Planning on giving birth in a hospital? You're not alone. Although home births are on the rise, out of the four million births that take place every year, a whopping 97 percent still take place in a hospital setting. And with good reason. Statistically speaking, hospitals are the safest place for a woman to have her baby. And for some mamas-to-be with pre-existing conditions, giving birth in a hospital isn't just the smarter choice, it's the only choice.
Here, 15 reasons to give birth in a hospital.
1. It’s your first pregnancy. While every pregnancy and delivery won't be exactly the same for you, medically speaking, you can't be sure what to expect. "With first pregnancies, you don’t know if there’s anything you need to be worried about," says Alan Penzias, M.D., Boston IVF Surgical Director & Reproductive Endocrinologist. "In the small chance that there’s a problem, a hospital has all the backup you could possibly need."
2. You’re attempting a VBAC. In this case, there's a 25 percent chance that you'll need a repeat C-section and so a hospital is the safest place to give birth. "I wouldn't advise a home birth for a VBAC for any woman who has more than one prior cesarean, any woman who has any level of PTSD from her prior delivery or maternal mental health issues, or if you're a couple who doesn't feel safe as a unit birthing out of hospital," says Rebecca Egbert, a certified midwife and maternal health coach in Minneapolis. (If your doctor or hospital won't give you the option of a VBAC, seek a second opinion or a provider within the hospital who will allow you the choice.)
3. You have uterine fibroids. Because you're more likely to require a C-section, have a breech baby, have labor that fails to progress, and/or have preterm delivery, it's widely recommended that you deliver in a hospital.
4. You’re expecting twins, triplets ... or even more. "Depending on the gestational age of multiples, a hospital is the best setting for birth," says Egbert. "Multiples are seen as high-risk due to the myriad complications that can arise during labor, delivery, and postpartum."
5. You’re ... of a certain age. Being advanced maternal age (35 or older) isn't necessarily reason alone to choose a hospital delivery, but it's certainly one to consider it, as older women are more likely to experience complications. "We do know that there is a higher likelihood of placental complications, multiples, Down syndrome, and Trisomy's when a women is older than 35," explains Egbert. "A couple has to make an informed decision about their best birth option and one where they will receive quality education and support. I believe this is a great demographic to birth with midwives in hospital who can seamlessly transfer your care to an OB team, should you need advanced maternity care.
6. You have gestational diabetes. Many women who have gestational diabetes have healthy babies and uncomplicated deliveries. However, there are always exceptions, which is why a hospital is an ideal setting for this situation. "The reason it's great to birth in a hospital if you have gestational diabetes is because these are babies who can get sick fast due to sugar levels dropping within the first 24 hours of life," notes Egbert. "It's best practice to have these babies closely monitored and close to your skin to help with regulation."
7. You have placenta problems. "Don't mess with placenta problems," explains Egbert. "We know that the number one reason women die during childbirth is because of complications with postpartum hemorrhage. Most often, hemorrhage presents with the delivery of the placenta or after the placenta. Placenta accreta, placenta previa, and placental abruption are all real complications and are best monitored by the care of midwives or GP/OBs in-hospital."
8. You've had problem pregnancies before. If you've had issues with a previous pregnancy or delivery, birthing in a hospital is a smart bet. "If someone has had a previous delivery where there’s been an issue, there still at risk," says Dr. Penzias.
9. You have a lot of kids. "The ability for the uterus to shrink after giving birth decreases for women who have had five or more children," says Dr. Penzias. "This is called uterine atony, and it can cause significant blood loss." A hospital is ready to deal with anything that may arise.
10. Hello, health insurance. Almost all insurances will cover births in hospitals, whereas the same doesn't ring true for home births. If money is an issue, a hospital birth might be your best bet.
11. You live in the boonies. Strange as it sounds, if you don't live near a hospital, you should seriously consider giving birth in a hospital. From fully trained staffs to high-tech equipment, hospitals have everything required in the case that anything should go wrong in any birthing situation. If you're too far from a hospital, you might not be able to get yourself or your baby there in the event of a home birth emergency.
12. Your baby is less likely to die or have complications caused by childbirth. Doctors and researchers have recently reported that babies born at home via midwives have four times the risk of neonatal deaths than those delivered in the hospital by midwives.
13. You have preterm labor. "I was trained that any baby born before 37 weeks must be cared for by a hospital birth team," explains Egbert. "Evidence and intuition always made me feel safe about this regulation, even if that baby was born pink and screaming with Apgars of 9 and 10. Babies born before 37 weeks are at a higher risk for developing infections and experiencing lung/breathing complications." Egbert also notes that the best place for all babies, particularly preterm ones, to be born is in a setting that supports rooming in and to be skin-to-skin immediately in order to help establish breastfeeding.
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14. Your baby is breech. Statistically speaking, breech babies are at a higher risk than a head-down baby. "The baby's arm or head may get trapped, delaying the birth, depriving the baby of oxygen, or the placenta may start to detach as the uterus shrinks down rapidly (because most of the baby is out) and contracts strongly in an effort to expel the baby," says Egbert. "Current evidence tells us the safest place to birth a breech baby is in a hospital."
15. You want a "natural" birth. You can have a natural birth in a hospital. Many hospitals now welcome drug-free, midwife deliveries. Some even provide water therapy, birthing balls, and encourage laboring women to walk around the hospital floor. Do you research and find out which hospital is most in line with the type of birth you'd like. "Even though a woman is put in the high risk category at a hospital, she and her birth team can still prepare for a beautiful and peaceful birth experience by good planning and communication before," says London King, doula and co-founder of Baby Caravan in New York City. "I've attended necessary planned c-sections, and we still use all the relaxation tools like Hypnobirthing, foot massage, and music. It's the close team of love and support around her."
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