I had 5 DCs during the 90s and one in 2001 in the US. Mu Dsis had one in Dublin.
Differences:
Nice clean hospitals and chance of a private room with a private ensuite bathroom that is clean. Bliss.
Decent food and menu to choose from but bad tea.
Depending on the hospital, nursing care can be really excellent.
Some hospitals have birthing centres where part of the service is a nurse visit once you're home. Most hospitals do not provide this service and local health departments do not send HVs. Basically once you're home with the baby you're on your own and the only contact you'll have with health professionals afterwards is the pediatrician's office, for the 2 week checkup and then the checkups where they start immunisations.
Pre natal care managed mostly by OB/GYN not midwives although there are midwife practices and some OB practices have midwives on staff.
Your own doctor or midwife usually attends your delivery and if not then a hospital resident (if teaching hospital) will do it.
You choose your own medical team.
You choose a pediatrician, not a GP for baby and child care. Smart to ask the hospital pediatrician for a referral or ask if the hospital pediatrician has an office him or herself. I chose to go with the hospital pediatrician, and luckily he was on my insurance preferred provider list. He developed a great relationship with my family. Sadly dead now but very fondly remembered.
When choosing a pediatrician, ask about how knowledgeable the office nursing staff are and whether the office prefers to deal with issues over the phone or have you drag children in. My office liked to weed out potential sick visits over the phone and saved us a fortune. They can do nothing for a virus and no point in going in -- you have to pay and you are wasting your time.
Insurance pays a proportion of your tab and pays separately for the baby. Usually 80 insurance/20 you. Insurance pays nothing if you don't have specific maternity coverage. Don't assume maternity coverage is standard with general health insurance.
Maternity insurance normally assumes well baby care/standard newborn nursery care but you need to check these details. Check also for coverage of care for a baby needing more than normal care.
Check this very important detail and apply for state coverage for pregnant women and newborns if you find you don't have coverage. Even non-citizens are eligible.
Insurance doesn't cover doulas iirc.
Check also that your insurance covers well child care (immunisations and routine visits for checkups) as otherwise you'll pay a lot.
You will get separate bills from hospital for you and the baby, a bill from the anesthesiologist, one from the doctor/midwife and one from the pediatrician, and also from any specialist involved in the care of the baby.
You will have to bring all your insurance info and identification with you to the hospital and check in with the receptionist no matter how much in extremis you are.
Epidural normal. Not as frightening as MN threads on the subject make it out to be, same goes for episiotomies.
(Nurses may be pushy because there is a window of opportunity after which a canula can't be inserted. No harm in getting the canula in just in case. Nurses may also be aware of how few anesthesiologists are available and may realise it's now or never. Plus, an epidural canula can be used in the event of a CS so you don't have to be knocked out. Wise to consider having it inserted therefore).
IV normal.
No gas and air.
Hardly ever an option for a water birth outside of major cities. If you want this sort of option look for a 'birthing centre' either freestanding or within a hospital.
Normal care assumes a baby will be whisked off to the nursery for observation.
You will be asked if you want to circumcise a son and it will be done by the OB/GYN or midwife if you want to have this done. It is usually covered by well baby/child care.
I had only two scans at most during each pregnancy.
Had several non-stress tests each time at the end as I was always late.
Doctors press for induction quite vigorously if you are late.
Care for conditions like gestational diabetes excellent (my midwife practice had a dietician on staff), but normally insurance doesn't cover testing supplies, neither the machine nor the test strips, and this can be expensive.