The traditional birthing choice in the United States involves having a doctor-assisted delivery in a hospital setting. Despite the popularity of the traditional hospital birth, there are other birthing options women may want to consider before signing on the dotted line for admission. Most obstetricians support hospital births, but a growing number of professionals support a healthy, pregnant woman’s options for alternative birthing choices.

The team

Your team is made up of caregivers and support staff. In a traditional setting, the team is generally made up of your obstetrician or the attending obstetrician and nursing staff on the labor and delivery wing of the hospital. Other important members of the medical and support community to consider include:

• Midwives: Midwives are trained and experienced in helping women give birth when no other medical conditions or pregnancy complications exist. If you have had a flawless pregnancy with no complications, a midwife could be hired as part of your birth team. If there are complications, midwives tend to bring the pregnancy to the attention of partner obstetricians or hospital personnel.
• Family Doctors: Just because family doctors see patients with every ailment from the flu to a broken finger does not mean they are incapable of delivering a healthy baby. Low-risk pregnancies are within the realm of care for family doctors. High-risk pregnancies are typically addressed with specialized training and education unique to the obstetrician. 
• Doulas: Doulas are not part of the medical birth team – rather, doulas offer support during labor and delivery. You can have an obstetrician or midwife and a doula.

The environment

Where will you give birth? Home births are on the rise and water births provide a relaxing environment for many women – but the birthing environment is only partially in your hands. The primary member of your birth team needs to support that choice 100%. Obstetricians tend to support hospital births as do many family physicians. More certified nurse-midwives (CNM) tend to also deliver in the hospital.  

Pregnant women must take into consideration the increased risk of complications such as an increased risk of neonatal death associated with homebirth and the distance from the birth environment to the nearest medical center. If there is a complication during labor, delivery or the postpartum period for the mother or infant, a transport to the medical center will be necessary for medical care since it can take too long to get to the hospital from home. Birthing too far from supportive medical staff could be dangerous.

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The short and long of labor support

Your birthing choices do not stop after choosing the primary care provider and environment where you will be giving birth. Labor can be long for some women and extremely short for others, so you need to establish a birth plan.

The birth plan can be as vague or as detailed as you like, but it should include details about who you want in the delivery room and who you have chosen as your go-to person for childcare (if applicable), bedside support, and family/friend contact.

Options for medical interventions

There are some medical interventions you have the right to choose and others that will be used based on medical necessity. VBAC or vaginal birth after C-section is one of the birthing choices you can discuss with your obstetrician. The details of your previous pregnancy, the reason for the C-section and current pregnancy health status will help your doctor determine if you are a candidate for VBAC.