Know Your Birth Options — Nurture Birth & Health
Free Guide

Know Your
Birth Options

A St. Louis Parent's Guide to Hospital Birth,
Birth Centers, and Home Birth

You Have Options

If you're pregnant or planning to become pregnant in St. Louis, you might assume the hospital is your only option. It's the default path most families take — and for some, it's the right one.

But it's not the only one.

Across the country, families are choosing birth centers and home births alongside hospitals — and experiencing better outcomes, more personalized care, and a more empowering journey in the process. St. Louis City currently receives a failing grade for prematurity from the March of Dimes, and racial disparities in maternal and infant outcomes persist. Families often find navigating the health system challenging, feel rushed and pressured in care, and lose support after the 6-week visit.

Nurture Birth & Health is building Missouri's only community freestanding birth center right here in St. Louis — a community-anchored maternal health hub designed to change that structure. A place where care is relationship-based, where wellness wraps around the whole person, and where community voices shape how care is delivered.

This guide gives you a clear, honest overview of the three main birth settings, the questions you should be asking your provider, and a curated list of local resources to support you through pregnancy, birth, and beyond.

What's Inside

Section 1: Compare Your Options — Hospital, Birth Center, and Home Birth side by side
Section 2: 12 Questions to Ask Your Provider
Section 3: Your St. Louis Resource Map

Who Is This Guide For?

  • You're pregnant or planning to conceive and want to understand your options before choosing a provider.
  • You had a previous birth experience that didn't feel right and want to explore alternatives.
  • You're a partner, family member, or support person who wants to be informed and helpful.
  • You're simply curious about what birth can look like outside a hospital setting.

Compare Your Options

Each birth setting has distinct strengths. Here's what to expect from the three main options available in and around the St. Louis area.

Hospital BirthBirth CenterHome Birth
SettingMedical facility with surgical capabilities and NICU accessHome-like freestanding facility, midwife-led, with transfer protocolsYour own home with a licensed midwife attending
ProviderOB/GYN or CNM; rotating staff commonCertified Nurse Midwife (CNM) or Certified Professional Midwife (CPM); continuity of careCPM or CNM; same provider throughout
Best forHigh-risk pregnancies, those wanting epidural access, or medical intervention optionsLow-risk pregnancies, those wanting personalized care in a calm settingLow-risk pregnancies, those wanting full autonomy in familiar surroundings
Pain managementFull range: epidural, IV meds, nitrous oxideHydrotherapy, nitrous oxide, movement, massage; no epiduralsHydrotherapy, movement, breathing; no medical pain relief
Typical cost$15,000 – $25,000+ (before insurance)$5,000 – $10,000 (many insurers cover)$3,000 – $7,000 (insurance coverage varies)
Average stay24 – 48+ hours postpartum4 – 6 hours; home the same dayAlready home; midwife stays 2–4 hours post-birth
C-section rate~31% nationally~6% (via transfer)~6% (via transfer)
Key advantageImmediate access to surgical and emergency interventionLower intervention rates, continuity of care, integrated wellness supportMaximum comfort, autonomy, and privacy in your own space
Key considerationHigher intervention rates, less provider continuity, institutional settingMust transfer to hospital if complications arise; no epidural optionMust transfer to hospital if complications arise; requires advance planning
"There is no single 'best' way to give birth. The best birth is one where you feel informed, supported, respected, and safe."

12 Questions to Ask Your Provider

These are the questions that help you understand not just what your provider does — but how they think about your care. Bring this list to your next appointment.

1
What is your philosophy on birth?Listen for whether they center your autonomy or institutional protocol.
2
What is your C-section rate?Ask for their personal rate, not just the hospital's. National average is ~31%.
3
How do you feel about birth plans?A good provider will welcome the conversation, not dismiss it.
4
Who will actually be with me during labor?In a hospital, your OB may only arrive for delivery. Ask who's present throughout.
5
What non-medical pain management do you offer or support?Hydrotherapy, movement, breathing techniques, doula support — are these welcomed?
6
Under what circumstances would you recommend induction?Some inductions are medically necessary; others are convenience-based. Know the difference.
7
What is your approach to fetal monitoring?Continuous monitoring restricts movement. Intermittent monitoring is evidence-based for low-risk pregnancies.
8
How do you support breastfeeding / chestfeeding in the first hour?Skin-to-skin contact and early feeding support matter enormously for bonding and milk supply.
9
What happens if I need to transfer care during labor?Especially relevant for birth centers and home births — ask about the specific protocol and timeline.
10
What does your postpartum support look like?Some providers offer a single 6-week checkup. Others offer structured first-year follow-up. Know what you're getting.
11
Do you support having a doula present?If a provider discourages doula support, that's worth noting.
12
What would you do differently for me versus a textbook protocol?This reveals whether they see you as a person or a patient number.

