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Tips on Choosing a Hospital or Home Birth

While over 99 percent of American women have their babies in a hospital or birthing center, interest in home birth has grown. Choosing a home birth can mean fighting off protestations from well-meaning family members and friends, but as long as you choose a qualified practitioner to assist at the birth, assess your risks carefully and have a good back-up plan in case of emergency, home birth can be a safe and viable option. Talk to your practitioner about the pros and cons of home birth.

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Pros and Cons of Hospital Delivery

Familiarity and public acceptance are two of the biggest advantages of hospital birth. If you already have an obstetrician, it's very likely that he delivers only in a hospital, so a hospital birth might mean you already have a caregiver you trust. Most hospitals also have anesthesia available if you need it and can do a cesarean section delivery quickly if the need arises. The downside of hospital delivery is that, no matter what your birth plan says, the hospital is ultimately in charge and can limit your options on where and how you give birth. The C-section rate for hospital delivery in the United States is 31 percent, much higher than the 5.2 percent of moms who planned a home delivery, a January-February 2014 article in the "Journal of Midwifery and Women's Health" reports.

Pros and Cons of Home Birth

If "there's no place like home" strikes a deep cord in you, having your baby at home might seem like the most natural way to welcome your newcomer into the family. Being in familiar and comfortable surroundings, with no restrictions on who can be at the birth, what you can eat or drink during labor or whether you need to stay tethered to the bed can make home birth sound heavenly. But in a study published in "BMJ" in 2005, 12 percent of women who intended to have a home birth with a certified nurse midwife ended up transferring to a hospital during labor. For this reason, choosing a midwife who can determine when home birth is not a safe option for you and who can assist with the transfer is essential.

Contraindications to Home Birth

In some cases, home birth is too risky. Certain health conditions -- such as pregnancy-induced hypertension; placenta previa, in which the placenta partly or entirely covers the cervix; or placenta abruption, in which the placenta becomes partially or entirely detached from the uterine wall -- are absolute contraindications to home birth because of the risk to both the mother and the baby. If your baby is sideways, in a transverse position, you will need a C-section delivery unless he changes position. Some midwives won't help with a home birth if your baby is in a breech position, if you're having twins or if you have a medical condition, such as diabetes.

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Home Birth Essentials

Home birth is only a good idea if you can provide a clean, safe place to have your baby. If you have other children, you will need to have someone present to help with them. Finding an experienced midwife to work with you could be a challenge, depending on where you live. Certified nurse-midwives are registered nurses who undergo additional training to become a midwife. CNMs can't legally assist at home births in some states. Certified professional midwives take courses that qualify them to take the North American Registry of Midwives exam. In the 2005 "BMJ" study, the rate of neonatal death with certified professional midwife births was 1.7 per 1,000, similar to that of hospital births.

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