The Location of the Birth

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During pregnancy, people often ask where you plan to give birth. There are many different opinions on this—what choice will you make, and why?

There are two places where you can give birth: at home or in the hospital. But giving birth in the hospital can take various forms.

First of all, you may be advised to give birth in the hospital because there is a reason why giving birth in the hospital—which is a secondary-care facility—is recommended. In that case, you will give birth medical. In many cases, prenatal care is already provided by secondary care providers, for example, in the case of a multiple pregnancy. However, it’s also possible that secondary-care providers will take over prenatal care, for example, if your baby is in a breech position after 37 weeks or if your previous delivery was a C-section.

It’s also possible that your delivery will take place under a shared responsibility model, known as B-D Indications. We are responsible for your care during childbirth, but we do recommend giving birth in the hospital. The reason for this is that even before labor begins, there is already an increased chance that you might end up in the hospital. For example, if you lost a lot of blood during a previous delivery or if the baby needs to be examined by a pediatrician after birth. To prevent the increased risk of having to be transferred from home to the hospital in such cases, we recommend giving birth in the hospital. You’ll still be able to give birth with our support, but if a risk arises, there will be no need for a transfer. Additionally, the secondary care team is already partially aware of the situation, which means less time is needed for a handoff.

If you are not considered to be at increased risk prior to delivery, you have the option of giving birth at home or in the hospital.

What are the differences between them, and why would you choose one over the other?

Home is your own familiar environment, where you’re often more relaxed. This can help ensure a smooth delivery. You can move around in the different rooms of your home. You don’t have to get in the car to go to the hospital, and you won’t have to travel anywhere after giving birth either. You’re less likely to develop infections or require medical interventions, such as labor-inducing drugs or an epidural.

A birth center is a place within the hospital where you can give birth. At the Amersfoort, it’s located on the same floor as the delivery rooms. The rooms are tastefully decorated. You have the option of giving birth in a birthing tub, and one of the two rooms is equipped with nitrous oxide. We work with a team of permanent maternity nurses who assist with care during childbirth. We’ll contact them to check for availability when we take you from home to the birth center.

If you give birth at a birthing center, there is no contact with the hospital staff. This means they don’t know who is at the birthing center. If you have a medical indication, we will contact the medical staff. They will then check if there is space available in the delivery rooms. It’s possible that there won’t be any space available and that you’ll need to be transferred to another hospital. In emergency situations, there’s always space available.

What will you choose?

Neither option is safer than the other. You should give birth wherever you feel most comfortable.

As midwives, we are qualified to assist with home births or births at a birthing center. We monitor the progress of labor. If any risks arise, we will discuss them with you and contact the secondary care provider to take over your care.

When will you make your decision?

The moment when the decision ‘must’ be made is during labor. With your first child, we head to the hospital when you’re about 6–7 cm dilated, and with your second child, often as soon as you enter the active phase—meaning contractions every 5 minutes that last for one minute. That’s when you really need to make the decision. You’ve likely already developed a preference for where you want to give birth earlier in your pregnancy. In any case, it’s important to think about the different options during your pregnancy and to discuss them with your partner. If you’ve made your (preliminary) choice during your pregnancy, it would be great if you could let us know as well.

Sometimes you may find that you ultimately no longer have a choice. This could be because you’re advised to give birth in the hospital for medical reasons, or because things are progressing so quickly that we no longer have the option of getting to the hospital safely. In the latter situation, labor has already progressed to the point where it’s safer to stay at home. So don’t just prepare for the location where you’d most like to give birth—also keep in mind that things can sometimes turn out differently.