Midwives weighing a newly born baby at a birth center.

Birth Center or Home Birth? What’s the difference?

Midwives weighing a newly born baby at a birth center.This weekend, I announced that we’ll be opening a new birth center in Winchester, Virginia early in 2016 — Premier Birth Center. Personally, I’m pretty excited about it! I love home birth, but sometimes a birth center birth is a better option for a family. A birth center offers a bit of a middle ground between home and hospital, and for some families, it’s just the right fit. Here are some questions to consider when thinking about where to welcome your baby:

How far away is the hospital?
Most birth centers are located fairly close to a hospital. Premier Birth Center is about 15 minutes from Winchester Medical Center, and the local EMS is less than a mile away. In fact, there are two EMS stations within a mile and a half. Typically, over time, a birth center’s staff develops a relationship with the local hospital and EMS (ideally, meeting regularly with EMS), making for a smooth transfer to the hospital in the event of an emergency.

On the other hand, if your home is in a more remote location, your distance to the hospital may be greater, and your local EMS may not be familiar with midwives and home birth. This doesn’t mean it will be a problem. It just means a hospital transfer can take a little longer and can be a little less smooth.

How big is your birth space at home?
It isn’t a big deal to your midwife. We generally can work anywhere; the baby will still be born, and the baby doesn’t care how big the place is. But, all things being equal, if you have the choice between a small space where you’ll feel crowded once the midwife and birth assistant arrive, and a larger space where you don’t feel so cramped, maybe you’d like that bigger space. Of course, I’ve been to plenty of home births where the birth space was enormous, way bigger than any birth center I’ve ever been to!

One benefit of a birth center that I hadn’t considered until I had been at a few birth center births was that at a birth center, the midwives can easily be out of your birth space. At home, once the midwives arrive, even though there is no desire on their part to pressure you to hurry up and have your baby, there is a sense that it’s baby time. No matter where they are in their house, they are in your space. At a birth center, you have your own space in the birth suite, and the midwives can just leave you to your laboring, while they go about doing their own stuff. They’re close enough by in case you need them, but far enough removed that they don’t feel like they’re hovering.

What about your kids?
Sometimes, it’s just easier to have someone come to your house to stay with your kids, while you go somewhere else to give birth. Sure, you can stay home while someone is there taking care of your kids, but sometimes it’s nice to not have the distraction of knowing your kids might hear your birth sounds, or worry about what they might experience if there were an emergency.

Do you want to do it yourself, or do you want it done for you?
With a home birth, you are in charge of getting your birth space put together. If you want a waterbirth, and you don’t have a big enough tub at home, you’ll need to rent or buy one. You’ll usually need to buy a birth kit, which is a box of disposable supplies your midwife will want you to have for your home birth. There will be other supplies you’ll need to gather from around your house, acquire from friends, or buy. There are a few other preparations, too. None of this preparation is a big deal; you just have to do the work. Your midwife will probably have a list for you and will help you through it.

With a birth center birth, you just show up with your bag of personal items and some snacks and beverages. The midwives take care of everything else. The pool is there. The supplies are there. And, there are backup supplies, in case you have a long birth and run out of something.

Who’s doing the cleanup?
At home, your midwife and birth assistant will do a little bit of cleanup while they are there. They’ll gather together the trash and laundry. They’ll tidy up your birth supplies a bit. But, that’s about it. There’s generally not a big mess to deal with, but there’s still a fair bit of work you’ll need to do to put away all of the things you gathered for the birth. Of course, it doesn’t need to happen right away, but it is work that will need to be done eventually.

At a birth center, you don’t do any of the cleanup. You leave and go home to your house the way you left it. The birth center staff takes care of the cleanup.

Who’s helping you after the birth?
At a home birth, the midwives usually leave about 2-4 hours after the birth, so long as mom and baby are stable. Some birth centers, including Premier Birth Center, offer an extended postpartum stay. With this option, you can stay up to 12 hours after the birth for additional monitoring and help from one of our postpartum nurses. This can give you additional reassurance, especially if you were GBS positive, want assistance with breastfeeding, or just want some extra time to rest and have help with your baby.

Ultimately, the decision about where to give birth should be based on what feels right for you. All of the questions listed here are things to consider, but some decisions need to be made with your heart and not your head. Your baby’s birth place should be where you feel is best for you and your baby.