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Birth setting

Where you want to give birth: a hospital, a birth center attached to a hospital, a freestanding birth center, or at home. It affects who is present and what is available if something changes.

Where should we give birth: hospital, birth center or home?

In short: Parents choose between 4 main approaches: Hospital unit; In-hospital birth center; Freestanding birth center; Planned home birth. Evidence: experts disagree. Credible bodies or researchers disagree — decide whose guidance you'll weigh. Best settled: during pregnancy.

Evidence
Experts disagree
Best settled
During pregnancy
Part of
Pregnancy to first birthday

Birth setting: what are the options?

Parents usually land on one of these 4 approaches.

  1. 1. Hospital unit

    You give birth in a standard hospital labor and delivery unit.

  2. 2. In-hospital birth center

    You give birth in a midwife-led unit inside a hospital, with doctors down the hall.

  3. 3. Freestanding birth center

    You give birth in a midwife-led center that is separate from a hospital.

  4. 4. Planned home birth

    You plan to give birth at home with a trained attendant.

Birth setting: what does the evidence say?

Experts disagree. Credible bodies or researchers disagree — decide whose guidance you'll weigh.

ACOG advises against planned home birth: it reports more than twice the perinatal death risk (1-2 per 1,000) and about three times the risk of neonatal seizures or serious neurologic dysfunction, while supporting a discussion of risks and benefits with eligible, interested people. The UK's NICE (2023) reads the evidence differently for low-risk pregnancies: planned birth in a midwife-led unit is linked to fewer interventions with no difference in outcome for the baby, home is the same for people who have given birth before, and for first-time mothers home carries a small increase in risk. The two bodies are reading different data and populations, so the disagreement is real; Canadian guidance was not retrieved

Sources

What else is worth knowing?

Each setting offers a different mix of medical backup and home-like comfort. A hospital has surgery and newborn intensive care on site; a birth center or home relies on transferring if something changes. What is available, and what your provider and insurance support, varies by where you live.

Questions to ask each other

  • Where do you picture the birth, and what makes you feel safest there?
  • What would need to be true for us to feel comfortable in a different setting?
  • What would we want to happen if we had to transfer or change plans?

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First published 2026-10-03. Last updated 2026-10-05. General information, not medical advice.