Home birth or birth center

A tale of two settings

In the U.S., 95-98% of human birth occurs in the hospital. This is a phenomenon which started only 100 years ago, when all births took place at home. There are many reasons for birthing in hospital such as lack of familiarity with options, lack of access, insurance and finances, lack of agreement from support system, medical reasons making hospital birth the only safe option, and belief that only birth in hospital is safe. Families choosing not to birth in the hospital may have the option of a nearby birth center and /or home birth. If they do, what leads decision to one or the other?

While both settings have safety in common, there are differences, benefits, and drawbacks of birthing at home and at a birth center.
Home is for birthing people who want to be at home. This sounds obvious, but not everyone likes to be at home. There is no travel. This is protective of the intricate hormone changes of labor by:

  • reducing need for the laboring person to come into their beta brain, and

  • protecting oxytocin flows and reducing cortisol (stress) and adrenaline (fear).

Labor, like sexual intimacy, is a primal, highly instinctive, sensitive, and guttural event. The body responds best when undisturbed and sensing safety in these activities.

Home also allows for the “queen of the castle” guarding for authority over who and what comes and goes.

Birth center may be chosen by people who live far from the hospital, do not feel comfortable at home, or do not want any responsibility for setup or cleanup. Some folks choose the birth center setting to have more room, use of the luxuries offered, different surroundings, or distance from family, friends, or neighbors in comparison to home. Others may have insurance coverage offered by provider in home or birth center settings. Perhaps the most critical reason of all considered is a connection with the birth team— whether home or birth center.

For whatever reason(s) folks may choose home or birth center, the crucial need is for increased access, coverage, and inclusivity. Support legislation for:

  • midwife autonomy in practice in all states, and

  • insurance coverage of homebirth and birth center birth on par with hospital reimbursement of normal, spontaneous vaginal birth.

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