If you’ve decided to give birth in a hospital, then you should tour the hospital as soon as possible. If this is your first time visiting a hospital labor and delivery ward, trust your instincts and choose a birthing place you feel matches your personality and will honor your preferences. Your tour should include Intake, Labor and Delivery, Recovery and Maternity. During the tour, ask these four key questions to determine if the hospital is right for you.
1. What is the hospital’s policy regarding people in the delivery room?
Some hospitals only allow family in the delivery room, while others limit the number of people who can be present to two or ban young children or even doulas. The same question should be asked regarding visitors in the maternity ward. If the hospital’s policy seems excessively restrictive, consider switching hospitals or, if that’s not an option, set up a flexible schedule of who will be in the birthing room with you during your labor. Lastly, if the hospital has banned doulas but allows an unlimited number of family in the delivery room, consider referring to your doula as your cousin or sister instead, especially when asked by hospital staff.
2. Will they allow intermittent fetal monitoring?
Most, if not all hospitals, prefer moms to be on their backs, hooked up to an electronic fetal heart monitor for the duration of their labor. While this may be convenient for the hospital, this is definitely not desirable for the laboring mother. During your tour, be sure and ask what the hospital's policy is regarding fetal monitoring and find out if they will honor your wishes for intermittent monitoring. In addition, inquire at what point during labor hospital policy will require that you remain in bed. Ideally, a laboring mother will have the freedom to move about as long as she wants; however, most hospitals restrict the mother to the delivery bed upon dilating past a certain diameter.
3. What is the policy on cord clamping?
Ideally, the hospital will encourage delayed cord clamping until the umbilical cord has stopped pulsing; unfortunately, that is rarely the case. In the interest of time, among other reasons, most hospitals encourage immediate cord clamping or, at best, allow cord clamping for a couple of minutes. This is hardly enough time for the baby to receive back all the blood trapped in the placenta; cords can take up to 30 minutes to stop pulsing. Don’t let that discourage you if delayed cord clamping is what you want. If you sense a definite hostility on this point, either find a new hospital or, if that is not an option, consider telling the hospital staff that waiting for the cord to stop pulsing is a sacred act, one of great religious significance to your family. Hospitals are required to honor the wishes of patients that are grounded in religious beliefs. In that same vein, if you want to take your placenta home but sense that your hospital will not “allow” that, inform them that not permitting you to do so would violate your religious beliefs.
4. What is the hospital’s policy on breastfeeding?
A successful breastfeeding relationship is established within minutes of birth, and hospitals that are breastfeeding friendly have several policies in common. For starters, they encourage immediate skin to skin contact between mother and baby after birth, followed by at least one hour of uninterrupted alone time for the new family. They do not separate mom and baby unless it is a life threatening emergency, but rather, allow them to bond and initiate breastfeeding. Secondly, breastfeeding friendly hospitals have free lactation consultants on staff visiting new mothers in the maternity ward and do not give away free formula samples upon discharge or advocate formula supplementation during the first hours after birth. Rather, these hospitals encourage new moms to relax and let their baby nurse at their breast, drinking in the tiny drops of colostrum that will provide baby with valuable immunity and a few precious calories. This is all a baby needs in the first few hours and days after birth: to be at his mother’s breast and in her arms, uninterrupted. Hospitals whose policies run counter to this “breast is best” philosophy are best avoided; however, if avoidance is not an option for you, then have the birth partner remain vigilant during your hospital stay to ensure your breastfeeding relationship is honored and respected.
Obviously, there are many more questions you can ask. These four questions are great jumping off points for further inquiry, as they are general enough to stimulate thought and discussion but also hit on four major areas of dissention among parents and hospital workers. Ideally, take a draft birth plan with you on your tour for reference and use it to ask further questions; you will get a sense of the hospital’s attitude towards birth just by watching their reaction to you referring to a birth plan during the tour. Lastly, go with your gut. Listen to that little voice telling you to “run, don’t walk” out of the hospital or, conversely, telling you that this hospital is a wonderful place to give birth. I have never met a person who regretted a decision made by listening to their gut.
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Monica is a Certified HypnoBirthing® practitioner serving the Northern Virginia area, DC and some parts of Maryland. Her practice is called NoVA HypnoBirthing® LLC and she provides group as well as private classes.