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Choosing where and how to give birth is one of the hardest tasks that pregnant women face. If your pregnancy is low-risk, you may have many options. What should you know about hospital birth, birth center birth, and homebirth?

Giving birth is both exciting and scary to most pregnant women, whether they are first-time mothers or already veterans. You are eagerly anticipating the birth of your little one, but probably worry about the possibility of complications, the pain, and the atmosphere at your birth. A competent healthcare team with which you feel comfortable can help a lot.

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Where would you ideally like to give birth? What type of healthcare professional would you like at your labor and delivery? Do you have any pain management preferences? Is there anything else you are specifically hoping to get out of your birth? Many expectant mothers and their partners have lots of options. Those experiencing healthy, low-risk pregnancies are especially lucky in this regard.

What options are available to pregnant women? 

Hospital birth: Many Options In One

Most pregnant women and their partners will end up giving birth in a hospital. In the United States, 99.8 percent of all births take place in a hospital in a labor and delivery unit. Eighty six percent of these births happen in the presence of a physician, and approximately 85 percent of physician-led hospital births are considered to be low-risk.

Hospitals are the only choice for families experiencing a high-risk pregnancy. These families may still be able to choose between several hospitals, and they'll want to opt for the hospital with the best neonatal intensive care unit or the hospital that is most experienced in dealing with the particular situation they are facing.

Low-risk pregnant women — and that is, as you see, the vast majority — have more choice. You may be able to choose between a birth presided over by a gynecologist/obstetrician (OBGYN) or a Certified Nurse Midwife.

Midwives are a particularly good choice for women who like the idea of having a natural, unmedicated birth and who would like more personal care and attention during their labor. Midwives tend to care for smaller numbers of laboring women, and are thus able to spend much more time with their clients. They also generally have lower rates of medical interventions, and birthing mothers in their care are less likely to have a cesarean section. Midwives are often more comfortable with unmedicated vaginal births, even if they do not progress in a textbook fashion.

If you are pretty sure you would like an epidural during your labor, an OBGYN may seem like a more obvious choice. In many hospitals, you'll still be able to get an epidural if you choose midwifery care.

Women giving birth under the care of an OBGYN will generally have access to emergency care more quickly. Their labors tend to be monitored more closely through electronic fetal monitoring, regular cervical checks, and similar interventions. They may therefore also face more restrictions, like not being able to move around during labor. However, many women feel safest with a highly skilled medical professional who can care for them ever when things go wrong.

It's good to have in mind that the term “emergency c-section” refers to all unscheduled cesarean sections. Only a small number of emergency cesarean sections need to be carried out immediately after the emergency has become apparent. The American College of Obstetricians and Gynecologists (ACOG) believes that obstetrical units should be capable of beginning a c-section within 30 minutes of the decision that one is needed — which seems like a long time to wait. 

You may have to wait for an OR to become free, even if you're already physically very close to one. Patients transferring from midwifery care within the hospital, and even those transferring from birth center or homebirth settings, should not have to wait longer. If you're interested in the c-section decision to actual c-section times at your hospital, be sure to ask.

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