By: Phylana Stowers, RN, BSN
There are many different opinions and sides to this subject; I think we should all just agree that everyone is looking for the best pregnancy experience they can get, and that means different things to different people. Every woman should have the opportunity to choose what kind of delivery they would like, but those facing complicated or high risk pregnancies should take into consideration the health and safety of herself and her unborn child and think about additional services that may be needed. There are pros and cons to both sides, and even the pros and cons are relative, depending on which side of the fence you sit.
“When it comes to hospital births, they are more controlled. The environment is pretty sterile although delivery of a baby is considered to be a “clean” procedure.”
When you are admitted to the hospital for labor, whether it is induced or natural timing, intravenous IV access is obtained, and you are placed on fetal monitors and a transducer that monitors your contractions.
You are usually confined to a bed, especially if the membrane of your amniotic sack has been ruptured (this can happen naturally or the doctor can “break your water” with an amniotic hook), and you are then limited to ice chips. Your food and fluid intake is limited, in case you have to have a Cesarean Section or another emergency that would require anesthesia.
If you would like, pain medication is readily available in two forms. The first is Nubain, a short acting narcotic that lessens pain perception and makes the pain more tolerable. Second is a longer acting epidural that is administered by an anesthesiologist through the space between the spinal cord and the outer membranes, this space being called the epidural space. The epidural, when working properly, dulls the sensations from your stomach to your legs or feet. These are all pretty standard features that come with the hospital.
Another thing that seem to be standard is the administration of Pitocen, which is a medication that is started to help your contractions become strong and regular. Pitocen is made to simulate Oxytocin, which is a hormone that causes muscles to contract in the uterus. The use of this medication is one of the causes of debate. Sure, if a woman needs help getting contractions started, a little help is wonderful, but rarely in the hospital setting is the need for this medication assessed. It seems to be more about time management, and that is one of the problems with hospital births (in my opinion). Instead of letting the birth happen naturally, they want to speed up the process or make it happen at a desirable time for the doctor or mother.
Home births with midwifes or at birthing centers (BC) are different in that you are able to walk around without intravenous access or monitoring of the baby or contractions, and you’re able to eat and drink. With home births or BC births, you can have as many people involved in your delivery as you would like, as opposed to the limit of two or three in the hospital.
Having an experienced person there will also make it run a bit smoother because they know what is needed and how to help comfort you during contractions and throughout the process.
The home delivery can be a quiet and private experience, or a celebration. This all depends on your desires and expectations. Focus is on how you are tolerating the contractions, and keeping you comfortable seems to be the key.
There is also no time constraint – real or assumed. We all need to remember that birth is a natural occurrence; and you don’t need a hospital, a nurse, or any other personnel for it to happen. It happens on elevators, in the backs of cabs, and other inopportune times. The use of midwives or medical personnel makes it safer in the event your baby needs some help at delivery. Having experienced people there will also make it run a bit smoother, because they know what is needed and how to help comfort you during contractions and throughout the process. This being said, one of the cons of home births would be if there were problems that were unforeseen. A newborn that is in distress needs immediate attention, and a wait for the emergency medical service could make a big difference in the outcome of your baby and his or her health.
Of course, this is just the tip of the iceberg; there are several differences between the two settings. If you are being care for by accredited professionals, you should be able to tell them your idea of how you would like your birthing experience to go, and a plan should be prepared that will help you have the experience you desire. Just keep in mind that the most important thing is the outcome of a healthy baby; if that is your goal, everything else should either fall into place or be adjusted to suit. Keep asking questions, keep informed, and keep your options open.