I’m a pretty rare case of woman who has had a child in a hospital with a doctor and a child in a birth center with a midwife and had good experiences with both. I thought I’d use this unique insight to help any of you wondering which route to take with your next delivery. I’m going to present this as equally as I know how and hope it leaves a clear path for you to choose what fits your desires best. But keep in mind, this is just one woman’s experiences. I tend toward easy, uncomplicated, unmedicated labors. If you have (or fear you may have) a different experience, please continue researching and talking with different medical and alternative medicine professionals to help you chose your path.
I’ve decided to divide everything into categories to compare the two rather than presenting one right after the other to help you easily determine the differences between my hospital birth and my birth center birth. The hospital birth will always be presented first, not because of preference but because of sequence. My first labor happened in the hospital, my second in the birth center. Also keep this in mind when I talk about speed and ease of delivery. First time labors typically last much longer than subsequent labors.
Hospital: Following the basic pattern of prenatal care, my visits increased from once per month to once per week as I neared my due date. Driving 2 hours one way every week while 38 weeks pregnant was less than enjoyable.
Appointments typically lasted 15 minutes and that was only because dressing took so long as a largely pregnant woman.
I had to undress my lower half every appointment during the last month or so for a cervical check. Also, that is not fun or pleasant.
I had to provide a urine sample and get weighed at each appointment. They also measured my stomach and listened to the baby’s heartbeat. The end.
I was sometimes seen by my doctor and sometimes by a woman who worked in the office as well. I didn’t usually know which it would be until I arrived. They were polite but not particularly personable but I realize this was specific to my office. Some doctors are much chattier. I could ask any questions and get answers but didn’t necessarily feel comfortable doing so.
Birth Center: They typically followed the same pattern of prenatal visits but provided a much more flexible timeframe. I had a three hour drive each way so they allowed me to stretch the time between visits to two weeks for much longer into my pregnancy and then a week and a half for the very end. I stayed with family that lived nearby for the very end of my pregnancy just so I didn’t have to worry about driving those 3 hours in heavy labor.
The midwives also didn’t mind if I woke up the morning of my appointment and didn’t want to go in. I could just call and reschedule. No one got mad. No one charged me extra. They specifically told me I was welcome to cancel anytime I didn’t feel up to going.
My appointments typically lasted close to an hour. They were always over 30 minutes. They also measured my stomach and listened to the heartbeat but they had me take my own weight, blood pressure (on a fancy little machine) and urine sample, that I then used a dip stick to analyze. At first I really didn’t like doing those things but after a little while, I enjoyed getting to see the results of the tests. I saw when my Chick-fil-A lemonade spiked my glucose levels. I never saw those things going to the doctor.
I never had my cervix checked. Yup. Never. They asked if I wanted it. I said no. They were perfectly fine with that. Their motto was basically, “It’s your body. We’re just here to help it.” They were SUPER friendly and chatty and even a little fun. I never knew which of the midwives I would see at each appointment or even who would be on call for the delivery but I really liked them both so I didn’t stress about it.
Hospital: I paid the doctor and the hospital separately. The doctor actually cut us a really great deal because I moved partway through the pregnancy and so he was only seeing me for the second half. We also paid cash upfront because we didn’t have insurance which further decreased our costs. The hospital I delivered Casey in was doctor owned which also cut down costs considerably. They offered discounts for cash payment as well and also charged based on the length of labor…which as strange as that sounds, really motivated me when I thought I was too tired to push any more. All total, we paid somewhere around $6,000-$7,000.
Birth Center: Still uninsured we paid cash upfront at the birth center. We happened to get in at a great time because they were offering discounts as part of a promotional celebration of their second office opening that month. Total cost for the use of the birth center and the midwife’s delivery fee was around $5,000.
Both costs included normal labs and one ultrasound.
Medical Advice & Requirements
Hospital: I received very little guidance from any of the medical professionals I encountered during my pregnancy. I felt like I got funneled through the system that cranked out healthy babies. I was ok with that. Still, nothing about exercise, nothing about diet, nothing about anything really…except the obvious – no smoking, drugs, or alcohol. During delivery, the nurses were very helpful at telling me to do things to relieve some pain and offered coaching on how to push because I felt absolutely NO need to push on my own. Weird. I know.
