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How Should You Choose Between a Hospital and a Home Birth?

April 7, 2014
Health, Medical Costs
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How should you choose between a hospital and a home birth? The decisions associated with having a child can be some of the most important ones you will make in your entire life. From dealing with nine months of ups and downs during pregnancy to shelling out big bucks for diapers, groceries and, later, tuition — there is a lot that goes into becoming a parent. One of the first decisions that come with passing on your genes is where to have your baby. Parents-to-be will spend countless hours researching doctors and baby names and planning appointments and baby showers — but what is the right choice when it comes to a home birth versus a hospital delivery?

You may be astonished at the question, thinking home births are a thing of the past. But according to the Centers for Disease Control and Prevention, births outside of a hospital setting increased 29 percent between 2004 and 2009 — that’s almost 30,000 births. The CDC also reports that 1 in every 90 births for Caucasian women occurs at home, whereas home births for other racial and ethnic groups are less common. While the number of home births is climbing, most women make the decision to visit the hospital on their due date: just 0.72 percent of births took place outside of the hospital in 2009. Consider the following to determine which option is right for you and your wallet.

What kind of experience do you want?

Consider your options based on the type of birth experience you are looking for. Many mothers choose an at-home delivery because of the comfort and personalization that comes with the more familiar environment. Women opting for home births may also have the opportunity to switch positions during birth, eat, drink or move freely throughout the experience. Those who want to avoid medical interventions such as a Cesarean section may lean toward a home birth, but they should have a plan to go to a nearby hospital should the need arise at any time during delivery.

On the other hand, women may choose a traditional hospital birth for safety reasons and the peace of mind that comes with a team of doctors and nurses armed with medical equipment. Stress can complicate the birth, and some women may find the presence of experienced medical professionals in a delivery room to be calming.

Complications of home birth are a major reason for choosing to deliver in a hospital. According to a recent study, the mortality rate for babies delivered by a midwife at home is four times higher than for those delivered by a midwife in a hospital. The study cited stillbirth as the most common issue with home births, with approximately 18 to 19 deaths each year that could have been avoided in a hospital setting. Proponents of home birth, however, maintain that low-risk pregnant women who chose to have their baby at home can reap a multitude of benefits, from less stress to better health.

What will it cost?

For many, cost is an important factor in considering birthing options. A survey by the U.S. Agency for Healthcare Research and Quality determined that the average cost for a vaginal birth with no complications in a hospital rose from $9,617 in 2009 to $10,657 in 2011. Prices were higher for births involving C-sections or complications, with totals falling anywhere from $12,532 to $23,923. The cost of having a baby can vary from hospital to hospital, but having insurance will help to reduce your costs — especially seeing as pregnancy is one of many women’s health services now covered under the Affordable Care Act.

According to the American Pregnancy Association, an average, uncomplicated vaginal home birth costs approximately 60 percent less than a hospital birth. As in hospitals, prices can range depending on the midwife or home birth practitioner selected. Before settling on a home birth, check to see what your insurance company will cover for a home birth versus a hospital birth.

What to expect?

For families opting for a hospital delivery, keep in mind that being in a hospital doesn’t necessarily ensure safety — but it does put you in a better position to receive treatment should the need arise. Be prepared for complications (e.g., C-sections, medicines, longer stays) and the unexpected costs that may come along with them. Seek out a trusted medical consultant, whether an OB/GYN or a midwife, to be your guide, and ask the right questions about the hospitals you are considering for giving birth. Finally, keeping in contact with your health insurance provider — even before tests and procedures are performed — is another important step in financing your delivery.

Women considering a home birth should carefully evaluate their health status. Home births are more frequent in low-risk pregnancies, according to the CDC. Women with diabetes, teenagers and multiple-birth mothers often require hospital care for delivery. If you decide on a home birth, seek out a certified nurse-midwife or other experienced birthing professional who suits your needs and comforts. Advance preparation is key to a successful home birth, from securing insurance coverage to coming up with an emergency plan should complications arise.

Hospital image courtesy of Shutterstock.