What are the Differences Between Home and Birth Center?

Once upon a time I owned a gorgeous birth center here in LA. It was a dream of mine as there were no birth centers open in LA at the time. The Hollywood Birth Center (the midwives that did my home births) had closed its doors, and I was passionate about seeing this as an option for families. My vision with The Sanctuary was to make it as mainstream as possible so that families who didn't see themselves as "crunchy home birthers" could envision out of the hospital birthing. My practice of course has come full circle... I decided that the group practice that we envisioned as giving the midwives balance actually diluted the care in a way that I personally at this point in my career I wasn't interested in. I now dreamed of practicing as close to the way our grandmother midwives practiced. Home visits, small practice, with my clients and I deeply intimate. I'm editing our beautiful Sanctuary book so that I can use it for my current clients and this part needs to be cut...so I thought a perfect blog post!

What are the difference and whats right for you?

"Contrary to popular belief a birth center birth is technically no “safer” than a home birth. While this is an excellent option for some families (such as those families who are living with extended family or roommates, or families who live outside of the midwives’ home birth area) it is truly no safer for mother or baby. The only piece that may make it safer is proximity to a hospital, especially for families living in less urban areas like the canyons or in places where hospitals are not friendly to home birth transfers.

The same equipment, safety procedures, training and medicine are available at both a home birth and birth center. Both locations require a mother to be healthy, low-risk, and informed of the risks of an out of hospital birth. The birth team is the same and a doctor is not attendance (unless you have chosen to have Dr. Fischbein at your birth). The birth team arrives during active labor in both locations so the midwives attend to your care for the same amount of time and with the same attention during labor, birth and postpartum whether you’re giving birth in your home or ours.

A big difference between home and birth center birth is that you need to travel to the birth center during active labor and travel home a few hours after birthing, with your new baby in a car seat. Nothing is more beautiful than climbing into your own bed with your baby immediately after birth, having the birth team tuck you in before they finish cleaning up your house and leave as you fall asleep. However, some women are happy to leave their homes and find a place of quiet if they live with others, such as roommates or in-laws, or have older siblings that they feel may distract them during labor.

A lot of clients ask about the “mess” of a home birth. The birth team are experts at cleaning up after a birth and often leave your home cleaner than when they arrived. The birth team uses disposable pads that come in your birth kit to contain the birth and during the home visit, the midwife will review what you can do to protect your mattress and carpet, as well as supplies to have on hand. They take out the trash, throw in the first load of laundry, wash the dishes and clean up the birth area before leaving. The difference at the birth suite is that you don’t need to gather any supplies for the birth itself besides ordering the birth kit and bringing anything that makes the space feel like your own. Music, artwork, a special blanket or candle, and food and drinks for the birth. Some women find it more comfortable to go to the birth suite to focus and give birth without the distractions of home and return after their birth to their house as they left it.

Although natural birth out of the hospital carries a low risk for infection, you are less at risk of developing an infection in your own home than at the birth center because your body is already acclimated to the bacteria in your home. Your immune system has already responded to your environment. Even though we thoroughly clean and disinfect the birth center between births, it is still a place that is other than your home and your natural bacteria. " (taken directly from The Sanctuary Birth Center client book)

This is what we would tell women in choosing our team either at home or birth suite. If your deciding on whether you should deliver at home or birth center there are a couple additional things I have noticed from owning a birth center and now having a solo home birth practice.

*A birth center in a hospital is not the same thing as a free standing birth center...don't be fooled by the marketing. Its still a hospital with all the same mindset, policies and procedures.

*Some birth centers are able to take insurance including Medi-cal.

*Some birth centers have more restrictions on who can deliver there at the center (ie VBAC, breech etc)

*There are many subtle nuances that have the "practice" of a birth center be generally more conservative in their approach to many issues.

Any additional concerns or questions...let me know here or on social media...everyone will benefit from the dialogue...who knows maybe it will be a good video or podcast conversation!