Choosing the Right Birth Facility
Your Birth, Your Rights: Making Informed Choices for a Positive Experience
As an expectant mother, you likely spend time envisioning the incredible moment when you will finally meet your baby. What will they look like? How will it feel to hold them for the first time? Pregnancy is a transformative journey, culminating in birth—a profound and sacred experience where you get to see, hear, and touch your newborn for the very first time.
Every mother deserves a birth experience that is rooted in dignity, respect, and informed decision-making. Ideally, you would have continuous support from your chosen partner or coach throughout labor. Unfortunately, this is not the reality for many women in labor and delivery units across America today.
The Challenges in Modern Maternity Care
Through interviews with dozens of women about their birth experiences, a troubling pattern has emerged—many recount traumatic or dehumanizing treatment in hospital settings. One mother shared that her negative hospital experience played a major role in her decision to have only one child, describing the process as feeling like “a cattle cow being herded along” through the business of birth. This sentiment echoes the concerns raised in The Business of Being Born, a documentary by Ricki Lake, which explores how birth has become a for-profit industry in the United States.
The hospital environment, where approximately 98% of births take place, often lacks the continuous support that laboring women need. According to cultural anthropologist Robbie Davis-Floyd in Childbirth and Authoritative Knowledge: Cultural Perspectives, a woman in labor may encounter up to 16 different caregivers, yet spend much of her time alone. In contrast, midwife and birth rights advocate Ina May Gaskin reports that when women receive continuous care from a dedicated support person (often another woman), they give birth without anesthesia more than 90% of the time.
Regardless of how you choose to birth—whether with or without pain medication—your rights should remain intact. Women should know that they have the power to hire (or fire) a caregiver who does not treat them with the respect and dignity they deserve.
The Importance of Baby-Friendly Hospitals
Every mother in America should have access to a Baby-Friendly Hospital, an initiative led by the World Health Organization (WHO) and UNICEF. Their mission is to create a culture that supports breastfeeding and prioritizes the well-being of both mother and baby. While the number of Baby-Friendly hospitals in the U.S. increased from 86 in 2009 to 134 in 2012, this remains a small fraction of the 5,815 registered hospitals nationwide.
Given these disparities, expectant mothers should take an active role in choosing the right birth facility. Touring hospitals or birth centers and asking the right questions before labor begins can ensure a more positive birth experience.
Your Birth, Your Choice
Many women assume they must give birth in the nearest hospital, but that is not always the best option. Studies indicate that, in some cases, home birth can be as safe or even safer than hospital birth. Policies within hospitals often dictate rigid rules that may not align with evidence-based care. For example, some hospitals require mandatory newborn observation periods that separate mother and baby, restrict movement during labor, or enforce the lithotomy position (flat on the back with feet in stirrups), which actually narrows the pelvic opening.
Your body and your birth are yours. No one should make decisions about your labor and delivery without your informed consent. If a hospital’s policies do not align with your birth plan or evidence-based care, you have every right to choose a different facility.
Finding the Right Birth Facility
A hospital tour can provide valuable insight into its approach to childbirth. Ideally, you should schedule a private tour, as group tours are often geared toward introducing hospital policies rather than addressing individual concerns. If a facility refuses to offer a private tour, it may be a sign to look elsewhere.
Red Flags to Watch for When Choosing a Hospital
Be prepared with a list of questions when touring a hospital or birth center. If staff cannot answer these questions or provide unsatisfactory answers, consider looking elsewhere.
Key Questions to Ask:
- Can I labor and give birth in the position I choose?
- Does the facility provide tools like a birthing ball, tub, or shower?
- Can I wear my own gown and play my own music?
- If the hospital requires the lithotomy position or restricts laboring options, reconsider registering there.
- How is newborn care handled immediately after birth?
- Does the hospital practice immediate skin-to-skin contact?
- Are babies kept with their mothers unless medically necessary?
- If routine observation policies separate babies from mothers, this may not be a Baby-Friendly facility.
- What are the hospital’s policies on newborn procedures?
- Are vitamin K injections, eye ointment, and newborn bathing optional or mandatory?
- Baby-Friendly hospitals allow parents to make informed choices about these procedures.
- What is the hospital’s C-section rate?
- The U.S. C-section rate is currently around 33%, significantly higher than the WHO’s recommended 5-10%.
- High C-section rates may indicate an overuse of medical interventions.
- How does the hospital handle birth plans?
- Will nurses and doctors respect and follow a mother’s birth plan?
- Does the hospital have policies that prioritize patient autonomy?
By asking these questions and researching your options, you can take control of your birth experience and ensure you receive the respect, support, and care you deserve.
Empowering Women to Make Informed Choices
Every woman deserves a birth experience that honors her choices and prioritizes her well-being. You don’t need to be demanding or pushy to find a supportive birth facility—just well-informed. By taking the time to research and advocate for yourself, you can create the birth experience that best suits you and your baby.
Your body. Your birth. Your choice.
