Birthing Center Or Hospital? Comparing Care, Cost & Complications

If you are going through a pregnancy for the first time, you may find yourself wondering if you should go for a hospital delivery, or delivery at a birthing center. I share below what I call the 3 Cs (Care, Cost & Complications) of Hospital vs Birth Center prenatal care and delivery..

Some argue that modern day labor and delivery is over mechanized and medicated. Many will say women (..mammals in general) have been managing pregnancies and going through labor and delivery since the beginning of time without any of the modern day medication and technologies. The counter argument put forth is that modern technologies have led to better understanding of the process leading to improved maternal and infant mortality outcomes. There certainly is truth in both arguments and depending on the circumstances of each pregnancy, one can find benefits in both traditions and modern care. I personally started care at a birthing center and eventually transferred to a regular obstetrician due to complications.

Below are a few considerations to make regarding care:

• Prenatal care and labor/delivery was managed by a certified midwife with an OBGYN available for consultation if needed
• The center was designed to feel more like a home than a care facility. Center had multiple bedrooms with big king-sized beds with attached bathrooms
• The birthing center made it very clear from day one that they do NOT offer epidural for pain management during labor
• Labor is supported/assisted by movement i.e. walking around the nearby park, labor exercise such as exercise ball, using laughing gas if pain is unbearable
• Monitoring machines such as heart rate monitors for the baby are used only when absolutely necessary in order to allow the laboring mother to move around
• During delivery, one can go into different positions that aid the natural passage of the baby – squatting, going on all fours, bath tub delivery, etc 
• Post-delivery, the mom and baby are monitored by a nurse for 6hrs only and released to return home if there are no complications

• My doctor was a board-certified high-risk pregnancy doctor
• Due to previously observed heart-rate issues with the baby, I was attached to monitoring machines as soon as I checked in to the hospital for labor. This greatly limited my mobility as I had to carry around the machine.
• While I initially didn’t intend on taking epidural, I did eventually take it after repeated offers from the attending nurses and that slowed down my dilation
• When it came time to push, my doctor and nurse didn’t allow me to change positions even after asking so many times. I had to just lay on my back and push for almost 2 hrs
• During delivery, all critical staff was present in the room. This included the NICU attending physician and they all acted swiftly when my baby didn’t breath or cry right away. 
• I wasn’t discharged from the hospital until 3 days later based on my insurance coverage  while my baby was in NICU for 5 days

• The birthing center I started at was not In Network with my insurance (BCBS) so all charges were billed as Out of Network.
• My total out-of-pocket costs for regular prenatal check ups and delivery was estimated to run me $2000 which was to be prepaid in installments and completed before delivery. I advise people to check their insurance and thoroughly understand their coverage
• Other lab tests and ultrasound fees were not included in the standard care package for the $2000 paid. Those were handled and billed by third party providers.

• Once I had to transfer to an OBGYN, I went to an In  Network doctor and so most of my charges were fully covered after deductible based on the insurance coverage I had. 
• The hospital pre-billed me $600 based on their estimates of my charges for labor and delivery excluding fees for the epidural and any other medication or services I end up getting outside of standard care. 
• I did have to pay and additional ~$200 after all charges were filed with the insurance. So all in all, it cost me about $800 for the hospital delivery
• The charges for the baby, including staying in NICU for 5 days were not included the ~$800.

• The birthing center was only equipped to handle minor complications. NICU type/level care was not available at the center.
• In cases of emergency for either mom or baby, the center was located close to a hospital (within 0.5 miles) but would require calling for an ambulance
• If transferred to a hospital, the hospital’s attending OBGYN  will be in charge  and no longer the midwives

• I delivered at a Level III hospital so all facilities and expertise was available at the time of delivery.

In conclusion, I started prenatal care at a birthing center and and had intended to experience labor and delivery as naturally as I could. Ultimately, with all the complications, I was glad to have delivered at a hospital with access to all the modern day expertise and technologies readily available. My baby’s 1 minute APGAR score was 1 and all I can say now is that she is a healthy bouncing baby!

Disclaimer: Please note that the information below in no way serves as professional or medical advice. This is strictly based on my experience.