How does maternity care compare in regular hospital maternity units versus in-hospital birth centers?

A systematic reviewHodnett, E.D., Downe, S., & Walsh, D. (2012). Alternative versus conventional institutional settings for birth. Cochrane Database of Systematic Reviews, 8, CD000012. found that neither women nor newborns using in-hospital birth centers had worse outcomes than those using regular hospital maternity units. Care was better for women in in-hospital birth centers than for women in regular hospital units due to:

• More experience of no analgesia/anesthesia.
• Less use of epidural analgesia.
• Less use of medicine to speed labor (synthetic oxytocin or “Pitocin”).
• Less use of vacuum extraction or forceps.
• Less use of episiotomy (cut just before birth to widen opening of vagina).
• More experience of a vaginal birth with no vacuum extraction or forceps.
• Less use of cesarean birth.
• More very positive views of their care (just two studies measured this).
• More breastfeeding at 6-8 weeks (just one study measured this).

The same systematic reviewHodnett, E.D., Downe, S., & Walsh, D. (2012). Alternative versus conventional institutional settings for birth. Cochrane Database of Systematic Reviews, 8, CD000012. found that the following outcomes were not different between in-hospital birth centers and regular hospital maternity units:

• Excess maternal bleeding after birth.
• Early condition of newborn.
• Perinatal death.
• Use of newborn intensive care unit.