Where to give birth: Here are your labor and delivery options

Is a doctor or a midwife best for you? Here's what to think about for your upcoming birth.

OBGYN vs midwife
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Whether you are just starting to think about getting pregnant or are already on your pregnancy journey, an important step is deciding where you will receive prenatal care and give birth, and who will care for you along the way. When it comes to where to deliver your baby, you'll need to decide between giving birth in a hospital, a birth center or at home. And you can also decide which type of provider to receive prenatal care from: an obstetrician (OB/GYN), a family physician, a midwife or a doctor of osteopathic medicine (DO).

You definitely have some choices. Before we get into them, please remember that this is YOUR BIRTH. Do what feels right for you. Factors such as what you have access to, your insurance and underlying medical conditions may limit your options, but ultimately you make the decisions that are best for you.

It's important to get reflective and honest: Research shows that those who are not thrilled with their birthing place choice can feel anxious throughout pregnancy. So choose wisely, but and remember that you can always change your mind.

Let's break down your options for where to give birth and who to have guide your pregnancy and catch your baby.

Where to give birth: hospital, birth center or at home?


As I share in The Motherly Guide to Becoming Mama, there are some questions you can consider which might help you decide where to give birth:

  • What do you want the overall experience and vibe to be like at your birth?
  • Do you have any medical conditions that may require additional support during your pregnancy and birth?
  • Do you expect to have a low-risk or high-risk pregnancy?
  • How do you think you will want to cope with labor and birth? Epidural or other medications? No medications? Undecided?
  • How do medical settings make you feel? Comforted? Or nervous?
  • What types of settings do you have access to?
  • What settings does your insurance cover and how much, if any, are you able to afford to pay out of pocket for uncovered expenses?
  • If your family is LGBTQIA+ or you are concerned that you may be treated in a different way from other patients, it's important to look into the organization's approach or to get a reference from friends. Consider whether the staff have received sensitivity training, if they regularly provide services for families like yours, and if you generally feel like you will be treated well at the facility.

1. Hospital births

The majority of women in the U.S. give birth in a hospital labor and delivery unit. Birthers in hospitals have access to a wide range of medical interventions including continuous monitoring, pain medication and labor-inducing Pitocin, and are also down the hall from an operating room in case a Cesarean section becomes necessary. You can be attended by a physician, midwife or doctor of osteopathic medicine in a hospital.

Intervention rates are the highest in hospitals; more than half of women get epidurals, and the chances of having a C-section are the greatest. (Check out this Consumer Reports guide to see whether your potential hospital shares its C-section rates.)

Is this the right option for me?

Women who choose hospital births may have a health condition that requires more advanced medical care. They may know that they want to have an epidural for their birth, or they may simply feel most comfortable in a hospital setting.

2. Birth center

The American Association for Birth Centers defines a birth center this way: "A birth center [is] a home-like setting where care providers, usually midwives, provide family-centered care to healthy pregnant women. Most birth centers are located separately from hospitals, while a few are physically inside hospital buildings."

A large study of more than 15,000 women found that birth centers are a safe place for women with low-risk pregnancies to give birth, and that women experienced lower rates of Cesarean sections and other interventions than those who gave birth in a hospital. Birth centers work with hospitals, so if an issue comes up during your birth, you can be transferred to receive more medicalized care.

Is this the right option for me?

Those who choose birth centers have low-risk pregnancies and want an unmedicated birth in a cozy setting, but may not be able or want to have a home birth. Some birth centers do administer some forms of pain medications, but not epidurals.

3. Home birth

Just like it sounds, a home birth is when you give birth in your home. Less than 1% of women have home births, but this number is on the rise. You'll be attended by an experienced midwife (though some physicians and doctors of osteopathic medicine do make house calls). The midwife will bring a big kit of equipment with them, including emergency medications and oxygen. They'll check the baby's heart rate periodically with a doppler and will be there to ensure your and your baby's safety throughout the labor and birth. People often ask about the safety of home birth, and indeed it is a controversial topic. The Cochrane Journal found that there is no strong evidence from randomized trials to favor either planned hospital birth or planned home birth for low-risk pregnant women.

But we need more studies. Women who have home births do enjoy fewer interventions and many describe the experience as life-changing.

Is this the right option for me?

Those who choose home births have low-risk pregnancies; want to have unmedicated, low-intervention births; and feel that they will be safest and most comfortable birthing at home.

Who will catch your baby: obstetrician, family physician, midwife or doctor of osteopathic medicine

In addition to deciding where to give birth, you'll need to decide who takes care of you during your pregnancy, birth and the postpartum period.

