E133: Birthplace Choices

The loudest voices online will tell you there’s only one “right” way to give birth and that anything else is unsafe, uninformed, or unempowered. We don’t buy that. We want to slow the whole debate down and talk about what actually matters when you’re choosing a birthplace: safety, trust, support, and the kind of information that fits your real life. 

We walk through the full range of options in plain language, including free birth (unassisted birth), birth center birth, planned home birth with a midwife and transfer plan, and planned hospital birth with OB or midwife care. Then we dig into why people make these choices, from past trauma and fear of medical settings to a strong need for autonomy and a belief in birth as a normal physiologic process. We also name the social media problem head-on: algorithms reward outrage and idealized birth stories, which can blur risk, erase nuance, and make you doubt your own instincts. 

From there, we get practical about informed consent and informed choice: not blind trust, not TikTok-driven fear, but asking the right questions about benefits, risks, and alternatives. We talk about what doulas actually do, how “natural birth” means different things to different families, and how empowerment can show up in many forms, including making decisions in the moment. If you’re pregnant, postpartum, or supporting someone through birth, you’ll leave with a clearer framework for building a plan that protects both autonomy and safety. 

If this conversation helps, subscribe, share it with a friend who’s sorting through birth choices, and please leave a review wherever you listen.

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Show Credits

Host: Angie Rosier 
Music: Michael Hicks 
Photographer: Toni Walker
Episode Artwork: Nick Greenwood 
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker

Transcript

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Welcome And What We Cover

SPEAKER_00 0:10

Welcome to the Ordinary Doula Podcast with Angie Roger, hosted by Hatchedon Last. Here, we explore the many layers of pregnancy, labor, birth, breastfeeding, and postpartum life through the lens of more than 20 years in a busy doula practice, supporting thousands of families. Whether you are preparing for birth, navigating feeding, or adjusting to life with a new baby, this podcast is designed to offer practical knowledge, thoughtful conversation, and empowering support for the real experiences of parenthood.

SPEAKER_01 0:51

Good day to you and welcome to the Ordinary Doula Podcast. We are hosted by Hatched and Latched. Check us out at hatched and latched.com. And my name is Angie Rosier. I'm your host, and I enjoy spending this time kind of thinking about working through different topics, seeing what people might be interested in to hear about and to learn about.

What Birthplace Options Mean

SPEAKER_01 1:13

So I want to talk a little bit about birth place. Like we hear the term free birth, home birth, hospital birth, and those are all different approaches to birth. If you spent any time on social media, you've probably seen some kind of intense conversations about birth. It's kind of a hot topic. Like people get fired up about it in all the ways on all the sides of the topic. People are into home birth or hospital birth, medicated birth, cesarean birth, natural birth, interventions, free birth. There's so many ways to get passionate about this. And those ways are usually can be pretty polar from each other. So depending on which corner of this internet you're in or which side of this polarity you are on, you might have been told that one of these ways is the only way to have an empowered birth. So it's just interesting to me when we have these strong opinions coming across, sometimes by influencers, folks on social media, just and algorithms feed this to us. What this conversation is really about. It's not about where you should give birth, but it's it's about having information and having respect and support and giving birth where you feel safe. And that'll be a little bit different for everybody. So, real quick, we probably know what free birth is. Um that is, you know, we have that's giving birth on your own, or it's also called unassisted birth. So it's intentionally on purpose giving birth without a trained medical person there or um with free professional attending the birth. Um, birth centers, they're freestanding, they're outside of hospitals. Sometimes they're hospital affiliated. You do have um staff there, there's a midwife, there's other, you know, birth attendants, birth assistants, or nurses who are there. It's appropriate for low-risk pregnancies. There's planned home birth where people are just going to be at home. They do have a midwife assistance coming, perhaps a doula. You know, there's lots of different team members that can come there and they have a plan for emergency transfer. And then the vast majority of births are planned hospital births. That's what our cultural cult, that's what our cultural and social norm is is giving birth in a hospital with an OB, perhaps a midwife, there's gonna be nurses, anesthesiologists, there's surgical services available, of course. Um, so those are all the play the kind of the types of birth there are. And I want I want to reiterate that that planned hospital birth is a pretty young player here. Like if we look at the grand scheme of human history, that's been around for not very long in the whole grand scheme of things. About a hundred and ten years max. Um, so when we look at how long people have been born, that's really not very long. So it's it's taken us all by storm, and that's our norm now, but it historically hasn't been.

