Hospital, Birth Centers
What’s the Right Choice for You?
If you, like the great majority of childbearing women in the
U.S. are well and healthy, you can consider the full range of
places for giving birth. The Sacramento region has many hospitals,
an out-of-hospital birth center, and several highly qualified
homebirth midwives who attend births in the mothers’ homes.
Click on the following link calhospitalcompare.org and view the ratings under "maternity" of local hospitals. We encourage you to research
all your options, and thereby educate and empower yourself to
make the decision that is right for you and your family.
How Does One Compare the
Let’s begin with hospital birth:
In the United States, the hospital is the most common place for
giving birth, with care usually provided by physicians who subscribe
to the medical model of care. The philosophy of the medical model
of care is that pregnancy and birth are a medical condition,
usually requiring intervention, and is “normal” only
in retrospect. Caregivers subscribing to this model rely more
on the facility’s technology than your body’s physiology
to assess your well being and that of your baby.
Hospital birth does have some advantages: A hospital is best
equipped to diagnose and treat mothers and babies with serious
complications. If a genuine need for medical intervention develops
during your labor, a hospital is the place to get it. Also, if
you desire medication for pain relief, hospitals are the only
place to get it.
In a hospital, you may find that your care is
standardized, with various interventions routinely implemented,
whether or not you have a clear need. Difficulties – or
variations from normal – are
typically addressed with medications and high-tech procedures.
There is generally not enough staff available to provide the
help and support you may desire. That is one of many reasons
to have a birth doula, whose only focus is you.
Not all hospitals are alike. They can vary widely in many ways,
including rates of induction, cesarean section, and instrumental
deliveries. Also, they can have different policies regarding
such things as how many people can be in the room with you, whether
you can eat or drink during labor, or continuous vs. intermittent
electronic fetal monitoring. Some have midwives available, some
don’t. Of those that do, some have them available 24 hours
a day, others only on weekdays. Similarly, they vary with regard
to the availability of lactation consultants.
These are just a few of the things to consider, and a few of
the ways hospitals can differ. We encourage you to choose the
hospital that best meets your needs from among those available
to you. If only one, learn their policies, and where they are
willing to “bend” if you want something different.
What You Can Expect at an Out-of-Hospital
In the Sacramento region, we only have one out-of-hospital birth
center, named (appropriately enough) The Birth Center. It is
located in Fair Oaks, very close to Mercy San Juan Hospital,
though not affiliated in any way. We have provided a link to
their website on our links page, and encourage you to check
it out yourself.
In general, by choosing to give birth in an out-of-hospital birth
center, you will receive the midwifery model of care, with its
underlying philosophy that birth is a normal, healthy event,
albeit one needing supervision and care. This means that you
can expect more emphasis on your individual needs than the standardized
care of the hospitals. Also, there is a far lower rate of interventions,
less use of technology and more focus on your body’s physiology.
You will also find staff available to give you continuous physical,
emotional and informational support during your labor and birth,
and support for your family members, as well. If the need for
medical intervention arises, transfer would be made to the appropriate
Home Birth: Do People Really Do That?
Yes, they do – though relatively few make that choice.
What you can expect with home birth is similar in some ways to
an out-of-hospital birth center experience, in that you will
receive the midwifery model of care with its underlying philosophy
of the normalcy of birth and respect for individual needs and
preferences. Additionally, giving birth at home means there would
be no need to figure out when to go to the hospital as your labor
progresses, and no changing rooms once the baby is born. Our
region has several home birth midwives, all committed to safe,
Although pain medications are not an option
for home birth, home birth midwives employ many non-pharmacological
methods of pain coping/mitigation, thereby keeping your risk
status low. And since you may be wondering, they do carry medications
and equipment to treat or stabilize emergencies. A competent
midwife would inform you of any development in your labor that
may call for medical intervention. Together, you would make the
decision to transport, if needed, in a timely manner.
not all midwives are the same. They may have different kinds
of training, experience or credentials, style of practice and
rates of using tests and procedures, or policies and restrictions.
If you are considering home birth, we encourage you to interview
several and choose the midwife (or midwives, as they usually
work in teams) that best meets your needs.
Evidence for the safety of home birth is extensively
referenced, and literature summaries provided in the book, The
Guide to a Better Birth, by award-winning medical writer, Henci
Goer. You’ll also find more on some of the websites on
our links page.
The information here is your starting point – daunting,
isn’t it? We’re here to help. We’re not here
to steer you in one direction or another. We can provide you
with resources and information, and talk with you about your
personal priorities and desires for your birth. You’ll
only give birth to this baby once. Your time spent researching
and planning will be time well spent. We would love to help.
the Perfect Baby Shower Gift — a Doula
Do you know an expecting
family that already has everything to fill the
baby's room? How about giving the gift of an experienced
doula? We have gift certificates available for
various levels of child birth support!