In The Motherly Guide to Becoming Mama, I share questions you can ask potential providers:

  • Where do you deliver babies?
  • How many years have you been practicing?
  • Do you work with anyone else? What are the chances that you will be the person who delivers my baby, versus someone else? Can I meet that person (those people) if someone else may deliver the baby?
  • Will you see me for each visit, or is there a team of people I might see?
  • What is the Cesarean section rate at the place you attend births? What is your Cesarean section rate?
  • How many laboring women do you care for at a time, on average?
  • I would like an unmedicated/medicated birth. How do you feel about that?
  • I would like a water birth. Is that a possibility with you?
  • I am nervous about ________. What are your thoughts about it?
  • How do you feel about working with doulas?
  • I am LGBTQ+. Have you had experience working within the queer community?
  • I am a survivor of violence. How will you help me to feel safe while giving birth?

For midwives specifically:

  • Are you licensed by the state?
  • Under what circumstances would you need to collaborate with a physician for my care, or would I need to transfer completely to physician care?
  • Do you have privileges at the hospital I would be transferred to (for home and birth center births). Will you be able to continue to be my provider if we transfer?
  • What other types of professionals will I have access to during my pregnancy?

1. Obstetrician

Obstetricians, or OB/GYNs, are medical physicians who specialize in pregnancy and delivering babies, as well as gynecological care to non-pregnant women. OB/GYNs care for all types of pregnancies, though their focus is usually in high risk. They can perform surgery if needed (like a C-section), and they predominantly work in hospitals.

2. Family physician

Family physicians are doctors who care for the entire family, and this sometimes includes pregnancy and birth. They usually care for low-risk pregnancies, though this is not always the case. You'll find them attending births in hospitals and at home.

3. Midwife

The word midwife is means “with woman." Midwives are highly trained professionals who provide holistic care and support to women through pregnancy, birth and the postpartum period. They also care for non-pregnant women. A few things to know:

  • Midwives attend birth in hospitals, birth centers and at home.
  • Midwifery care often results in fewer medical interventions, though you absolutely can still have an epidural, ultrasounds and other procedures with a midwife.
  • Midwives usually care for low-risk pregnancies. If you require additional medical interventions during your pregnancy or birth, you will likely be transferred to the care of an obstetrician.

To learn more about midwives, you can visit the American College of Nurse-Midwives and the Midwives Alliance of North America.

4. Doctor of Osteopathic Medicine (DO)

DOs are licensed physicians who, in this case, specialize in caring for women during pregnancy and birth, as well as provide gynecologic care. The American Osteopathic Association states that focus on "emphasizing a whole-person approach to treatment and care, DOs are trained to listen and partner with their patients to help them get healthy and stay well."

DOs work in all birth settings.

It's a lot to think about, we know. If you're having a hard time deciding, you can do some interviewing: Meet with a few types of providers, ask questions and make a decision that is informed and feels right.

For more guidance about your birth options, may we present The Motherly Guide to Becoming Mama:

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The HATCH Mama collection is everything your pregnant body needs right now

Their oil is the only thing that stopped my belly from itching as it grew bigger.

Conz Preti

Let me start by saying I'm not a fan of moisturizing. I hate being wet and sticky and after applying product to my body, I have to stand around awkwardly until I'm fully air-dried—a practice that is not compatible with having three kids under the age of 3. However, as someone who has carried three children in her body, I also know how much your belly needs hydration as the baby grows.

This was especially true with my second pregnancy. My belly popped way sooner (a thing that happens with subsequent pregnancies) and on top of that, I was carrying twins, which meant I became super pregnant super fast. My belly was itching constantly from the skin stretching (I checked with my doctor to make sure I didn't have Cholestasis) and there was no scratching in the world that could ease my discomfort. My doula recommended the HATCH Mama belly oil and changed my life. The oil is nourishing—but more important to me, quick-drying—so I could apply it all over my planet-sized twin belly and get dressed immediately after without having my clothes ruined nor stuck to my body. Because of how much I loved the oil, I tested other products, and let me tell you, they're all equally amazing.

Curious about the HATCH Mama collection? All of their products are non-toxic and mama-safe, designed to help pregnant people overcome the challenges unique to pregnancy. As their website claims, "from stretch marks to thinning hair, to sleepless nights, we're helping you tackle every prenatal and postnatal beauty issue head-on so you can continue to feel like the best version of you." I'm here for all of this. For the entire Hatch Beauty collection click here.


