13. Discerning the Right Birth Setting For You: Hospital, Birth Center, or Home?

In this episode, I'm walking you through one of the most important decisions you'll make during pregnancy—choosing your birth setting. Whether you're considering a hospital birth, birth center, or home birth, each option comes with different levels of support, intervention, comfort, and control, and there's no "right" answer—just the one that's right for you and your baby.

I'll be honest—when I was pregnant with my first, I didn't even realize I had options beyond my OB-GYN's office. But as I started researching and praying about what kind of birth experience I truly wanted, I discovered a whole world of possibilities that I wish I had known about earlier.

Whether you're just starting to consider your options, feeling overwhelmed by all the choices, or even in your final weeks wondering if it's too late to make a change—this episode is designed to give you clarity, confidence, and most importantly, help you discern where God is leading you for your birth.

In this episode, I share: 

🏥 The honest pros and cons of hospital births—from immediate medical access to potential intervention cascades 

🏡 Why birth centers offer a sweet middle ground between medical care and home-like comfort 

🌸 The unique benefits and considerations of home birth, including my own experience with Daniel 

💰 How to navigate insurance coverage and financial considerations for each setting 

✝️ How to tune into the Holy Spirit's leading when making this deeply personal decision

Scripture Shared: 

"Trust in the Lord with all your heart and lean not on your own understanding. In all your ways, submit to him, and he will make your paths straight." – Proverbs 3:5-6 (NIV)

Mentioned in this episode: 

📊 Birth Setting Quiz: Take the quiz to help determine which setting aligns with your values and desires 

📞 Schedule a Private Coaching Call: Get personalized guidance for your birth preferences and options

📚 Christian Mama Birth Prep Library; Free birth prep tools, worship playlist & more

💕 Work with Me 1:1 – Virtual Doula Support & Christian Childbirth Education

Remember, mama—this isn't about what setting sounds most impressive. It's about what aligns with your body, your baby, and where you feel God is calling you to give birth. You are not alone in this decision, and He will equip you wherever He's leading you.

If this episode gave you clarity, please subscribe, leave a review, and share it with a friend who might be weighing these same decisions.

Let's keep choosing faith over fear, one birth decision at a time. Go here for the full blog post, show notes, and the birth settings quiz!