Why Some Choose Free Birth

SPEAKER_01 3:57

So free birth, let's chat about that. Why do people choose free birth? This is um kind of interesting. Um, and I don't want to start by you judging the choice or me judging the choice, but ask why. Um, why do people want to do free birth? Well, they may have felt ignored if they had a hospital birth or felt pressure. Um, they may have had a previous traumatic birth, they may have an intense fear of hospital places or medical places or not trust providers. They might have a total lack of trust in providers based on what they've been exposed to in their life. They might feel like birth is just normal, right? Like this is a normal biological, physiologic event that doesn't need all that structure and framework around it. They might want total autonomy. Um, there's lots of different reasons people might choose that. Um, recent discussions around free birth has kind of connected the trend with past birth trauma and distrust of maternity systems. That's not always the case, but it definitely can be. So, a question we could ask is what would happen in our maternity system for someone to feel safer giving birth, um, more completely unattended than they would in a hospital setting. Now, those working in a hospital cannot understand that. Those were that have due free birth or home birth can also cannot understand where they would see a hospital birth being incredibly safe. So we have two totally different perspectives here, which is kind

Social Media Extremes And Nuance

SPEAKER_01 5:20

of interesting. And then we have the social media dilemma in the middle, where we can connect directly with um people who think like us, right? And so it feeds into people who think like us, not always people who don't think like us. It tends to also give us extremes, like says hospitals are dangerous, home birth is dangerous. Neither one of those are true for all situations, of course. Um, your body knows exactly what to do. You need an induction and an epidural. Both could be true depending on you and your situation. So, kind of avoiding those extremes, most of us lie in the middle of extremes anyway. And algorithms that feed us content don't really give us the nuance of that. Um, they like engagement, outrage gets engagement, um, sensationalized things get engagement. So, research has kind of found that social media is a major source of pregnancy information and a lot of other things, right? Um, there are studies of popular birth accounts that found that social media portray portrayals can present idealized low intervention versions of birth than the broader reality of birth, because we have a lot of situations, a lot of bodies, a lot of people, a lot of ages of people with different health histories, of different areas of support in different medical situations or disease or um whatever, you know, if we have people with chronic illnesses, like all kinds of people are giving birth. And so we can't slap one sticker on it and say people should do what that, you know, what this person does. That's not

Informed Consent Beyond TikTok

SPEAKER_01 6:44

the case. So, what this is about is informed choice. Like, what does informed choice actually mean? Informed consent is not just saying my provider told me to do this, and I totally agreed. I will trust anything the doctor says. Uh, I hear that a lot. Um, that, you know, that's one side of things. And then it also is not like I saw a TikTok telling me that hospitals are bad, or I saw a TikTok, you know, we could find all the things TikTok tells us about birth, but coming back to your own situation, your own body, your own belief system, your own history, your own family and personal culture about birth, and then making informed decisions for your situation, knowing what your options are. Um, our financial, like our medical financial system, makes hospital the most um common option financially for people. What are the benefits of all the options? What are the risks of all the options? What are the alternatives to your options? Did you know you have alternatives? Um, so we the brain questions we call them. We ask all these questions. If if you didn't explore any other type of birth, you're probably going to be in a hospital, most likely with an OB. But knowing that you have other options and why you might want to choose other options could be an interesting journey to go

