Deciding what type of birthing strategy you want to have is arguably one of the earliest and most important decisions you’ll make as a parent. And New York has as diverse a pool of options as there are mothers. Depending on how natural or how medically advanced you want the process of giving birth to be, here, in brief, is what you should know.
Hospital Birth With an OB
If you’re pre-diabetic, expecting multiples, or otherwise experiencing a medically risky pregnancy, the home-versus-hospital decision may take care of itself. But even if you have the cleanest bill of health, a good old-fashioned hospital birth can be the most reassuring choice, especially if you tend to be a worrier. “When my patients get anxious,” says Dr. Millicent Comrie, an OB at SUNY Downstate Medical Center, “I always tell them: 80 to 90 percent of the time, if I sit in a chair and I do nothing, this baby will come. But 5 to 10 percent of patients develop problems that need to be monitored.” Since you can’t always know in advance whether you’ll be in that five to ten percent, it’s comforting to have a team of medical professionals keeping track of your blood pressure and fetal heartbeat. Dr. Comrie advises getting to know the various members of your hospital staff over the course of your pregnancy, so that by the time you go into labor, “it feels like a family taking care of you.”
Home Birth With a Midwife
“A natural process” is often more pleasant than a traditional hospital birth, says midwife Coralie Macqueen. “In the hospital, the fetal monitor and blood-pressure cuffs limit movement,” she explains, whereas with a midwife, “the majority of labor is moving around trying different positions: upright, walking, moving, squatting.” Some of the natural methods—water therapy, massages, sitting on a birthing ball—sound downright enjoyable, which is the whole point, says Macqueen. It means “less need for pain medication and epidural.”
Dr. Comrie, though an OB, is also a proponent of using midwives, as long as it’s “a reputable midwife who’s cognizant of New York State laws”—for example, that newborns should receive antibiotic eye ointment and vitamin K shots. It’s important to note that choosing the proper midwife is no different from choosing a doctor. “You don’t want a rigid doctor who wants to give you an epidural as soon as you walk in the door,” says Dr. Comrie, “and you don’t want a rigid midwife who insists that the baby come out the vagina no matter what.” Trust your instincts and go with whoever best suits your needs.
Birthing Center With a Midwife and Medical Backup
If you can’t decide which birthing plan you prefer, it’s possible to have access to both approaches in one place. “I like birthing centers,” says Dr. Comrie. “If they’re attached to a hospital, it’s win-win.” The Birthing Center at Roosevelt Hospital, established in 1996, was the first of its kind in New York and remains the most successful. “There’s no hint of hospital” in the birthing rooms, says Dr. Jacques Moritz, the director of gynecology at Roosevelt Hospital and frequent “backup” doctor for midwives. “There’s no call button, no chatter, no noise.” There’s also essential emergency medical equipment, which is hidden behind paintings and easily accessible if needed. Each room comes equipped with a Jacuzzi and a king-size bed, which you can share with your partner. If anything goes wrong, medical help is just one floor away, ready on call from what Dr. Moritz calls “the Bat Phone.”
Keep in mind, birthing centers are becoming increasingly scarce. St. Vincent’s closed down, and Bellevue can’t accommodate every mother who wants to take this route. Even if you do manage to get into one, Dr. Moritz warns that they aren’t for everybody. “It’s not for people who want to give the whole natural-labor thing a try but know from the start that they ultimately want an epidural,” he says. “Midwifery is labor-intensive—no pun intended—so it’s important that you’re committed, too.”