Transcript

Natalie Portman: 0:45

Welcome back to the podcast. I'm so happy you're here because today we're walking through birth settings, how to choose between a hospital, a birth center, or a home birth. And each of these come with different levels of support, intervention, comfort, and control. So there's really no"right" answer. It's just the one that is right for you and your baby. So I'll start off with a little story behind why I'm doing this episode. When I was pregnant with Ellie, I didn't even realize that I had options. I basically assumed that you just go to your OB GYN. It was the OB GYNI had been seeing for several years and just thought, okay, well everyone just delivers their baby with their OB GYN. And the more that I started researching about birth and just resolving that I really wanted to pursue an unmedicated or low intervention birth, that's when I started looking more into pursuing something like a birth center. But unfortunately my OBGYN's practice had me pay for their, full package all up front and they did not give refunds. And so I felt pigeonholed into going with the OB GYN, even though I did feel like the birth center probably would have been more aligned with what I was actually wanting. And especially if you are in the earlier part of your pregnancy where you're still shopping around. But say you're even in the final weeks of pregnancy, I have actually had a handful of clients who decide the last second 35 weeks plus that they want to choose a different option going from a hospital birth to a home birth even, and they all have ended up being so beautiful. So all that to say. You're not too late if you're at the end of the pregnancy, but this is really a great time to start looking when you're in that first trimester, especially if you can do a bit of research and just praying about it and doing all the necessary prep work to see which option is best for you early in the pregnancy. And then, you know, I share my birth story with Daniel, but then we ended up choosing a home birth with him. However, I did start that pregnancy going to an OB GYN because I was having cramping and bleeding and just some other issues. I had a low lying placenta and so I did go with an OB, GYNA different ob GYN practice. And they even have midwives that are managing low risk mom and baby care. And so I was with their practice until I was about 20 weeks and then I switched to a home birth midwife. And again, you can always choose a different option than what you started with. If you feel like that's what the Lord's calling you to and that pathway opens up. But whatever way you're leaning, hospital, birth center, home birth, I wanna just walk you through some of those pros and cons of each option. But then most importantly, I want you to really tune into what the Holy Spirit is telling you to help you make a decision that aligns the most with where the Lord is leading, what values you have and how you envision your birth experience. Oh, and then another thing I wanted to mention is I have a birth setting quiz that can help you hash out maybe what birth setting is most appropriate for you. I'll have that quiz inside the show notes. So check that out. So we'll first start with the pros and cons of hospital birth. So we'll start with the pros. The pros are that in the hospital setting, you have immediate access to emergency care, surgery, having a C-section, if that's needed, having access to an epidural. And the nicu if your baby is needing that level of care. And so that's a huge pro, especially if you know you or your baby are high risk for some reason to have all of that immediate care available to you. Another thing is they always are staffed with obstetricians, anesthesiologists, and nurses. And even if your particular practice isn't available, say the doctor, the OB or the midwife that's on call isn't around and something emergent comes up, there's usually something called a hospitalist, and this is an OB that works for the hospital, not for a particular practice that is there to manage things that are emergent. So that's another benefit of having the hospital birth is again if you're in a high risk situation or you know, you're already high risk for some reason, or baby is to have that staffing care and those interventions readily available. Another pro to going with a hospital birth is that a lot of insurance policies cover your care if you go with this more traditional option. And so that's something to definitely consider. And then this honestly could be a pro or a con. But typically your stay postpartum after you've given birth is longer than if you're giving birth at a birth center or obviously at home. So that, again, can be a pro or con. When we had Ellie and we had that hospital birth, I felt like there was someone coming in and out of our room every 10 minutes and it was so obnoxious to me. It was like the moment that I felt like I could finally just rest and relax, someone would come in and ask me to do something or I people just coming in at all points of the day. And so that was a con for us because we just were itching to get home. We were healthy and just wanting to get back home to our comfy bed. But for some people they really like that hospital stay. It's a time to say you have older kids, you know, not have to worry about older kids and other things. So that's a pro or a con. And then the cons of the hospital birth is typically, this is a setting where things are much less personalized. You're not gonna necessarily know the nurse you have. You may know who your actual provider like OB or midwife will be at the hospital. But typically, most practices have it to where you just get whoever is on call. It's really rare, at least where I am. Where a practice will say, oh, for sure I will be attending your birth. Most practices are a group, and so you're gonna be around, I don't know, three to seven, potentially different obs or midwives that could manage your birth. And so that's a little less personalized, especially if you didn't get a chance to meet every single provider in that practice. Or even worse, say you have met them all, but you had a run in a not great experience with one of those providers, and you may end up getting them, which that's not something to be anxious about. That's just the reality of being in a larger group practice. So something to keep in mind, and another con is that you just have a higher likelihood of having interventions and having what I call a cascade of interventions, where they're typically going to offer you things like having an IV placed continuous fetal monitoring, wanting to give you fluids so that you're staying hydrated, limiting you eating and drinking things like this. That's really common in a hospital setting. Of course, not every single provider is requiring or pushing those things. But many of them