Real Stories Of Empowered Choices

SPEAKER_01 7:53

on. Um, I have a creepy client recently that um chose to do a home birth, and I was a little bit surprised, um, impressed, surprised, a little bit concerned, um, and and incredibly proud of her. And it it told me that she was looking for something different. Like she had had a couple of hospital birth experiences, um, and I was at some of them, and she made a pretty big choice to do look for something very different. And that's a lot of times what people are doing. What they're looking for is something different. So if we could come together in the middle and try to understand each other, I think that's always helpful. Difficult, but helpful. Some people um do a different type of birth because they get to make the decisions, right? They want autonomy, and autonomy does not mean that nothing bad will happen. You know, it's a very important decision to make where to have your baby. It can be a big deal. You can have a beautiful, I've seen thousands, yeah, literally, um, of beautiful hospital birth experiences. I've seen a lot of traumatic hospital birth experiences. I've seen birth experiences in hospitals where people didn't even know what they weren't getting and they didn't even know how they were being treated. They were just along for the trust ride. Um, I've I've seen traumatic home birth experiences. I've seen really empowering cesarean births and um unplanned C-sections that feel really traumatic or planned C-sections that feel traumatic. I've seen incredibly empowering peaceful hospital or uh sorry, epidural births. I was at a birth recently where this mom was, she had, it was her her third baby, and she had given birth with an epidural without an epidural, and this one she was leaving open. She's like, I think I'd like to do it without an epidural, but I'm not sure. I'm just gonna give myself that the ability to make the decision in the moment. And she did. She made the decision in the moment. And it was as we discussed things with her throughout her labor and throughout the day, she came to a point where, like, yep, and she made a kind of quick decision. And she'd been pondering it on it all day. I'm gonna get an epidural, and she did, and she felt incredibly powered by being able to make that decision. Like her gut just said, get an epidural now. And then within half an hour, she had a very beautiful um vaginal delivery, which was, I mean, all her babies have been worn vaginally, and it was incredibly positive for her, and she didn't know her exact path till the very moment. So that was awesome. What she did do that was different on this one, and I've I've I I've and this actually made me think of social media because I had a lot of clients asking specifically about this lately, is they want to receive their own baby, they want to reach down and help deliver the baby, and which she requested and did, and incredible, like just absolutely incredible um what that was like for her. We got it on video, we got it on camera, um, and so cool to see the look on her face. And she said that was her favorite part was being able to reach down and receive her baby, which is pretty awesome. Um, so location does not always determine if somebody feels empowered or not, right? A lot of people are gonna feel very traumatized by a free birth, like an unintended accidental home birth. That's not the same as a free birth, but um to some people that's a tragedy, right? I have a a lifelong friend um who is very against home birth, very, very against home birth because her dad's story. So her dad um was a, and this is a long time ago, right? He's like an older gentleman by now, but it's interesting what his how his experience impacted my friend's experience, who is his daughter. So when he was a little boy, his mom had an unintended home birth and she hemorrhaged. So he, I don't know how old he was, little boy, six, seven, eight, I don't know. Um, but his the vision in his mind is that home birth is dangerous. And he had a real true legit fear of home birth for the rest of his life. So he grows up, becomes an adult, gets married, has a family. Now his family, his children are having children, um, and he was terrified of home birth. Now, luckily his children, luckily for him, his children didn't choose to give birth at home, but others in their family had like cousins and things like that, and he was terribly, terribly afraid of that. But based on his experience, you can see why, right?

