Choosing the Birth Setting
That is Right for You
H ow do you envision yourself giving birth? Are you surrounded by friends and family, in a quiet setting alone with your mate, or, perhaps, on a busy labor floor with many doctors and nurses looking after you? Would you feel safest and most secure in your home, a hospital, or a freestanding birth center? And which health care provider will you trust to help you to give birth to your baby?
Thinking about your options in pregnancy care and childbirth can be a
daunting task. But if you take the opportunity to research your options,
just as you have researched other very important choices in your life
that have required an informed decision, you are much more likely to look
back at your birthing experience with satisfaction.
You put plenty of energy into choosing your home, your career path, your
mate, motherhood, your spiritual journey—all the things that are
most important to you. Now that you are choosing to become a mother, what
will best meet your needs for a safe and satisfying birth experience?
Where does one start?
Referrals: Ask friends, La Leche League members, playground acquaintances, co-workers, your health care providers, etc., about their birthing experiences and if they would recommend their providers.
Meet and Interview: Make an appointment, and take your notebook and list of questions! Think about what you want, and focus on those topics.
Evaluate the Settings: Tour the freestanding birth centers and hospital labor units in your area. Take a good look at your home as an option.
The Printed Word: Visit your library or bookstore. You will be amazed at the number and range of books about pregnancy and childbirth!
Travel Online: There are web sites ranging from professional organizations, such as The American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists, to personal web sites dedicated to individual testimonials. There’s a lot out there, but remember to use your own discretion.
There are some people who believe that you will be safe only in a hospital
with a physician—and that is the right option for many women. But
you may be surprised to know that there is sound research that has been
published in the Journal of the American Medical Association supporting
the safety of freestanding birth centers.
In fact, the birth center model has demonstrated such impressive levels of safety and satisfaction that one of the founding mothers of this model was awarded the MacArthur award. Ruth Lubic, CNM, took the “genius grant” monies awarded with the MacArthur and started a new birth center in the heart of Washington, D.C., where the infant mortality rate is staggering.
A recent study done by the National Center for Health Statistics tallied birth certificate data from 1991. They published it in the Journal of Epidemiology in May of 1998. The outcomes showed that the infant mortality for nurse-midwife-attended births in 1991 was 4.1 per 1000, while the national average for that year was 8.6 per 1000.
Some people worry that if they opt for a midwife, they will be in hot water if problems arise. Actually, in many settings, the doctors and midwives work as a team, along with the labor nurses, to provide the most appropriate care. For instance, the physicians that I work with provide the high-risk care, while I focus on the normal births. I like to kid them that they do all the hard work while I have all the fun. In truth, though, we are all very invested in providing for positive birth experiences. We believe that a good birth can launch a woman into motherhood with confidence and pleasure—and that can only be good for mother and baby.
It’s great to have options and to have the freedom to decide what setting, provider, and support people will be part of your birthing experience. Above all, please be well-informed and remember — you deserve a good birth.