do. And so if you know for a fact that you want to eat and drink during labor, but your provider has already made it known to you that they really want you to restrict eating and drinking or outright will not allow you. Quote unquote, allow you to eat and drink during your labor. That's definitely something to consider because for me, I love eating and if somebody told me that I couldn't eat, I would not be okay with that. We ended up having me sneak snacks all throughout my labor with Ellie in the hospital because I was doing such hard work, and I was like, I'm getting hungry, so I'm going to eat. But I had to be sneaky about it and I didn't really like that. And then like I mentioned, the cascade of intervention. You know, because you have access to more interventions, it's more likely that you will receive more interventions than if it's not really an option for you. So for example, if you are starting to have really intense labor pain and the OB or the nurse is observing that. Their framework is to offer you an epidural because in their experience and based on the tools that they have, that is a great option for pain management. And not that is right or wrong, but if you're giving birth in a birth center or a home birth setting, that's an, that's not an option to get an epidural. And so you have to get creative with having other options to manage that intensity of the labor. So just something to throw out there. But what that might lead to getting the epidural is when you get an epidural, it also leads to needing to get a full bag of IV fluids to help manage blood pressure changes for you. And after they place the epidural, they will require that your baby is monitored continuously. Whereas before maybe you were doing intermittent monitoring or even had like wireless monitoring if you were up and moving. So that changes potentially. And then they also will do a catheter where they will drain your bladder for you because your muscles are numb and you're not able to pass urine on your own, and so they will manually do that for you with a catheter. So that's, you know, just again, thinking about the cascade of interventions is how one intervention leads to another. Not always, but that is a fact that when you start introducing interventions it has a higher chance of leading to more interventions. So that's another con. Another con to the hospital birth setting is feeling a little bit rushed especially if your labor is progressing more slowly. And again, going back to what these providers in the hospital setting are used to is having access to things like pitocin, the synthetic version of oxytocin, which causes the uterus to contract. And so if your labor is slowing down or things are just not moving as quickly as they would like or hoped, then they will likely offer things like Pitocin to get the labor going and if you choose that option, then things can really start to intensify. And so something else to just consider is that some providers, again, depending on your provider, but many providers in the hospital setting. Are trying to make the birth just be as efficient as possible, which is not a bad thing. It's not evil that they want that it's just a reality that then some moms can feel this pressure. Of I just need to get this baby out because then I feel like I need to start moving things along so that other things don't happen. But when it comes to the hospital birth, I know I'm ending on a low note here. But when it comes to the hospital birth setting, it's obviously the most chosen option for many women. And I had a beautiful hospital birth with Ellie. And so I am not saying all of this to only encourage out of hospital birth, but it is a reality that you have to be aware of that yes, there are definitely amazing pros to this hospital birth option, but you also really need to consider the cons as well because you, like I'm saying, have options, especially if you are low risk and baby is low risk. To really consider other options that might be available to you that might be more appropriate for the birth experience that you're hoping to have. So now let's talk about birth center. So some of the pros of a birth center. Is that the birth center has a more home-like atmosphere and feeling. And yet you're still managed with medical professionals. These are midwives that are trained in all of the things that are common, you know, emergencies. And so it's not like they are just. They have no tools at their disposal. But the pro is that you get to labor with a medical professional, a midwife, but the atmosphere itself is so much more cozy than a clinical hospital setting. The other pro with this option is that midwives are much more experienced and used to having care that is focused on natural and unmedicated birth options, and they're just going to naturally have more tools at their disposal for that type of birth experience. And with your birth plans, whatever, things that you desire for your birth, they're typically much more able to accommodate those versus having a hospital provider that might have to by hospital protocol or their practices protocol do certain things just because that's the policy, not necessarily because it's most appropriate for your actual situation. And so birth centers typically have a little bit more leeway with doing the monitoring and things like that. Most birth centers that I see do intermittent monitoring where the midwife is just there listening in on baby, making sure everything sounds good, and then you go back to laboring and you're not bothered by having the contraction monitor on you the whole time. You also have the ability to move around more. They are really great about having lots of tools and things there, which hospitals sometimes do as well, like the birth ball, which birth balls are a little bit harder to come by in hospital settings, but some of them do. But peanut balls, cub seats, which is like an inflatable, U-shaped almost looks like a pool float thing. But yeah, so all of those things are available typically in birth centers and other just non-medical comfort measures to help get labor going. And then they also are good about having good family involvement. And so if you have older siblings. Siblings are even allowed to come into the birth center and, be with mom as she's laboring. And definitely be there after baby is born. Whereas in the hospital setting, that might be a little bit harder depending on visiting hours or just the policies that they have around having, you know, younger siblings involved in the birth experience and postpartum. And then some of the cons of the birth center option is not being as close to emergency equipment and surgery like a C-section if complications were to arise. But if you and your baby are low risk and having an uncomplicated pregnancy, there's a good chance that you will not transfer to