The Dreaded Car Ride
I have heard it said that for people choosing a hospital birth, the first intervention they experience is walking through the hospital doors. What this soundbite is referring to is the way the birth environment affects the hormones of the birthing person, which in turn can affect how the progress of the labor goes. The entire process of being in labor, grabbing your bags to leave your home, sitting in the car, and arriving at an unfamiliar (or less familiar) place can cause your body to stop producing as much oxytocin. Oxytocin is the hormone our bodies release when we are feeling sensual, comfortable, and loved, and it is one of the primary hormones responsible for keeping labor moving along.
This brings us to one aspect of the debate between a birth center and home. First, let me say that I am specifically talking about freestanding birth centers here, not ones attached to or affiliated with hospitals. A typical freestanding birth center will have all the same capabilities and emergency equipment that most midwives carry in their birth kits to every homebirth. But like at a homebirth, you will not be able to access pain medications or an operating room. Birth centers may have permanent fixtures in their birth rooms like tubs or installations like horizontal bars along the walls to use as support for squatting. They will likely also have a variety of available props, like a birth stool or a peanut ball, which can be helpful as comfort measures or to promote a good labor flow without the use of drugs.
The main issue I see with a birth center is that you still have to leave your home. You have to take that dreaded car ride to go somewhere else, and spend time laboring in an unfamiliar (if possibly very comfortable) environment. Most birth centers also have policies in place to get their new families home shortly after the baby is born, possibly as early as six hours postpartum. Which means you have to get back into that car, with your fresh newborn baby to head home again.
I can see a lot of reasons why someone would choose to have a baby in a birth center rather than at home. The cultural phenomenon of going somewhere, anywhere else than home to have a baby is very strong, so friends and family may more easily accept your explanations of your birthing plans if you can tell them you’re going to a birth center. Your home may not feel like the most pleasant environment in which to give birth; perhaps you have roommates, or you live in a small space, or you have neighbors close by who would be concerned by the noise. There are a lot of understandable reasons why someone would choose that route. But it may be nice to consider that saving yourself the back and forth trips in the car could be really worthwhile, and may make more of an impact than you would think!