The short answer: A birth center is a home-like place run by midwives, made for healthy pregnancies and undisturbed birth. A hospital has doctors, anesthesiologists and epidurals on site, and many have midwives too. Birth centers usually have their own fee. Ask the center for its price and your insurance company what it covers.
By Sybille Mom of two · first birth in a hospital, second at home · Education only, not medical advice
My first baby was born in a hospital, with an epidural. I was completely numb, and I felt helpless. That was my experience, and it isn't everyone's. Many moms feel wonderful about their hospital births, and an epidural can be a real gift.
What I wish I'd known is that I had choices. So let's gently look at two of them side by side.
Who cares for you
At a birth center, midwives lead your care, often the same small team from your first visit to your last. The American Association of Birth Centers describes a birth center as "a maximized home rather than a mini-hospital."
At a hospital, your care is usually led by an obstetrician, a family doctor or a certified nurse-midwife, with nurses by your side during labor. Certified nurse-midwives work in hospitals, birth centers and homes (ACNM).
What's available
At a birth center, you'll often find large beds, birth tubs, freedom to move, eat and drink, and plenty of quiet. Birth centers don't offer epidurals, so you'd go to a hospital if you want one.
At a hospital, epidurals, doctors and an operating room are right there. Many hospitals also offer tubs, birth balls and dimmable lights, so ask what yours has.
How birth tends to go
Birth centers are built for undisturbed, low-intervention birth. If you'd like an epidural or need more help, the hospital is there for exactly that, and I'm grateful it is.
What it costs
Birth centers usually have their own fee. Ask the center for its price and what it includes, and ask the hospital what a birth there usually costs. What you pay depends on your plan, so call your insurance company and ask what it covers at each. Here's more on insurance.
Gentle questions to help you choose
- Where do I picture myself feeling calm and cared for?
- Do I want an epidural available down the hall, or do I want to try other comfort tools first?
- Who would care for me, and can I meet them before labor?
- At a birth center: which hospital do you work with, and how would we get there if plans change?
- At a hospital: can I move around, eat, use a tub and keep the lights low?
- What does my insurance cover at each?
Many moms also consider a third option, a home birth.
Whatever you choose, talk it through with an experienced midwife and your care provider. They know you and your pregnancy, and they're the right people to help you decide.
Questions moms ask
Can I get an epidural at a birth center?
Birth centers don't offer epidurals. If you'd like one, you'd go to the hospital, and that's okay.
Do birth centers have doctors?
Birth centers are run by midwives, and they work with doctors and hospitals nearby. Ask each birth center which hospital and doctors it works with.
Is a birth center cheaper than a hospital?
It depends on the birth center, the hospital and your insurance plan. Ask the birth center for its price, and ask your insurance company what you'd pay at each.
Can I have a midwife at a hospital?
Yes. Many hospitals have certified nurse-midwives. Ask your hospital or insurance company how to find one.
Can I make a hospital birth feel calmer?
Often, yes. Ask about dimming the lights, moving around, eating and drinking, using a tub, and who can be with you. Bring your own playlist and pillow.
