This article outlines the options of where to give birth for women in New Zealand. There are 3 main options of where to give birth.

Most commonly women give birth in hospital maternity units; some regions have the option of a birth centre or stand alone midwifery unit; and some women choose to give birth at home.

There is certainly no ‘right’ place to give birth – much depends upon your personal preference, your local facilities, the health of you and your baby and professional advice you receive.

Wherever women choose to birth they have built up a relationship with their Lead Maternity Carer (LMC) during pregnancy and have had an opportunity to plan the labour and birth, according to their hopes and wishes and the information they have gained during pregnancy.

Giving birth in Hospital

There has been a change in culture over the last century as birth and death have moved ‘en masse’ from the home to hospitals and there has been much debate over the effect that this change has had upon our overall health and well-being surrounding childbirth.

It is therefore helpful to consider the advantages and disadvantages of the choices available to you:

Advantages of hospital birth

  • There is a range of specialist personnel available to help you, if this is necessary
  • A wide range of services is provided by the hospital – from simple cleaning and meal provision to surgical and anaesthetic services.
  • If complications occur there is rarely a need to transfer the mother during labour
  • The mother gets an opportunity to rest (hopefully) after the birth

Disadvantages to hospital birth

  • For some families it appears impersonal and clinical
  • Some women find the hospital environment to be stressful and this can affect their labour
  • All institutions have routines and protocols, which may not meet the needs of individuals and their families/ whanau.
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Giving birth in Birth Centres

Birth centres are available in some regions – they may be part of a small community hospital or a stand alone service. They are midwifery, rather than medically, focused.

Advantages of birth centres

  • They provide a ‘middle ground’ between the home and the hospital
  • Some of the hospital services may be offered – cleaning, laundry and meal provision
  • The mother gets the opportunity to rest, away from toddlers and the needs of other children
  • They are usually homely and relaxed – women are often ‘pampered’
  • They are more likely to offer individualized care

Disadvantages of birth centres

  • If complications arise in labour the mother will need to be transferred to a hospital
  • Although there will be midwives and nurse aids present, there will not be specialist services available in an emergency

Giving birth at Home

As mammals we generally labour well if we feel relaxed and, most importantly, safe. If interrupted, or frightened, then adrenaline will override the hormones that produce our contractions and the labour will slow down or stop. For many women this safe place is at home, surrounded by all that is familiar to them.

Advantages of home births

  • As this is women’s natural environment, many feel more relaxed at home and therefore labour well
  • Women feel free to move around and can get into their own bath/ shower whenever they wish
  • If all is well with the birth, the woman will not need to leave the comfort of her own home to travel to hospital during labour.
  • Older children are safe at home with their parents during the birth
  • Nobody except their own baby to wake them up!

Disadvantages of home births

  • If complications arise in labour the mother will need to be transferred to a hospital and there may be a time lag, depending upon local facilities and geography.
  • Epidural pain relief is not available and midwives may not want to give pethidine at home births either, so pain relief is limited to ‘natural options’.
  • Although your midwife, or midwives, will be present during the labour and birth, there will not be specialist services available in an emergency
  • The mother does not get an opportunity to rest away from the demands of other children, so it is vital that support and help are arranged for this.

If you are unsure about where to give birth, then find out about the facilities available in your region; talk to your LMC and other women who have recently had a baby in your area. It does pay to keep an open mind, see how your pregnancy progresses, and see how you are feeling nearer the time!

Useful Birthing Websites / Articles

Choosing a LMC has useful information about your options of health professionals for pregnancy and birth.

To read more about the role of a Doula, click here.

Pain Relief in Labour discusses your option of pain relief, which is linked to where you give birth.

The Maternity Services Consumer Council outlines your choices about where to birth. www.maternity.org.nz/choices.shtml#where

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Paula Skelton is a qualified NZ nurse and midwife, a midwifery & childbirth educator and the mum of three lovely girls.

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