a hospital either before or during labor. But sometimes that does happen. And so you have to be okay with the possibility that if you're going with a birth center and for some reason your blood pressure starts spiking, you're starting to show signs of preeclampsia. Baby for some reason isn't having some good signs, then you will not be able to give birth in the birth center. You will need to be transferred to a hospital under the care of an ob. And that also can cause a lot of anxiety, especially if you are on the cusp of. Having some medical issues between you or baby that you're worried or concerned about. And so something to consider at that point, if you don't have care established with an OB, GYN or a midwife practice in a hospital, that you would then have to be at the mercy of whoever is there at the hospital, whatever hospitalist at whatever hospital you choose. Sometimes you don't even get a choice. It's just whichever hospital is closest to you. So something to consider with that, if everything goes smoothly, it's fine you don't have to change birth location, but if there are complications, you have to be okay with the possibility of a transfer. And then another pro or con, depending on how you wanna look at it, is you have a much shorter postpartum stay. Right after baby is born, you typically stay at the birth center for four to eight-ish hours, and then you drive home. And for some that's great, they wanna get home for others, if you're needing just a little bit more time, that can feel a little bit rushed. So again, just depends on what you're needing at that point but that could potentially be a con. And then another con to the birth center option is you have limited availability and locations, depending on where you're at and how quickly the birth centers in your area fill up. So like in Jacksonville, we only have a couple birth centers and their availability can be extremely competitive because there aren't many options. So look at that. And you also have to qualify for a birth center birth, meaning you are low risk. So again, if you have some known issue or are starting to present issues, you will risk out of birth center being an option for you. And that may or may not be something you wanna deal with you know, mentally and emotionally and spiritually or even financially. And so keep that in mind as you're thinking through this decision. Okay. And then some insurance plans if they do cover birth center at all some just don't cover birth center birth whatsoever. And so that's another thing to keep in mind is just the financial impact of choosing a birth center birth over potentially a hospital birth that is covered fully or has more coverage financially for that option. And now the final option we'll go over is home birth pros and cons. So for pros, you have the most autonomy and control over your birth setting when you're giving birth at home. And obviously that makes sense. You are in charge of your house and who all is there, who all is not there. And so that's really great if you're wanting that level of control. The other thing is you don't have to pack or travel far away to a birthplace, a birth center, or the hospital if you are choosing this option, everyone comes to you. If you've ever experienced contractions in a car, I've thankfully only had to do that once. But having contractions when you're riding in a car is not comfortable at all. Like you, we need to move when we're contracting. And so when you're just like confined to your seat. That can feel overwhelming. And for a lot of moms, that alone can be a reason why they don't wanna give birth anywhere else besides home. Another pro to the home birth option is there are typically fewer interruptions. And so this really helps your labor flow where you are not being asked questions. And this is a thing that I see a lot in hospital births is nurses are required because this is their job, to ask you a lot of questions about your health, about your baby's health have you fill out forms and like sign forms that you've already filled out once before and it can just become very interrupting when you are trying to just stay focused on relaxing and breathing through contractions, which requires you to be in your instinctual part of your brain. But then when you're having to recall facts like. When was the last time you had a bowel movement and what was the first day of your last menstrual period? You're having to go into your thinking brain and that is not helpful when you're trying to stay in a good labor flow. So keep that in mind as well, when you are in a home birth setting, the beautiful thing is you don't have to answer those types of questions. You get to just be there and everyone who's coming into your space. Knows you and you know them. Maybe the only person you don't know is the midwife's assistant. That was the only person I didn't know ahead of time before they were in my home, during my home birth experience. And so that's really cool that I knew every single person. They knew what I wanted and it was really beautiful to just feel like it was like a party at our house. That was just a really beautiful part of having a home birth. And then a lot of women who have home birth, they tend to have a really satisfying birth experience and are having lower rates of interventions in their birth experience, which makes sense because home birth midwives are trained to be able to manage the common risk factors and common things that can be unsafe for mom or baby. So for example, baby having a hard time transitioning after being born. This is something that the midwives. Carry oxygen for, they know how to do CPR they know how to manage that. It's not like the midwife is just oh, sorry. They are trained to help in these types of situations. And then of course, if things become much more high risk or throughout the labor birth, or even just before. You would, again, need to have that understanding that there's a chance that you would have to risk out of your home birth and go under the care of an ob in a hospital setting. And so that is a con. This would not be an option for you if you actually do have high risk pregnancy factors, or your baby has some high risk factors and so that can be really disappointing. I will be completely honest. The Lord had to really helped me through some anxiety and things that I had in Daniel's pregnancy because after we had chosen to do the home birth, I had not gotten 100% clearance that my placenta, which was deemed low lying, was not completely resolved yet, and if the placenta had remained low lying or even covered, part of the cervix a C-section would've been my only option for delivery because a vaginal delivery would've been much too risky, and that kind of was in the back of my mind gnawing at me, and I just had to give that to the Lord and I'm so glad that we continued