The Birth Setting: Choosing the Appropriate Place to Give Birth

The Appropriate Setting

Hospitals have not always been the place for birth. In earlier times, childbirth always takes place at home without any analgesia and the women give birth the natural way. However, today a lot of birthing choices were developed, and birthing centers have become hospitals instead of at home.

Women are still given the freedom to choose where they would want to give birth provided that the woman does not have a complicated pregnancy, and the health of the fetus is stable.
Women who have complicated pregnancies have less freedom in choosing that the usual because they are advised to give birth only at hospitals for provision of emergency care if needed.
Birthing centers are now fully equipped with resources that could compete with hospital facilities, which is why most couples consider giving birth here than going to the hospital.

The Birth Attendant and Support Person

Most women who give birth are always attended to by their physicians or obstetricians. But as there are more and more courses offered for family practitioners to become certified birth attendants, even with only a midwife or nurse-midwife to attend to a birth is now considered as appropriate and preferred by couples.

Alternative birthing centers employ more nurse-midwives to attend to births.
Another consideration that a woman should make is who would become her support person during labor up until her delivery.
In the past, experienced women in the community take up the role of the support person.
Later on, support persons became the father of the baby.
Today, any family member may take up the role of a support person.
Doulas are also preferred by more women today, as an addition to their support person.
Doulas are women who are specially prepared to assist with childbirth, and they are helpful especially when the support person would find it hard to provide enough support during labor.
When a woman’s support person becomes too emotional to assist the woman in labor, the doula could take in charge to allow the father or any support person to enjoy the experience and involve them emotionally in the situation.
The support of the doula can also reduce the rates of cesarean births, epidural anesthesia, and oxytocin augmentation, according to some research.

Hospital Birth VS Alternative Birthing Centers

Hospital birth has always been preferred by women when they want to ensure their safety during delivery and to be certain that the baby would be handled by professionals. However, the emergence of alternative birthing centers gave women the chance to choose which setting they would want to give birth in, as both could have advantages and disadvantages to consider.

Hospital Birth

Hospitals have standards when it comes to their maternity services as influenced by the First Consensus Initiative of the Coalition for Improving Maternity Services.
The organization provides a set of practices that would make a hospital mother and baby friendly.
The mother should be able to consider her experience as healthy and joyous regardless of her age or circumstances.
The mother should have access to a full range of options regarding her pregnancy, birth, and care of the newborn.
The mother should receive utmost support when it comes to her birthing choices based on her beliefs or culture.
The mother should be allowed to give birth in any environment where she would feel safe and secure.
The mother should receive information and updates about anything that could affect her pregnancy and her baby, with the rights to informed consent and refusal.
At hospitals, women are encouraged to control the discomfort and pain of labor through nonpharmacological measures despite the availability of epidural anesthesia.
Information is readily given to women regarding the birthing process and to help her decide on procedures that would be performed.
Breastfeeding is highly encouraged at hospitals to promote bonding between the mother and the baby and to aid in uterine contractions.
Labor, birth, and postpartum care can be done in one single room at hospitals which could provide more ease and comfort for the woman.
Skilled professionals attend to the woman during birth, and emergency care is readily available if the situation warrants it.
However, the family and the woman might be separated for one night during delivery, and the mother may sometimes feel that she is not in full control of her experience.

Alternative Birthing Centers

Alternative birthing centers are wellness-oriented childbirth facilities that encourage birth outside of the hospital setting while still being able to provide medical resources appropriate for any emergency that might arise.
Nurse-midwives attend to the birth at ABCs.
Before a woman is permitted to give birth at an alternative birthing center, she is screened for complications first to avoid increasing the mortality rate of mothers and infants in this setting.
Women are also encouraged to deal with labor pain through nonmedical measures.
Family members are allowed to accompany the woman throughout the experience.
Skilled professionals attend to the woman during birth, and emergency care is also readily available.
High-risk care may not be easily and immediately arranged at alternative birthing centers.
The stay of the woman at the facility may only be brief, so fatigue is most likely encountered after birth.
The woman is also expected to monitor her postpartal status independently because of her brief stay in the healthcare setting.
Women remain at the ABC 4 to 24 hours after birth because the woman can recover quickly because of the minimum analgesia used.

Practice Quiz: The Birth Setting

Quiz time!

1. A woman could only give birth in an alternative birthing center if:

A. She does not have the funds to give birth at a hospital.
B. Her location is far from a hospital.
C. She does not have any complications with her pregnancy.
D. She has a complicated pregnancy.

2. Why should a couple plan their birth setting in advance?

A. To provide more choices on the birth setting.
B. To give the couple a sense of control over the experience.
C. To avoid cramming over last minute decisions.
D. To determine if the woman is allowed to give birth at any birth setting provided that she has no complications.

3. What is an advantage of hospital birth over other settings?

A. Women can use breathing exercises.
B. Labor and childbirth can be pain-free.
C. Extended high-risk care is available.
D. The cost of hospital stay is low.

4. Why do some couples prefer alternative birthing centers than hospitals?

A. ABCs are nearer to their homes than hospitals.
B. ABCs foster family integrity more than hospitals.
C. ABCs are more affordable than hospitals.
D. ABCs have readily available extended high-risk care.

5. What are doulas?