Considering an out-ofhospital birth
While most women in the United States give
birth in a hospital, some women choose to give
birth at a standalone birthing center or in their
own homes 먹튀검증.
Talk with your care provider in choosing a
birthing location. Being pregnant for the first
time, being pregnant with multiples, having a
previous cesarean delivery and other risk factors
are considered in weighing the safety and
recommendations for each woman. For all
women, a certified midwife or physician
attending the birth and ready access to a nearby
hospital are critical for a safe outcome.
Birthing center Birthing centers can be
independent facilities, or they may be affiliated
with a hospital. Most birthing centers are run by
certified nurse-midwives or teams of obstetrical
care providers, and they strive to provide a more
natural birthing experience for low-risk, routine
pregnancies, without overuse of medical
intervention. Because of the reduced need for
personnel and equipment, birthing centers may
be more cost efficient. You might consider a
birthing center if your pregnancy is low-risk,
you’re looking for a homelike experience and
there’s an affiliated medical center nearby. Be
sure to check on the licensing and credentials of
the providers, as well as your insurance
coverage. If you’re worried that complications
could arise, a birthing center may not be the best
choice. If you do experience complications, you’ll
likely need to be transferred to a hospital, and
that takes time.
Home In the United States, each year about 1
percent of women have their babies at home.
The trend for home births has been growing in
recent years and remains somewhat
controversial, as the risks even for women with
healthy pregnancies are greater than in a
hospital. Midwives are almost always the care
providers for home deliveries. Women who
choose to deliver at home often wish to avoid
medical interventions and the hospital
environment. The disadvantage is that if
problems arise, they may not be recognized early
on. In certain situations, delay of care could
compromise the health or life of mom and baby.
Research suggests there may be certain benefits
to women in these settings compared with
hospital births, including fewer interventions,
such as labor induction or episiotomy, and fewer
perineal tears. However, the possible benefits of
a home birth must be weighed against a higher
risk for both mom and baby.
Keep in mind: Current research findings
reflect that women who plan to give birth out of
hospitals generally have fewer risk factors than
those planning hospital births, leading to
differences in outcomes. In addition, out-of-
hospital birth statistics may not include cases in
which a woman is transferred from home or a
birthing center to a hospital due to
Further research is needed to better determine
the benefits and risks of out-of-hospital births in
the United States. Meanwhile, care providers can
help review risks for those considering birth
outside a hospital setting.
Family physicians Family physicians provide
care for the whole family through all stages of
life, including pregnancy and birth. Some family
physicians, however, choose not to handle
Practice Family physicians may work solo, or
they may be part of a larger group practice that
includes other family physicians, nurses and
other medical professionals. Family physicians
are usually associated with a hospital where they
can perform deliveries.
Advantages If you’ve had the same family
doctor for a while, he or she will probably know
you well and be familiar with your family and
medical history. Thus, a family doctor may view
your pregnancy as part of the larger picture of
your life. Another advantage of a family doctor is
that he or she can continue to treat you and your
baby after birth.
Issues to consider Family physicians can
cover most obstetrical care, but if you’ve had
problems with a pregnancy before, your family
physician may refer you to a specialist in
obstetrics or use a specialist as a backup
provider. The same may be true if you have
diabetes, high blood pressure or another medical
problem that may complicate your pregnancy.
You might choose a family physician for your
prenatal care if:
-You and your doctor don’t foresee any
problems with your pregnancy.
-You want your doctor to be involved with all
members of your family.
-You enjoy the continuity in care from
prenatal appointments throughout
childhood and beyond.
Maternal-fetal medicine specialists Also
called perinatologists, these specialists are
trained in the care of high-risk pregnancies.
They deal with the most severe pregnancy
Practice Maternal-fetal medicine specialists
often work as part of a group practice, and
they’re generally associated with a hospital,
university or clinic.
Advantages This highly specialized doctor is
familiar with the complications of pregnancy and
adept at recognizing problems. When women
with major medical concerns become pregnant,
their physicians often consult with maternal-fetal
medicine specialists to optimize care for
both the mother and her baby.
Issues to consider Maternal-fetal medicine
specialists concentrate solely on the problems
that occur with pregnancy.
A maternal-fetal medicine specialist rarely
serves as the primary health care provider for a
pregnant woman. This specialist is brought in at
the request of another care provider. You may be
referred to a maternal-fetal specialist if:
-You have a severe medical condition
complicating your pregnancy, such as an
infectious disease, heart disease, kidney
disease or cancer.
-You’ve previously had severe pregnancy
-You plan on having prenatal diagnostic or
therapeutic procedures, such as chorionic
villus sampling, amnio-centesis, or fetal
surgery or treatment.
-You’re a known carrier of a severe genetic
condition that may be passed on to your
-Your baby has been diagnosed before birth
with a medical condition, such as spina
How to decide Navigating the health care
system to find the right care provider can be a
daunting process. Here are some suggestions
that may be helpful.
Ask for help Try these approaches:
-Check with your insurance company to find
out which hospitals and services are
covered. The “find a doctor” feature on your
health plan’s website may be helpful.
-Consult with your regular doctor and other
-Ask family and friends whom they would
-Check the website of the clinic or hospital
you prefer to find out who provides
-Contact the labor and delivery unit at the
hospital you prefer and ask for a
Issues to consider Ask yourself these
-Is the care provider certified by a medical
board or the board of nurse-midwifery?
-Is the provider’s office a convenient distance
from home or work?
-Is the care provider going to be able to
deliver my baby in the place I want to give
birth ? at a particular hospital or birthing
center, or my home?
-Does the care provider work in a solo or
group practice? If it’s a group practice, how
often will I see him or her? How often will I
see others from the practice?
-Who will replace my care provider if he or
she isn’t available in an emergency or when
-Is the care provider available to answer
questions in between my scheduled
-Do I want my care provider to be able to
treat my entire family?
-Did the individual listen to my concerns and
answer my questions?
-Did the individual seem open and caring?
-Is the care provider covered by my