on with our home birth plan, and it ended up resolving the placenta grew upwards more and it wasn't an issue at all, but, you know, every time some little thing came up something with my blood work, I can't even remember what it was now. I think it was my, maybe my platelets or I can't remember. Something was not right, and I had to start taking supplements to make sure that was good, because if my blood work wasn't looking right, then I would've had to transfer under the care of my OB again. And so that was a little bit stressful. But if you know, and recognize that's an option, but you're still willing to go with this option, that's great. The other con to the home birth is that you have to set up your birth environment, meaning you have to gather the right supplies and have them on hand and ready. If you are not good at staying organized or your house is always a mess. I, that honestly can be a factor whether or not it's a good idea for you to be doing a home birth. You need to have the towels washed and ready to go. And obviously your home birth midwife would give you all of the things that you would need. My home birth midwife actually has a kit that you just purchase, and then there's some straggler things that we needed to get outside of that kit. But she had all the stuff for us that we needed. But, gathering all those supplies instead of, you know, in a hospital setting where they will have all those supplies for you, and even in a birth setting they sometimes have you bring the supplies that you ordered or they have it there with you, or a combination. But yeah, in a home birth setting, you have to make sure you have all of the supplies ready and cleaned and available for when labor begins. And then another con to the home birth setting is many of the times, although not always, you have to you have to pay for this option out of pocket. Brian and I were really blessed that our insurance actually covered part of the home birth. And so that was a huge blessing that we were able to get a couple thousand back from our home birth experience, but that's really dependent on your insurance carrier. And my home birth midwife has a biller where she took all of our records and sent the billing information to the insurance company for reimbursement. And so if you do decide to go with a home birth midwife, that's a great option to look into. Seeing if she has a biller available or doing some research asking around if, you know, if somebody in your area that can help assist you with getting your billing submitted to insurance for reimbursement. Something to consider if that is a huge factor for you and your family. I hope this information was helpful, but I hope that you don't feel like you need to have everything figured out today. I want you to take your time, pray about this, ask more questions, and most of all, please listen to where you feel like the Lord is leading you. This isn't about what setting sounds impressive. It's about what aligns with your body, your baby, and believing that God is with you no matter where you choose to give birth. That's why I created that birth settings quiz. I wanted it to just help you reflect a little bit more on what experience you hope to have, and hopefully it can give you some clarity there so that quiz again will be linked in the show notes. And I'm also available for private coaching calls and so if you ever have any questions and birth setting is a great one to a great topic to talk through. But if you ever have anything you want to talk about related to your birth preferences. Options that you're looking at, I would love to connect with you. And so if you go to my website, faithoverfearbirth.com/private-coaching-call, sorry, that's a mouthful. I'll link that in the show notes. You can go there to get more details about that private coaching call with me, for us to connect one-on-one and I can help you decide what option might be best for you or just any other questions that you have related to this season in your life. So I want to just impart some scriptural wisdom for this topic. And I really love Proverbs 3:5-6, where it says, trust in the Lord with all your heart and lean not on your own understanding. In all your ways, submit to him and he will make your paths straight. And this could not be more perfect because I think there is understanding what your options are, but not leaning fully only on your own understanding in all of this. I wish so much with my first birth with Ellie that I really had sought the Lord more instead of just feeling tied to a certain option because of financial things or just not even realizing that there were options available to me, not that I made the wrong choice. I'm not saying that. It's just that I know that I would have had a different experience and probably one with a little bit more support than my hospital birth and. It's really so personal where you decide to give birth. I like to say it is so important to give birth where you feel the most safe and you should feel most safe with where the Lord is leading you. And so please trust in him. Lean not fully on your own understanding, but submit your ways to him and he will make your path straight. He will show you which path you are to choose and will continue to walk down that path with you if it continues to be windy and not at all what you expected. I'd love to just pray for you and encourage you more in this decision. Father God, thank you so much for being a God who cares for these details. I pray for the mama listening right now that you would give her clarity, help her choose her birth setting with faith, not fear, and show her where she will be most supported. By people who love her and honor her desires for this birth and who will just speak life into this season. I pray that you would remind her that she is not alone and that you are always with her no matter where she goes. Thank you that you are making her path straight, even when she doesn't have every answer figured out. I believe that you will show her clarity to the path that brings you the most glory Jesus. It's in your name I pray. Amen. Thank you so much for joining me on today's episode. I pray this encouraged you, and if you would, please do me a favor. Will you please leave me a review either on, on Spotify or Apple Podcasts, wherever you're listening to this. I so appreciate reading those and it really does help so many more women find this podcast and this information. So I would love that so much. If you wouldn't mind taking a few minutes to do that. And don't forget to take the birth settings quiz. The link is in the show notes for that, and I just pray that also just helps give you a little bit more confidence and clarity when you're making this decision. And most of all, I just, I hope that you realize and remember that God will equip you wherever he's calling you.