Here are my favorite products from HATCH Mama:


Belly oil

HATCH COLLECTION  Belly Oil

Intensely hydrating + fantastic at reducing the appearance of stretch marks and scars, this will be your favorite through pregnancy + beyond.

$58

Belly mask

HATCH COLLECTION  Belly Mask Set

Not only does it help to minimize the appearance of stretch masks + scars during pregnancy + postpartum, but there is a little non-toxic wink (and that's to you, mama.)

$42

Nipple + lip ointment 

HATCH COLLECTION  Nipple + Lip

Calming + soothing, this magic sauce is lanolin-free & made of tropical butters and super fruits. I'm not lying when I say you will not want to stop using this, even way after birth.

$28

Belly tattoos

HATCH COLLECTION  Belly Tattoos

A very rock and roll way to honor your bump. And non-toxic + plant-based at that!

$18

This article was originally published in March 2021. It has been updated.

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Motherly created the flexible online birth class moms need

The Motherly Birth Class is completely online, which means you can take the class at your own pace.

Taking a birth class is a pregnancy milestone. Whether you've been excited to take a birth class for a long time or have just recently decided that you wanted to take one, sitting down for that first lesson feels big—spoiler alert, this is really happening! But finding time for a birth class isn't as easy as it would seem.

We know new parents are busy (hello, understatement of the year). Between diaper changes, pediatrician appointments, healing from birth and the general adjustment to #newparentlife, the days can fill up quickly. But a lot of people are caught off guard by how busy pregnancy can be, too! That first trimester is so often full of symptoms—like nausea and fatigue—that can make previously easy or simple tasks exhausting. The second trimester begins and (usually) we start to feel better. But then our days get filled with planning out baby registries and deciding on questions like, "Where will this tiny new human sleep?" And before you know it, it's the third trimester—and, well, then you're in the home stretch. Plus there are so many appointments!

All this to say that we get how busy you are—and how hard that might make it to fit in a birth class.

And that's why we created The Motherly Birth Class. The Motherly Birth Class is completely online, which means you can take the class at your own pace.


Think you'll want to watch each lesson a few times over? Great!

Due date's next week and you need the option to take a birth class very quickly? No problem!

Like everything at Motherly, we designed this class with you in mind.

Taught by Certified Nurse-Midwife Diana Spalding (who also wrote "The Motherly Guide to Becoming Mama"), this class is broken into 12 lessons—and you get to control how and when you watch them. We'll teach you about what your (amazing) body is up to in labor, how to decide when it's time to head to the hospital or birth center (or when to call your home birth midwife), what your options are for coping with pain and so much more.

When you sign up for The Motherly Birth Class, you'll get access to a downloadable workbook and meditations. Plus, you'll be invited to join our supportive private online community (where you can chat with the class instructor!)

Oh, one more thing: Your insurance or flexible spending account might even able to able to cover the cost of this class.

Pregnancy is wonderful—but it's a lot. You deserve a birth class that works for you and empowers you to have your best birth. Because vaginal or Cesarean, unmedicated or medication, birth is incredible. And you are the star of it all.

You've got this.

Sign up for The Motherly Birth Class today!

The Motherly Birth Class

pregnant-woman-looking-at-her-belly

Take our completely digital birth class from the comfort of your living room. We'll help you have your best birth—because you deserve it.

$79

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14 toys that will keep your kids entertained inside *and* outside

They transition seamlessly for indoor play.

Keeping kids entertained is a battle for all seasons. When it's warm and sunny, the options seem endless. Get them outside and get them moving. When it's cold or rainy, it gets a little tricker.

So with that in mind, we've rounded up some of the best toys for toddlers and kids that are not only built to last but will easily make the transition from outdoor to indoor play. Even better, many are Montessori-friendly and largely open-ended so your kids can get a ton of use out of them.

From sunny backyard afternoons to rainy mornings stuck inside, these indoor outdoor toys are sure to keep little ones engaged and entertained.


Secret Agent play set

Plan-Toys-Secret-agent-play-set

This set has everything your little secret agent needs to solve whatever case they might encounter: an ID badge, finger scanner, walkie-talkie handset, L-shaped scale and coloring comic (a printable file is also available for online download) along with a handy belt to carry it all along. Neighborhood watch? Watch out.

$40

Mini golf set

Plan Toys mini golf set

Fore! This mini golf set is lawn and living room ready. Set up a backyard competition or incorporate into homeschooling brain breaks that shift focus and build concentration.

