This post is NOT to provide you with the actual risk differences in birth outcomes by place of birth. This is a post about what questions are most often asked and what questions parents wish they knew to ask the first time around that they focus in on the second pregnancy, and a brief perspective from your midwives.

So, let's learn from the experts--your peer mentors--and jump the line to get a better shot at asking the right questions along the way.
3 most common questions we know to start with:
Is the birth center safe in case of an emergency for me? For baby?
Can I get all of the same tests, treatments, and procedures at the birth center and hospital?
I'm kind of a whimp when it comes to pain, what kind of pain management is at the birth center?
These are great questions--you should get them answered by the midwife or doctor you see.
Now here's the questions parents tell us they wish they knew to ask:
Will I be heard?
Will I be believed?
Will what I know and feel about my body and my baby be acted upon?
If I bring research and questions to appointments, will you have time to review them with me aka how long are my prenatal appointments?
How does your program help me combat loneliness and isolation (both shown to dramatically change pregnancy and birth outcomes)?
How will I learn everything I'm supposed to know to get to a great birth outcome?
How collaborative is my team?
Is there mental health integrated into my care? How?
How does anxiety impact my pregnancy and birth? How does this care address anxiety I feel?
How is my progress measured during labor? Am I on a timeline for any reason during labor and birth?
Who will be at my birth that knows me from my pregnancy care? If not, how do the people who will be at my birth approach meeting me for the first time in that heightened space?
How can this care help me achieve my goal of being a "good" parent right from the start? (This question always comes up and is so brave to ask. We all want to be great parents, and it is hard to figure out what that means for our family and what to prepare for, but parenting starts during pregnancy)
The number one thing that people who report birth trauma share is that looking back, they do not feel they were part of decision-making during pregnancy or birth. They feel something was "done to me" instead of feeling educated, included, and taken seriously. That is a crucial risk factor to pay attention to when you decide which location is safest for you to birth at.
Deciding on place of birth is all about asking questions, and ultimately you will be safest where you feel safest (barring any medical risk factors which make you safest to birth in a hospital). There can be a lot of grief if you choose one birth place and need to move to the other for medical reasons. Part of the remedy is preparation and education and collaboration.
And finally, moving from notes from peer-mentors and into a note from your midwives:
At Rainier Valley, we love our hospital partnerships. We work hard and intentionally with the doctors our clients might need care from at some point in their pregnancy or birth. We meet often. We call each other. We message each other with questions. These are really great people who want to support community-based providers and the families that choose community-based care. Having a support system that supports each other means you get the best of both worlds, all championing each other, and you. That bridge is crucial in our view--it eases client's burden of traversing a landscape full of potholes and ditches. We don't ask "birth center OR hospital?", we ask "will you have what you need or want, when you need or want it, from providers who can offer you the right kind of care for what you need or want, at the right time, together." We often provide prenatal care for families planning a hospital birth. They want our programs and the long appointments and personalized, individualized care during pregnancy. And they want a hospital birth. This opens doors, takes the air out of deciding, and keeps access, inclusion, and equity centered in your care.
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