Hospital, birthing center or home birth?

During your pregnancy, many questions will arise that you will think through before the birth of your child. This includes the question of where and how the birth should take place.

Before you think about which birth location suits your needs, you should be clear about what your needs are and what is important to you for your birth: How do you want to give birth? What is particularly important to you, e.g. comprehensive medical care or is the care of a midwife sufficient? Where do you feel most comfortable, e.g. in a homely atmosphere or in a delivery room? What gives you a feeling of security?

In addition to these questions, the health of you and your baby also plays a major role. If the pregnancy is high-risk, the birth is usually carried out in a hospital in order to have sufficient medical care and specialist staff on site in the event of possible complications. In some cases, the immediate proximity to a children's clinic may also be necessary. Decisive factors can be high blood pressure, gestational diabetes, a multiple pregnancy or if the baby is in a breech position at the end of the pregnancy. Of course, you must discuss your situation individually with your doctor and midwife.

hospital

If you decide to give birth in a clinic, you can choose between an outpatient or an inpatient birth. With an inpatient birth, you and your baby will stay in the hospital for a few days after the birth - usually between three and five. During this time, you will recover and the follow-up examinations (U1 and U2) will be carried out directly on site. The advantage here is that you will have permanent care available, as well as specialist staff and medical care for you and your baby.

Would you prefer an outpatient birth? If so, you can leave the hospital within a few hours – usually three to six hours after the birth – provided there are no complications or abnormalities with you or your baby. This means you can return home and to your familiar surroundings fairly quickly. The birth itself takes place under the same conditions as an inpatient birth. The U1 examination also takes place in the hospital. However, for the U2 examination you must find your own pediatrician to carry out this. A post-natal midwife should also be available. She can visit you on the day of your discharge, help you with the first problems, e.g. breastfeeding or feeding a bottle, and carry out further examinations. In summary, it is important that you find a pediatrician in advance (especially for your first birth) and organize a post-natal midwife.

If you are considering giving birth in a hospital, it is a good idea to be prepared for the fact that there may be a change in staff shifts. However, if you prefer a midwife who will be with you throughout the birth, you can look for a staff midwife. Staff midwives work with a clinic or a staff hospital and can be called in to the birth upon request.

Most hospitals offer information events and tours of the individual delivery rooms, so you can take a close look at everything beforehand and determine which hospital is best for you. Don't be afraid to ask the doctors on site any questions you may have.

All the advantages and disadvantages of the hospital at a glance:

Advantages:

• Follow-up examinations (U1 and, if necessary, U2) are carried out directly on site
• Permanent care
• Medical care and professional staff
• Classic pain relief measures, such as a PDA (epidural anesthesia), can be requested
• Possibility of an inpatient birth, i.e. you can stay in the hospital for a few more days
  

Disadvantages:

• Possible shift change during birth (exception: attending midwife)
• In the case of an outpatient birth: for the U2 examination, it is important that you have chosen a pediatrician in advance, i.e. more organization
• Not necessarily individual care

In addition to the traditional hospital, there is the option of giving birth outside of a hospital. This includes birthing centers as well as home births:

Birthplace

An alternative to an outpatient birth in a clinic is a birth in a birthing center. A birthing center is usually run by several midwives. Some birthing centers also have close contact with a doctor. The birthing center exudes a homely and homely atmosphere so that you can feel comfortable and safe. Many birthing centers also offer birth preparation courses and check-ups beforehand.

In contrast to the hospital, the birthing center offers minimal medical care. In addition to an oxygen monitor, a CTG monitor is usually also available. Classic pain relief measures such as a PDA (epidural anesthesia) are not offered in the birthing center. Alternative treatment methods for pain relief such as massages, acupuncture or homeopathic remedies are available and can be requested during the birth.

Unlike in a hospital, there is no change of midwife. During the birth, one or two midwives are at your disposal and will look after you exclusively.

You also have the option, just like in the hospital, to choose between different birthing positions or even a water birth.

All the advantages and disadvantages of the birthing center at a glance:

Advantages:

• Homely and cozy atmosphere
• No change of midwife
• Getting to know the midwife before the birth
• Alternative treatment methods for pain relief such as massages, acupuncture or homeopathic remedies

Disadvantages:

• No traditional pain relief measures
• Minor medical care

Home birth

Similar to a birthing center, you will usually be supported and cared for by two midwives during a home birth. A home birth is only recommended if there are no risks for you and/or your child. If you have a high-risk pregnancy or other conditions that affect the health of your child or your own health, a home birth is not recommended. But here too, it is important that you discuss this in advance with your midwife who is to conduct the home birth or your doctor.

On the one hand, you can often be more relaxed during a home birth because you give birth in a familiar and homely environment and feel more comfortable than in an unfamiliar delivery room. You can also have a water birth at home, similar to a hospital or birthing center. If you don't want to give birth in your bathtub or don't have one, there are so-called birth pools. You can borrow these from certain providers, or your midwife may be able to provide you with one. The birth pool often offers you a more comfortable entry and exit. In addition, your midwife can provide help from all sides.

On the other hand, clinical medical care is usually not available for a home birth and the journey to the hospital, if complications arise, usually takes longer. If you are considering a home birth, it is advisable to register with the nearest clinic in advance. This way, they will be prepared for you in an emergency and can act quickly. If there are siblings, it is also worth considering whether they should be looked after or be there.

All the advantages and disadvantages of home birth at a glance:

Advantages:

• 1:1 care by the midwife
• At home you feel most comfortable and are more relaxed
• Your own wishes are taken into account

Disadvantages:

• No clinical medical care
• The journey to the hospital (in case of complications) usually takes longer
• No traditional pain relief measures

If you want to find out more about home births, our interview with Julia Berg (Instagram @geburtsgefluester) is just right for you! Julia is a clinical psychologist and offers help in processing birth experiences. In Home Birth Part 1 and Home Birth Part 2 you will find out how Julia experienced and perceived her own home birth.