$40

Stepping Stones

Stepping-stones

Kiddos can jump, stretch, climb and balance with these non-slip stepping stones. The 20-piece set can be arranged in countless configurations to create obstacle courses, games or whatever they can dream up.

$99.99

Wooden doll stroller

Janod wooden doll stroller

Take their charges on a stroll around the block with this classic doll stroller. With the same versatility they're used to in their own ride, this heirloom quality carriage allows their doll or stuffy to face them or face the world.

$120

Sand play set

Plan Toys sand set

Whether you're hitting the beach or the backyard sandbox, this adorable wooden sand set is ready for action. Each scoop has an embossed pattern that's perfect for sand stamping. They're also totally suitable for water play in the wild or the bathtub.

$30

Sensory play set

kidoozie-sand-and-splash-activity-table

Filled with sand or water, this compact-sized activity set keeps little ones busy, quiet and happy. (A mama's ideal trifecta 😉). It's big enough to satisfy their play needs but not so big it's going to flood your floors if you bring the fun inside on a rainy day.

$19.95

Vintage scooter balance bike

Janod retro scooter balance bike

Pedals are so 2010. Balance bikes are the way to go for learning to ride a bike while skipping the training wheels stage altogether. This impossibly cool retro scooter-style is built to cruise the neighborhood or open indoor space as they're learning.

$121

Foam pogo stick

Flybar-my-first-foam-pogo-stick

Designed for ages 3 and up, My First Flybar offers kiddos who are too young for a pogo stick a frustration-free way to get their jump on. The wide foam base and stretchy bungee cord "stick" is sturdy enough to withstand indoor and outdoor use and makes a super fun addition to driveway obstacle courses and backyard races. Full disclosure—it squeaks when they bounce, but don't let that be a deterrent. One clever reviewer noted that with a pair of needle-nose pliers, you can surgically remove that sucker without damaging the base.

$16.99

Dumptruck 

green-toys-dump-truck

Whether they're digging up sand in the backyard or picking up toys inside, kids can get as creative as they want picking up and moving things around. Even better? It's made from recycled plastic milk cartons.

$22

Hopper ball

Hopper ball

Burn off all that extra energy hippity hopping across the lawn or the living room! This hopper ball is one of the top rated versions on Amazon as it's thicker and more durable than most. It also comes with a hand pump to make inflation quick and easy.

$14.99

Pull-along ducks

janod-pull-along-wooden-ducks

There's just something so fun about a classic pull-along toy and we love that they seamlessly transition between indoor and outdoor play. Crafted from solid cherry and beechwood, it's tough enough to endure outdoor spaces your toddler takes it on.

$16.99

Rocking chair seesaw

Slidewhizzer-rocking-chair-seesaw

This built-to-last rocking seesaw is a fun way to get the wiggles out in the grass or in the playroom. The sturdy design can support up to 77 pounds, so even older kiddos can get in on the action.

$79.99

Baby forest fox ride-on

janod toys baby fox ride on

Toddlers will love zooming around on this fox ride-on, and it's a great transition toy into traditional balance bikes. If you take it for a driveway adventure, simply use a damp cloth to wipe down the wheels before bringing back inside.

$79.99

Meadow ring toss game

Plan Toys meadow ring toss game

Besides offering a fantastic opportunity to hone focus, coordination, determination and taking turns, lawn games are just plain fun. Set them up close together for the littles and spread them out when Mom and Dad get in on the action. With their low profile and rope rings, they're great for indoors as well.

$30

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Extended breastfeeding just happened for me—and I'm in no rush to end it

My son is two and a half and still nursing, and it's what makes sense for us.

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When I became pregnant with my first child, I assumed that I would breastfeed. I also assumed that I would pump and give bottles. I even had all the bottles, a bottle warmer, and a bottle drying rack all ready to go. I made sure I got my pump before the baby came, so I was ready. But then, I actually tried pumping a couple of times and hated it. It was tedious, time-consuming, and not as effective, so nursing was the standard between my two children. It came naturally for me, and I found it the easier of the two options since I stayed home with them anyway. I was always there when they needed it.

I was able to breastfeed my first until she was two and a half, at which point, I was seven months pregnant with her brother. Between the hormones, being touched out, and being uncomfortable, I decided to fully wean her. It had been coming for some time because the clock was ticking on getting her to sleep on her own before the new baby came since we had been co-sleeping up to this point.

I cut night feedings first, moved her to her own bed, and then weaned her completely as I went along in my pregnancy. She still wanted to nurse to sleep, but I had to stop eventually because I was so uncomfortable. My body and brain could not take it anymore, but I'm proud I made it that far with her and that I nursed that far into pregnancy.

