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Article #233: Choosing Where to Deliver-pregnancy

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In general, your choice of where you is low. For women who have strong
deliver will be linked to your care preferences about the use of oxytocin or
provider. The majority of physicians take continuous fetal monitoring delivery at a
care of women in a hospital setting, birthing center may increase their
where most birth in the US take place. chances of avoiding these interventions,
Midwives also take care of women in a In addition, because epidural analgesia
hospital setting, although they also is not usually available you are likely
deliver babies in birthing center. to receive more intensive labor support
Hospital birth for your pain. While some believe that
There are three potential advantages to delivering in a frec standing birthing
choosing deliver in a hospital. First, if center will reduce your likelihood of a
you are among the 30-40 percent of women cesarean delivery or episiotomy, your
over 35 who require a cesarean delivery, care giver's practice style is probably a
there will be no need for you to be moved more important determinant than where you
from home or the birthing center. deliver.
Although most cesarean deliveries are not Getting The Most From Your Prenatal Care
urgent, in which case the delay will not The most important principle in choosing
cause you or your baby any harm, in an a care provider is to find someone you
obstetric emergencies, time can be of the feel comfortable with. Ask questions
essence. The second advantage is that you early on about things that are important
will have more pain control options. to you for example, the rates of
Although many first time mothers wish to episiotomy, cesarean delivery, and
avoid epidural analgesia, you may not forceps or vacuum delivery. When thinking
know what type of pain relief you want about your care giver's cesarean delivery
until you are actually in labor. If you rate, be aware that interpreting cesarean
are highly motivate to avoid an epidural delivery rates is very complicated, even
analgesia, freestanding birthing centers for statistical experts. Physicians who
and home birth are geared toward care for higher risk patients are likely
supporting you with out pain medicine. A to have very high cesarean delivery
third advantage is that a hospital birth rates, which are explained by the high·
may be safer if you have significant risk nature of their patient population.
medical problems such as diabetes or However, in low-risk patients, recent
blood pressure problems, which may affect studies suggest that either too high or
you or your baby. It is also safest to too low cesarean delivery rates may
deliver in a hospital if you've' had a indicate a problem.
cesarean section previously, because of Your care provider's philosophy about
the small risk of the uterus rupturing. pain control in labor is also important.
Birthing center or home birth Unless you share his or her view, avoid a
If you are having a normal, healthy care provider who has strong feelings
pregnancy, the risk to you and your baby about what type of pain control you
of delivering in an alternative setting should select in labor.






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