What Doulas Actually Do

SPEAKER_01 11:53

Um, I want to also kind of shift to, you know, there's life experience and then a doula's role. So I being a doula myself is kind of when I get a talk about what doulas do. Um, doula's are not there to keep you out of a hospital, they're not there to protect you from every intervention or to convince you to have an unmedicated birth. They're not there to argue with your medical team. And I'll tell you what, a lot of hospital staff feel that, that you're there as a doula to argue with them and to confront them. And um that's not the case. Doula should be there to provide information, to help people understand options, to collaborate with the staff, whether we're at a hospital, a home birth, uh, hospital birth, birth center birth, if there's staff there, free birth, there's not staff there, obviously, but to collaborate with other providers as well. They're there to offer continuous emotional physical support regardless of what's going on, becomes especially important during traumatic birth experiences. They're there to help partners participate, um, communicate preferences, understand options, navigate changes in the plan as you navigate labor. Labor is like the most unpredictable thing ever. That's not a negative. It's just we can never say what's gonna happen. And I, you know, I get surprised all the time about what things, what what can happen, what's possible. Um, they're also doulas there to remind that you have a voice. A lot of people just put absolute 100%, 110% of their trust in the um the hospital staff, their nurses, the doctors to make all the decisions for them. They're used to doing that, so that they'll be happy to do that, but um used to all the voice and what's going on. So recent public health work um continues to describe doulas as non-clinical professionals who provide physical, emotional, and informational support and can help you navigate um labor and birth. So then we talk about you know, natural birth, um, which that's a different, different um definition to different people, like what does natural actually mean? To some people it means no epidural, no intervention, like pitocinar inductions, no c-suction. Um so it can mean a lot of different things to a lot of people, but I think the overall, the overreaching theme there is that we want the body and the choices to be respected during birth, the process to be respected. It's manipulated plenty, right? We know that that is a possibility within a lot of our um medical constructs around childbirth. We have a lot of manipulation of the process with inductions, interventions, augmentations. Um, so there are interventions, but respecting that and communicating about what is wanted and what is needed in a particular situation. Um so think about what natural is to you. Is that the goal or is informed, supported, respected birth kind of the goal as well? Um when you're informed, you can make best choices. Um when you're supported and respected, you can have a positive experience.

Safety Risks And Real Safety Nets

SPEAKER_01 14:47

Um, and then uh I want to talk about safety in birth, pivot a little bit and talk about safety. Um, when we talk about free birth, birth center birth, home birth, hospital birth, there's a lot of different safety um well, safety perspectives there. Um, free birth does come with legitimate safety concerns because there are no trained professionals present to recognize or manage the common things that may come up, right? Which might be heavy bleeding, shoulder dystosia. One of these awesome births I was at last week had a 57-second shoulder dystocia. Still an incredibly empowering birth. Baby's great, mom's great. Um, there could be placental challenges, like third stage, there could be cord complications, feel distress, um, maternal hypotension, maybe a baby that needs a little bit of help, uh, some resuscitation afterwards. All these are common. Um, however, you know, a lot of people, I think we look at like the the animal world, like deer and um whatever has babies in the wild, everything, every animal that has babies in the wild, don't they don't eat a lot of that. Um, so that medical construct around them. Um and then we bring it to humans. It's not as simple as that, but yes, birth in a mammal is generally pretty awesome, pretty safe, and follows the laws of nature. If you are healthy, if right there's certain parameters, and you can never judge your situation against anyone else's because there's so many nuances to all of that. There are some emergencies that are time-sensitive that are totally unpredictable. That's the safety net. That's the safety net of being in hospitals. Now, hospitals are prepared for common things that aren't emergencies, but common things. They're also prepared for emergencies, but they're not prepared. I mean, nobody's prepared for crazy um emergencies when they're when we're surprised by them, right? Which can happen at any time. So, yes, there's an OR, but we might not be prepared for a massive hemorrhage right after delivery. Um, as in we were expecting it. We know what to do when it happens, but we might not have been expecting it. So knowing that some emergencies are time sensitive, some are minor, some are major, and we don't know until they happen. So kind of being in the middle of this polarity is um

