From 37 to 42 weeks of pregnancy you may give birth under the care of a community midwife. In every other case you are referred to hospital, where the birth is attended by an obstetrician or a hospital midwife.
If the pregnancy is progressing normally, you choose where to give birth yourself. You can choose between a home birth and an outpatient birth in hospital. The cost of a home birth is covered in full by your health insurer, which is not always the case for an outpatient birth.
The best place to give birth is usually the place where you feel safe, because that is where you can relax best — and the more you can relax, the better the birth tends to go. Surroundings that do not feel safe can slow labour down. Giving birth at home can be pleasant because you are in your own familiar surroundings and can simply carry on doing your own thing. The same goes for your partner. And afterwards you get straight back into your own bed.
Some people prefer to give birth in hospital because everything is at hand there and they would not have to be transferred if complications arise. Do bear in mind that a midwife is well equipped too, and that you cannot go into hospital at the first contraction. People also often assume an obstetrician or a paediatrician is present around the clock. That is not the case. But of course the choice of where to give birth is yours.
If you find the choice difficult, you can always talk it through with your midwife. What matters to your midwife is that you can look back on the birth with satisfaction.
If you have chosen to give birth at home, you can always change your mind — during labour as well — and decide to go to hospital after all. The same applies the other way round. A choice once made need not be final. It is wise to be prepared for both.
If you have particular wishes for the birth, you can write them down in a birth plan. There you can set out what matters to you and what you expect. Your midwife — and the obstetrician or hospital midwife too — will do their best to take your wishes into account.
Body Mass Index (BMI)
The Body Mass Index expresses the ratio between your height and your weight, and is worked out at the start of your pregnancy.
Regional policy is that with a BMI between 35 and 40 you give birth in hospital, which can be under the care of a community midwife. Regional policy is also that with a BMI of 40 or higher you give birth in hospital under the care of an obstetrician or hospital midwife.