1. Choose a place where you feel comfortable.
2. Choose people who make you feel comfortable.
I think the more you can do this, the more satisfying your birth experience.
By comfortable, I mean what place and what people put you at ease. A laboring woman who is comfortable can focus on the task of bringing her baby into the world. A laboring woman who is uncomfortable is distracted by external stress and finds her work more difficult.
Comfort is why I chose a birth center and I had a marvelous experience. I was even more comfortable delivering at home. Although if I had gone to the hospital, my doula and birth plan would have partly compensated for discomfort there. It seems most hospital personnel have yet to realize that the number one medical necessity for a laboring woman is her comfort (physically and emotionally). I do realize there are many mamas who feel put at ease walking through hospital doors. Feeling cared for by the nurses may help her relax. Or sometimes there are pressures at home. And for many, delivering away from ready access to medical equipment alarms her.
So rather than advising a home birth for everyone, I advise thinking where do you already feel comfortable? Ask yourself what place relaxes you, not where you think you would feel relaxed when it's time to give birth (especially if this is your first pregnancy). So if the yoga atmosphere of a birth center weirds you out, it's probably not the ideal place. If you're saying, "I don't like it there, but I hear it's the best place," you should either resolve why the place makes you uneasy or choose a different place.
Also think about if you are making the decision out of fear or out of confidence. Are you afraid of labor and delivery? I understand, but don't let that fear make your decision for you. Learn about birth and research your options until you find confidence, confidence in the marvelous design of your body and Baby working together to bring life. So when I say comfort, I mean more than simply not feeling terrified, more than appeasing fears. Comfort is soaking in Love.
Your ideal place may or may not work out, right? Just be aware that the place makes a big difference on your experience and Baby's experience. Knowing this can even help you deal with the discomforts that come up. For example, when the glare of a sterile room and interrupting nurses throws off your focus, you can close your eyes and ignore them (rather than feel obligated to acknowledge it all). Also, knowing this can help you sort through and and make sense of feelings of fear and depression postnatal, as the discomfort of a place may have contributed to those feelings.
I could say pretty much the same things about choosing the people around you as I just did about the place. Did you know you are likely to have an emotional connection to the person who catches your baby? So that you don't resent that connection, choose carefully. (An example of resentment that I've been told is when the doctor barely makes it in time; another is having a midwife who's a complete stranger). Often there is a team of midwives or doctors and you don't know which one will attend your birth. I've noticed that pregnant mamas typically have a preference who they hope will be there and often have some anxiety about one she hopes is not there to catch baby.
Who attends your birth will affect your emotions. And your emotions will affect your comfort. And your comfort will affect your labor and delivery.
This goes for all individuals who show up to your birth - nurses, husband, doula, friend, mother-in-law. Each person will affect (positively or negatively) your ability to bring Baby into the world.
Of course the effect can be mild or staggering and certainly varies based on the individuals attending and the laboring mama. Ignoring the emotional impact of place and people doesn't make it go away. Being aware helps you make healthy choices for you and Baby.
Birth is about comfort - not pain. So rather than ask, "How can I avoid pain?" ask, "How can I be comfortable?"
More from a Doula: "Why My Work as Doula Requires Emotional Connection"
And more on the labor experience: "Understanding and Assessing Labor Progress"
Practical ways to find Comfort: A Guide to Comfort in Labor plus a slideshow of pregnancy