Hospital birthing units Midwifery-led care

These are birthing centers staffed by midwives with minimal high-tech equipment, or use of epidurals.

There may be a birthing center in your community. Some centers are free-standing but often hospital based. Staffed by midwives for the most part, such centers offer a caring homelike setting with minimal use of technology. Since they are all affiliated with a medical center, transportation is made if labor becomes complicated, if the mother requests an epidural, or if she requires an assisted delivery or cesarean.

Getting the birth you want

Although there are no guarantees that your labor will proceed in the way you would like it to and it's probably best to approach labor with a flexible attitude, there are things you can do to make it more likely that you will end up having the type of experience you would prefer. Attending childbirth classes and being as informed as possible about labor and your choices will help you to prepare in advance. Other things women find helpful are having a supportive birth partner, making decisions with the midwife, being positive, and using a birth plan.

Communicating with your midwife helps to ensure that she is clear about your wishes and you work together.

A birthing ball provides support, but also means that you can be active by rotating your hips.

Hospital checklist What to check before going into hospital

Part of planning for labor is finding out which facilities your local maternity unit provides and what you might need to provide yourself to help you through the labor and birth.

  • Check if your local unit supplies equipment such as birthing balls or TENS units or whether you need to rent these in advance.

  • Check in advance if the hospital has a birthing pool and midwives trained to deliver babies in water.

  • Find out if your hospital has a dedicated birthing unit.


Visualize your dream birth and work toward making this a reality—whether a home birth, or creating a calm environment in your hospital birthing room


What could be more natural to reduce stress during labor than a soak in a warm bath or even standing under a shower?


While in the hospital, you may need to summon your assertive skills to ensure a safe environment for you and your baby

Home birth Planning a birth at home

Although only fewer than one percent of women in the US choose to give birth in their own home, this number is increasing. Research has shown that mothers may have shorter and less painful labors in their own home. It is not known why this is, although it may be due to them feeling more confident and comfortable in their surroundings. You will generally have at least one midwife with you constantly once you are in established labor during a home birth. Many women rent a pool for use during labor at home, and this may progress to a water birth.

Q: Will I be allowed a home birth?
A: If your pregnancy has been classified as “low risk”—you are healthy and have not had any complications in this or any previous pregnancies—then a home birth may be an option. If your doctor or midwife isn't able to help you with a referral, you could find a home-birth midwife in your community through Midwives Alliance of North America (MANA).
Q: How do I plan for a home birth?
A: If your midwife is agreeable to the possibility of you having a home delivery, you need to talk to her about the type of home birth you want to have, for example do you want a water birth or to use a birthing ball, and how do you plan to manage the pain? If you would like a water birth, you will need to rent a birthing pool well in advance. You may want to set up a special area in your home to have your baby, which ideally should be near bathroom facilities. Plastic sheeting and old sheets are advisable to protect your flooring, and shower curtains make a good surface for giving birth. You will also need a supply of plastic bags for waste.
Q: What will happen?
A: The midwife will meet with you once in your home prior to the due date. She will want to assess the layout and preparations for the birth. Many home birth practices have strict guidelines for travel time and will want to meet your partner and family if possible. You must agree to be transported to the hospital if your midwife feels it's necessary. Some midwives like you to provide towels and plastic sheets. You will not be able to have an epidural or a cesarean at home so candidates are selected carefully.
Q: What if there is a problem?
A: If the midwives are at all concerned about you or your baby's health, they will discuss this with you and it may be necessary to transfer you to hospital. This transfer is usually done by ambulance, accompanied by paramedics, your midwife, and your birth partner.
A home delivery:

Having your baby at home can be a relaxed and intimate experience, giving you control over your environment and allowing siblings to see the new baby right after the birth.

Water births Relaxing in labor

Some cultures have used water births for centuries to provide a gentle birthing experience. Today, there is evidence to support the fact that labor may be quicker and less painful in water.

Q: How can it help with the pain?
A: Possibly women feel more comfortable and therefore more confident and in control in water. It is thought that water sets off a surge of oxytocin (the hormone that triggers contractions), making contractions more effective. Some women find they can move around more easily in water, which helps them find a good position in which to give birth. Some feel the benefits of immersion in warm water as soon as they get into the pool, but for others it can take 15–30 minutes before they relax. Water can be a natural aid to relaxation as it soothes muscles and releases tension. When we feel less anxious, our bodies produce fewer “stress” hormones. This encourages the brain to produce endorphins, the body's painkillers, and promotes well-being. Dimmed lights and relaxing music can further aid relaxation. Some studies suggest that women have a shorter second stage of labor in water, and there may be less exertion needed to push the baby out. Pain medication is available to you if your are planning a water birth.
Q: Can the baby be monitored in water?
A: Your baby can still be monitored by the midwife using a stethoscope or a waterproof handheld electronic doppler.


Myths and misconceptions Is it true that…

Q: Owls are bad luck?
A: Owl superstitions are just plain silly! If a pregnant woman hears the shriek of an owl, her child will be a girl. An owl living in the attic of a house will cause a pregnant woman to miscarry. When the time comes to give birth there should be no owls in the delivery room—if they hoot at the moment of birth the child will have a miserable life. These really are myths!
Q: Raspberry leaf tea makes labor easier?
A: The evidence for this is largely anecdotal, although some studies have been conducted. Advocates of raspberry leaf tea claim it increases the muscle tone of the uterus making for more effective contractions, and therefore a shorter and easier labor. However, it's important not to use raspberry leaf tea (or extract) until the last two months of pregnancy because of the possible stimulating effect on the uterus.
Q: Your partner weighed 10 lb at birth, so your baby will be a whopper, too?
A: No, it's more complicated than that—it depends on the mix of chromosomes your baby inherits. So, if the father is a strapping 6'4” and was a huge baby, and you're a petite 5'2” and were a tiny baby, keep your fingers crossed that you have the more dominant genes!
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