnancy. It will include relevant information and a specific way to prepare. Don’t miss a single step along the way.
If you have any questions or need help with any step of the process, please comment below!
Resources For You
Nursery and NICU Level Descriptions
Where do people deliver? Who do people deliver with?