Birth Center: They allow an alternative to that awful orange flavored juice for the glucose test! They let me eat candy or drink a juice of my choosing instead. I had to carefully calculate to get just the right amount at the right times, and it’s actually harder to eat a king sized candy bar and a half than you might think…but it was still better than that orange flavored drink. They offered tons of advice on exercises for different stages of pregnancy, they always made me feel like I should eat healthier, and they were more than happy to talk about any health concerns I might wonder about. During delivery, they were much more stand-offish and let me “do my own thing” with an occasional suggestion or question.
Hospital: During the early stages of labor, I was free to roam about the country. I sat in the jacuzzi tub and walked around the room. But once I started really progressing (dilated to about an 8), I was moved to the bed and didn’t get up until after the baby was born, fed, weighed, and on his way to get bathed. I had to stay in the sit/lay position the whole time. That was not fun, comfortable, or conducive to labor.
Birth Center: I showed up to the birth center already dilated to about an 8. They let me wander around, get in the shower, sit or stand or kneel however I wanted, use the bathroom…anything. They even had a tub I could deliver the baby in if I wanted (which I didn’t cause it kind of grosses me out but to each their own!) or a stool shaped like a toilet if that felt comfortable. I actually delivered the baby standing up, leaning on a gigantic ball set atop the bed because when you’re laboring with a midwife, anything goes!
Hospital: I labored for approximately 7 hours in the hospital. This doesn’t count my entire day of contractions. They took measures to speed up the labor – breaking my water (which caused me to vomit and I didn’t like it one bit!), coaching me to push when I didn’t feel the need or even have any energy left, and preventing me from sitting up or laying down or really moving me at all because the baby’s head would slide back up a little. (I know that last one because I adjusted once and got in trouble from my nurse.)
Birth Center: I had a total labor time of about 3 hours. (Good thing I decided to go stay with family early!) I labored for about an hour to an hour and a half at the birth center. They did nothing to speed up the labor but allow me to do what felt natural. Simeon was actually born with the waterbag still intact. I didn’t push with this labor until he was crowning. Then, my push instinct finally kicked in. I wasn’t exhausted at all because I hadn’t spent hours pushing when I didn’t know how. I pushed 3 times and he was born. I also think gravity was on my side because I was standing.
Hospital: Casey wouldn’t cry when he was born. He was also a bit blue. The doctors took him away for awhile, never got a cry and brought him back perfectly fine. He did require some extra checks to make sure he was ok but I don’t know if anything was ever seriously wrong or not. I received an episiotomy (somewhat against my will but by that point I was desperate to get the kid out and told him to do whatever it took) which needed stitched back up but otherwise had no complications.
Birth Center: Simeon was born in meconium (he pooped before delivery) which can lead to complications. The midwife removed it from his lungs and otherwise he was perfectly healthy. I bled a lot of clots that wouldn’t stop coming so she gave me a shot to help me to not bleed to death. I also tore along my previous episiotomy and required stitches to repair that. She really tried to match everything up rather than the “whip stitch” procedure I received at the hospital but it took longer and hurt a bit more.
Post Delivery Handling
Hospital: Casey was taken away and brought back wiped off and wrapped up. They took him to bathe him soon after. I stayed in the hospital for about 36 hours. They checked on us a lot throughout the day and night. They would take him to the nursery when I wanted but it was hard to let anyone know when I wanted him back. They fed me, helped me learn to breastfeed, and to change diapers.
Birth Center: Simeon was immediately handed to me. They wrapped us up together in a big comfortable bed. I held him for hours before they took him to weigh or measure him. They waited to cut his umbilical cord much longer than the hospital did. I only stayed for about 4-6 hours after delivery where they checked on us a few times. I then came back the next day for a follow up check.
So in conclusion, for anyone afraid of going to a midwife because “what if something bad happens” then do some research on your particular midwife. Simeon or I could have died with an incompetent person assisting our labor but even with a midwife, we came out perfectly healthy and happy. We had more complications than my labor with Casey and both births were successful.
There is no option for pain medication with most midwives though. I knew I could do without but for some people, this could be a deterrent. I ended up being happier with my second birth because I was able to dictate what happened a little more than in the hospital. I would be willing to go back to a hospital though because now, I know what I like a little more. A lot of the issues I had with my first birth were due to lack of knowledge and experience.
Have any of you tried different types of medical care for having your children? How did they go for you? I’m especially curious about home births as I haven’t had that experience yet. Let me know in the comments!