The Middle Ground And Better Support

SPEAKER_01 17:00

where most people are. This is this is kind of where I think most of us sit. We don't have to be hospital, high intervention, managed birth versus free birth, like most people are in the middle. There's an enormous amount of middle ground. You could do a hospital birth with a childbirth class where you feel really educated and informed. You could do a hospital birth with a doula or with a midwife or a birth center with a midwife. Um, so education and preparation are gonna be pretty awesome to help you get a better experience. Um, there was a couple I was helping recently, and they had taken my childbirth class. And it was interesting to me. They reminded me, because I mean, you know, a lot of people come through and take childbirth class, and you don't hear from them or see from them, see how things went. Um, and I was helping them with lactation after they had their baby. So I hadn't seen them for quite a while. And um she said, Oh my gosh, what a great difference it was to have just had a class. Like we knew what to ask and we knew what our options were. Um, so they didn't hire anyone necessarily, but they had a really positive birth because of information, right? So um you can have an epidural, an induction, a cesarean, a feedback, like all types of or all kind of interventions and birth with a doula or without a doula. Um, you can have a high-risk pregnancy, high risk to mom, high risk to baby, and have have a doula or have continuous support as you build that support team can be really positive. Um, so we don't have to reject the medical system um to have autonomy. You can have um a form of autonomy, of course, within that as well. You don't also have to reject the value of medical care and have a free birth. Um there's there's value to all spots in this middle ground here. So really what we I think what all of us who care about birth is, no matter how birth is, that we care about it, um, the conclusion, the big over overarching concept I like to take away is that um not that everyone should do birth a certain kind of way, but that folks should be, everyone should be informed. They should be educated, informed consent should be a huge part of their care. They should have open and clear communication with our team. They should be respected. They should absolutely be. That's big to me, big to me that people get respected in their care. Um, they should have access to good medical care and to midwives, better access to do-lahs. Um, more people on the birth team need to recognize and work and practice in informed care so that um we don't have the those traumatic experiences that lead to lifetime challenges sometimes after a difficult birth. Um, there should be more support for partners who support the person giving birth. There should be meaningful choices and just remembering a big part of this is just remembering that this is an important day, that this is a huge event in their life, um, and it should be handled as such. We want to treat them like if you were working with them on their wedding day, um, you would give incredible support. You know, you're not gonna be berated on your wedding day and say, why are you doing this? Why'd you choose that? And um, and not have your choices second guessed, whether it's the color of flowers you chose or the partner that you chose. But think of supporting people on the birthday like you would on their wedding day. So our healthcare system um is full of people, right? People who um are good people who want to support, they are in the system, of course, but they um want to support healthy birth, right? There's lots of different ways to do that. And there's people within the system getting care that want autonomy and safety. And it shouldn't be a choice between autonomy and safety. They should be able to um kind of have both of those things. Okay.

Closing Reflections And Two Requests

SPEAKER_01 20:33

So um as you design your ideal birth experience or ponder on it, think about it, um, don't worry about what anyone else thinks. Just think about what you want and what works for you. That's gonna be different than your neighbor, than your friend, than an influencer. There's you haven't seen their medical record, you haven't seen their health history or their um emotional, you know, the emotional challenges that they face, make decisions that are appropriate for you. Ask, what do I actually want? Uh, and then versus what have I been told that I should want, and um kind of see where you are in that. So the answer to current birth debates be, you know, is we're convincing people or everyone to give birth in this way or that way, like there's no right answer. The answer is giving people better information, appropriate support, respecting them, and better care, and and giving them genuine choices. Your birth does not have to, it won't look like anyone else's to be a good birth. Whatever positive empowering is to you is right for you. Um, and make that you can make informed choices. You don't have to between choose between autonomy and safety. You deserve both of those things, and you can have those things in a variety of settings. Um, people really can. So that wraps up our little um discussion on polarity, um, free birth, hospital birth, and how we might feel about that in between. Hopefully, this is helpful for you along your journey. Um, I hope you have a great experience in postpartum and breastfeeding if you're gonna do that, if um, in however your birth goes. Um, my goal always for my clients and anyone I talk to and work with is that they have positive, empowering experiences. And hopefully you will have that because it's important in your life. Thanks for being with us today here on the Ordinary Do Love Podcast. This is Angie Rosier signing off. And please make a human connection with someone in your life today. Whether you get eye contact with someone, shake someone's hand, give them a hug, send them a text or a message, um, reach out to someone today and let them know they're important to you. Hope you have a great one, and we will see you here next time.

SPEAKER_00 22:37

Thank you for listening to the Ordinary Doolow Podcasts with Angie Roger, hosted by HatchdenLatch. You can find episode credits in the show notes and more information by visiting hatchdonlatch.com. If this podcast has been helpful to you, please leave a rating wherever you listen to your podcast. Your support helps us to continue having thoughtful conversations about birth, breastfeeding, and postpartum life. Be sure to tune in next time as we continue exploring the many experiences, questions, and realities surrounding the journey into parenthood.