When my second child came around, my son, breastfeeding was not only easier, but I found myself here: extended breastfeeding.


He recently passed two and a half, which is where my daughter stopped, and he is still co-sleeping. He still nurses quite a bit, because his tummy hurts because of constipation issues. He still uses it to soothe and help him go back to sleep at night. He's getting too big to stay in our bed much longer, but I'm in no rush to wean him completely until he's ready.

Being able to stay home with them has definitely fostered the breastfeeding relationship. Cuddling is a huge part of it, too, and I'll continue to breastfeed until it makes sense to stop.

While my husband doesn't always agree with that philosophy and tells him that he's a big boy and can be done having milk, it's ultimately not up to him. I told my son that we would work through it together.

It is still an emotional connection thing, and at the same time, it still has benefits for him. He's still getting nutrients especially designed for him. He's still getting supplemental nutrition while he doesn't want to eat as much otherwise if his stomach is hurting.

My body has been doing this for a long time. I'm used to it. While I get touched out some days, I also know how helpful breastfeeding still is to help him settle down and how much he still appreciates it. I don't feel the need to cut him off quickly—both for his sake and mine.

I'm also painfully aware that this is probably my last baby. My breastfeeding journey, over five years in the making, will soon be over. As long as he is still getting the benefits and I'm not stressed over it, I'll let it continue on a limited basis. I know it will end soon—it has to. He will be growing up and entering the next stage before I know it. But until then, I'm going to cuddle my baby boy a bit longer. I'm going to let him nurse at certain times and in certain situations.

I never intended to do extended breastfeeding with either of them, but it just happened naturally. And that's okay. You need to do what makes the most sense and do what your intuition tells you is right for your family.

Parenting

Car seat safety isn't a gray area: Why one mom's story is going viral

She texted her husband to remind him to tighten the straps. Minutes later, he was in a car crash.

This story was originally published on August 01, 2018

For most parenting tasks, there's more than one way to get things done. This is important to remember if you're parenting with a partner who has a totally different laundry system than you do or packs the diaper bag in a way that makes no sense to you. It's not the end of the world if the onesies are hung instead of folded or if the bottles are in the wrong pocket. We have to give our partners room to do things their way, too.

But when it comes to buckling our kids in their car seats, there really is only one way—the safe way—and one mama is thankful that she reminded her partner of that just in time.


Rebecca Tafaro Boyer is a new mom and nurse at St. Jude Children's Research Hospital in Memphis, Tennessee. On her first day back at work after maternity leave she asked her husband to send her hourly updates on how her 3-month-old son, William, was doing on his first day without her.

When her husband texted her a photo of William in his car seat, Tafaro Boyer knew she had to let her husband know that there's really only one way to buckle a baby in. "My nagging wife reply was to correct William's position in the car seat—the straps were too loose and the chest clip was way too low. And because I know my husband, I'm sure that he laughed at me and rolled his eyes before tightening the car seat and fixing the chest clip," she wrote in a now viral Facebook post about the experience.

Just 15 minutes after her husband fixed the straps, he and little William were in a collision.

According to Tafaro Boyer, an unlicensed, uninsured driver pulled into oncoming traffic attempting to make an illegal left turn, and although her husband slammed on the brakes at nearly 50 miles an hour, he just didn't have enough time to stop and hit the other car.

"My precious little bundle of joy was so well restrained in his car seat, THAT HE DIDN'T EVEN WAKE UP. Even with the impact of the two cars, William only received a minor jolt - so insignificant that he was able to continue on with his nap," Tafaro Boyer wrote.

Her husband was injured, but baby William was snug in his Britax B Safe 35 car seat. Had the straps been left as they were, it could have been a different story.

"I am so thankful that my husband took the extra one minute that was necessary to put William in his car seat safely," she Tafaro Boyer explained. "I truly believe that the reason my family is at home sitting on the couch with a pair of crutches instead of down at the hospital is because of my annoying nagging mom voice."

Fellow moms are all up in the comments of Tafaro Boyer's post tagging thier partners and leaving notes like, "This is why I nag."

It's not nagging if it's a safety issue.

Sometimes our partners (or our child's grandparents or babysitters) just don't know that something isn't safe. We've got to tell them when they're doing something we know could hurt our child. That's a text worth sending. The ones about the way your significant other folds the laundry wrong, those are the texts you might want to keep to yourself.

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    Car Seat Safety