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Hospital, Birth Center or Home Birth? How Do I Choose?

Photograph by Twenty20

Deciding on the where part of having a baby probably doesn't really seem like much of a thing for most people since most babies are born in hospitals, but then again, I'm not most people. Currently pregnant with Baby #3, I'm having a bit of an existential crisis when it comes to answering this seemingly simple question of: "Where are you going to have this baby?"

When it comes to baby-having you've basically got three options: hospital, birthing center, or home birth. So far I've tried two out of the three. Here's how it went...

With my first birth, I delivered at an out-of-hospital birthing center. I chose this option because of the negative experience I had with my big box HMO. I spent the first half of my pregnancy feeling completely disrespected about my wishes surrounding pregnancy and because of our insurance, had little option for choosing another provider. My husband and I couldn't afford to pay out of pocket to go to a different hospital, so we chose instead to pay out of pocket for a birthing center which (while still not chump change) was a lot more affordable.

I absolutely LOVED my experience at the birth center. It was sort of like giving birth at a lovely, little bed & breakfast. I received care from midwives I knew and trusted. Instead of questionable hospital food I could order takeout from all over Portland, and the post-birth massage that was included definitely didn't hurt matters. I had a 12-hour labor that was fairly straightforward (aside from her brow presentation) and was able to deliver my 8 pound 7 ounce baby girl in a tub without any medication. It was a wonderful, empowering experience.

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My second birth was at home. Having a natural birth under my belt, I felt more confident taking on the at-home experience the second time around. Even though for all intents and purposes the birthing center was basically a home birth without actually being at my own home, something about a home birth just made me a bit more wary with my first. This time I felt ready.

I loved so many things about home birth—especially the fact that my midwives came to me for every prenatal appointment. I literally had appointments in pajamas while sitting on my own couch which is a beautiful thing when you have a toddler. No waiting rooms? Yes please! I adored my midwives and I loved being in the comfort of my own home. That said, the experience was a lot different from my first birth.

Having had two natural births, I know that my body knows what to do and I know that I am strong and capable, but I also know that unpredictable things happen and it's important to consider all scenarios.

My labor ended up being much longer and more challenging, but after 19 hours—four of which was pushing—my son came into the world at a whopping 10 pounds 8 ounces and 23 inches. He was also posterior. I was a bit "war-torn" in an emotional sense to say the least. While I was so thankful for my safe birth and my healthy baby, the experience also left me feeling a lot less confident about birth.

This time around, I'm just not sure what I want to do.

The idea of possibly having an even larger baby than my son sort of terrifies me. Most women in my situation would've had a C-section and had I been in a hospital setting, I'm fairly certain I would've had one. I'm not sure my body could handle a much larger baby than a ten-and-a-half pounder, and because of it, I wonder if a hospital might be the best case scenario for Baby #3?

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I am still weighing my options. Having had two natural births, I know that my body knows what to do and I know that I am strong and capable, but I also know that unpredictable things happen and it's important to consider all scenarios. I know that a huge part of having a successful birth is perspective and mental state. With my first I was so prepared and very relaxed about it. With my second I was a bit less so, and this time, I am honestly a little fearful. I know what to expect and even though everyone says you forget the pain, I definitely remember it. I worry that if my mind isn't in the right place, then maybe my birth won't be as successful.

I have visited a hospital midwife and had two appointments there so far and have also gone back to the birth center where I had my first baby, but I still feel a bit confused and unsure. Hopefully I'll find some peace with a decision over the next few weeks.

Did any of you have a difficult time deciding where to give birth?

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