Pro tip: Bring a partner or support person to this conversation. Two sets of ears catch more than one. And remember — if a provider makes you feel rushed or dismissed for asking questions, that's information too.

Your St. Louis Resource Map

St. Louis has a growing community of birth and wellness providers. Here are trusted resources across the categories that matter most during pregnancy, birth, and postpartum.

Midwifery & Birth Center Care
Nurture Birth & Health
Missouri's only community freestanding birth center. Opening 2027 in St. Louis. Community-centered, integrated wellness model with wraparound care services. nurturebirthhealth.org
Doula Support
On Up
Community doula support organization serving St. Louis families.
Bornbir
Birth and postpartum doula services. bornbir.com
Missouri Community Doula Council
Statewide organization supporting community-based doula access and training in Missouri.
Lactation Support
Missouri State Lactation Association
Professional association connecting families with certified lactation professionals across Missouri.
La Leche League of St. Louis
Free peer-to-peer breastfeeding support groups and one-on-one help in the St. Louis metro area.
Perinatal Mental Health
SLU — The MOMs Clinic
Saint Louis University's Maternal Outpatient Mental Health Services clinic, specializing in perinatal mood and anxiety disorders.
St. Louis Pregnancy Counseling
Counseling and support services for expecting and postpartum parents in St. Louis.
Healing Spaces STL
Therapy and healing services centering the mental health needs of the St. Louis community.
Open Path Psychotherapy
Affordable therapy through a nationwide network of therapists offering reduced-fee sessions. openpathcollective.org
Postpartum Support International
Free helpline, support groups, and therapist directory for perinatal mood disorders. postpartum.net
Pelvic Floor Physical Therapy
Legacy Physical Therapy
Pelvic floor rehabilitation and women's health physical therapy in the St. Louis area.
Pelvimama Physical Therapy
Specialized pelvic floor PT for pregnancy, postpartum recovery, and beyond.
St. Louis Women's Physical Therapy
Women's health focused physical therapy including pelvic floor, prenatal, and postpartum care.
Insurance & Financial Navigation
Missouri HealthNet (Medicaid)
Covers prenatal, birth, and postpartum care for qualifying families. Extended postpartum coverage now available through 12 months.
Healthcare.gov — Special Enrollment
Pregnancy qualifies you for a special enrollment period if you don't currently have insurance. healthcare.gov
Community & Education
Nurture Birth & Health Workshops
Free and low-cost pregnancy wellness workshops. Sign up at nurturebirthhealth.org
Evidence Based Birth
Research-based articles and classes to help you make informed decisions. evidencebasedbirth.com
Birth Center Equity Network
A network of Black, Indigenous, and people of color-led birth centers building community birth infrastructure. birthcenterequity.org

You Deserve a Birth Experience That Feels Like Yours

Knowing your options is the first step toward a birth experience built around your needs, your values, and your vision for your family.

At Nurture Birth & Health, we believe women deserve to feel seen, heard, and supported — before, during, and long after pregnancy. We're building Missouri's only community freestanding birth center right here in St. Louis, with a three-part model that integrates clinical care, wraparound wellness services, and data-driven care coordination.

A haven where community is seen, heard, and respected.


Stay Connected

Website: www.nurturebirthhealth.org

Instagram: @nurturebirthhealth

Email: lena@nurturebirthhealth.org

Join our mailing list for workshops, events, and opening updates

Nurture Birth & Health is a proud member of the Birth Center Equity Network, a network of Black, Indigenous, and people of color-led birth centers created to grow and sustain community birth infrastructure for generations to come. birthcenterequity.org
Nurture Birth & Health  |  St. Louis, Missouri  |  Opening 2027
This guide is for educational purposes. Always consult your healthcare provider for medical advice specific to your pregnancy.