So, as you and your partner delve into discussions about your birthing plan, it’s becoming increasingly real; before you know it, the baby will be here. There is a plethora of considerations, and among them is the pivotal question: “Do we opt for a Vaginal birth or a C-section?” Epidural or natural birth without pain medication? Which OBGYN should you choose, or do you even want an OBGYN to deliver the baby? Yet, amidst these deliberations, a crucial decision that awaits you and your spouse is where the baby will be born

In 2024, home births may seem outdated, but a study conducted in 2019 showed the contrary from what you may think. There was a 77% increase in home births from 2004 to 2017 in the US^[1]. The COVID-19 pandemic also helped to increase home birth’s popularity. According to data published by the National Center for Health Statistics (NCHS), home births increased by 22% from 2019 to 2020 and 12% between 2020 and 2021^[2].

However, hospital births^[3] remain the most popular choice in the US with 98.4% in 2017.

So, where should your baby be born, at home or in the hospital? To help you and your partner make an informed decision, we will look at the pros and cons of each option.

Figure 1. Source: https://pixabay.com/photos/baby-birth-healthy-baby-child-1531060/

Home Birth – What?

Yes, you read correctly.

A home birth is precisely as it sounds, this is where your partner will be giving birth at home. However, rest assured, you won’t be the one delivering your own baby. A midwife or other birthing professionals will attend the birth at your home. Home births are typically recommended only for those with low-risk pregnancies. If your partner has health conditions such as high blood pressure or gestational diabetes, it is advised to opt for delivering your baby at a hospital or birthing center. Therefore, before contemplating a home birth, it’s essential to have a discussion with your healthcare professional.

In fact, there are many pros and cons to birthing at home.

Pros of Home Births

Avoiding unnecessary interventions by healthcare providers
Your partner giving birth in a familiar, comfortable setting
Significant lower financial cost compared to a hospital birth
You and your spouse will have control over things like skin-to-skin time with baby
You can have an active role in supporting your spouse and keeping her comfortable
A vaginal birth is more likely
You can have as many visitors at home as you please;
You can stay with the baby during routine tests or sleeping, etc.

Cons of Home Births

Home births are not for high-risk pregnancies
Should your partner want pain medication, it might not be an option
You may still need to go to the hospital should an emergency occur
Many health insurance plans do not cover home births
Home births are messy – you will need extra preparations like towels and plastic sheets

There are important considerations when thinking about doing a home birth. First, make sure that your health insurance does pay for a home birth. Then, you will want to get to know all the midwives in your area to see who you and your partner are most comfortable with.

Now that you have the pros and cons of a home birth, let’s compare it to a hospital birth.

Hospital Births – Why or Why Not?

It may be hard to imagine that babies are born in any other place than a hospital. Most people still prefer to give birth at a hospital because it is a safe birthing option. Moreover of the biggest advantages of a hospital birth is that Doctors and medical staff are on duty 24/7 and hospitals have the most advanced technology. And chances are that your health insurance will probably cover most of the birthing costs.

If your partner has a high-risk pregnancy, you’ll also want to consider a hospital birth. Reasons for high-risk pregnancies include pregnancy with multiples, gestational diabetes, high blood pressure, etc.

The downside of hospitals, however, is that hospitals can have unnecessary interventions that put the mother and baby at greater risk. You will also have to abide by the hospital policies such as having limited visitors, sharing a room, or separation from your baby.

Figure 2. Source: https://pixabay.com/photos/nursing-baby-bed-hospital-7158026/

Pros of Hospital Births

It may be the safest birthing option for your spouse
Potential for costs to be covered by your health insurance
Doctors and nurses are always available as well as advanced technology like the neonatal intensive care unit (NICU)
There are pain medications are available
Hospitals have staff that cleans any birthing mess

Cons of Hospital Births

The hospital environment can be impersonal and make your spouse anxious
There is a potential for interventions like C-sections and forceps which are routine interventions at certain hospitals
The nearest hospital might be a long drive
Room privacy is not always guaranteed especially if in a public hospital
Your partner and baby will be in an environment where sick people are, increasing their risk for infections
Your spouse may have limited birthing positions and a water birth may not be possible

Figure 3. Source: https://pixabay.com/photos/baby-hands-fingers-infant-child-2416718/

As you can see, there are a lot of aspects to take into consideration when deciding on your birthing plan. Finances alone can paint a pretty clear picture of your options. But most of all, you would want to consider the safest and most comfortable place for your partner to be in. Whether this be in the hospital or at home.

^[1] MacDorman, M., & Declercq, E. (2019). Trends and State Variations in Out-of-Hospital Births in the United States, 2004-2017. Birth (Berkeley, Calif.), 46(2), 279. https://doi.org/10.1111/birt.12411

^[2] https://time.com/6234756/home-births-rise-us-covid-19/

^[3] https://www.ncbi.nlm.nih.gov/books/NBK555484/ (MacDorman and Declercq, 2019; see Chapter 1).