Home Birth or Hospital Birth???

In a conversation with my sister-in-law tonight, she asked when my first doctor's appointment is...and I had to admit that I haven't called to set one up yet, partly because the pregnancy still seems so unreal and I still feel like I might lose it, but also because I can't figure out who to call!!! During my last pregnancy, I was pursuing home birth and had met with two WONDERFUL midwives who assist during home birth. But when I suspected a miscarriage, I called a local OB-GYN practice and ended up going there for the care during and after my miscarriage. I am equally as impressed with the midwife and other personnel I met at that practice (which does not involve itself at all with home birth) as I am with the home birth midwives. And now I'm in a huge quandary, with my mind going back and forth like a ping pong ball between home birth and hospital birth.

I decided to write down some thoughts in the form of a pros and cons list, so here's what I've got so far. I'll probably add to the list over time as more issues come to my mind and as I gain insight from conversations with various people.

Home birth:
+ Completely personal and tailored to me (my own home, bed, sheets, pillow, clothes, music, scents, shower, food, etc.)
+ Midwives who know how to support natural birth and who would give me their full attention (after my previous experiences with pushing, I really want someone who will guide me and encourage me in this area, and I’m convinced the midwives would do that)
+ Cheaper
+ No long separation from Josiah and David; we could be together as a family very quickly after birth
+ Seems really special to have a house “consecrated” by a death (my grandmother’s) and a birth (my baby’s)…what memories!
+ “Seamlessness” – the word that first drew me to home birth (written about by another mother)
+ Seems safe, since ANY health issues or concerns would be automatically transferred to the hospital (and since we live so close to the hospital, it wouldn’t take very long to get there…it’s not like we’re an hour or two from the nearest medical facility)
+ Why not? It’s been done for thousands of years, and in this day and age, it’s safer than ever!
+ Carolyn Fields would have to admit that I really and truly am an amazing pioneer woman!!! :)

- Midwives are farther away, would take longer to go to appointments with them
- No ultrasound/no extra reassurance that the baby is OK/no advance knowledge of the gender (unless I could find another place to get an ultrasound)
- Some mess to clean up (though I’ve heard it’s very manageable)
- Dad would worry
- If I had preterm labor or other serious issues and had to be transferred to someone else’s medical care, I wouldn’t be familiar with that person or group…there’s no back-up partnership between the midwives and a local OB-GYN practice (although from previous experience, when it comes down to it and I'm ready to have a baby, I don't care AT ALL who is in the room or who the doctor is...with Josiah's birth, I tried to convince the nurse to deliver the baby because I was ready to have him and the doctor had not arrived yet; she didn't take me up on that offer!...with David's birth, I didn't know a soul who helped with that delivery; in Israel, unless you pay a whole bunch of money for a private birth, you deal with one doctor during your pregnancy, then show up at the hospital in labor and get who you get!) -- so the lack of familiarity is not really a big deal for me


Hospital birth:
+ Best care in case of medical emergency
+ No mess that we have to clean up
+ OB-GYN practice is closer, wouldn’t take long to get there for appointments (but might have to wait in the waiting room)
+ Good reputation of midwives and other workers at Shenandoah Women’s Health Care, plus our good experience with them so far
+ Dad would be happy
+ Knowledge of baby's gender (with both Josiah and David, we found out as soon as we could that they were boys; and I loved having advance knowledge of that)

- More expensive
- Routine hospital interventions (waking me up in the middle of the night to take my blood pressure, wanting to give the baby immunizations shortly after birth, asking me every two hours, "Have you fed your baby?" etc.)
- More time away from Josiah and David (I hated this when I gave birth to David in Israel; I missed Josiah and could hardly wait to get home to start living as a family again)
- Possibly more pressure (or temptation, on my part) to have an epidural or other medical interventions
- Not my comfort zone; impossible to relax fully there
- Less sense of control/less confidence that my labor would go the way I want it to go (although I realize that can be true in ANY situation, whether at home or in the hospital or anywhere else!)