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