If you are preparing to give birth at a hospital, one of the things on your schedule between the time you get that first positive pregnancy test and the day you hold your sweet baby in your arms for the first time is taking a tour of the Labor & Delivery unit.
As your doulas, we often get asked, "What questions should I be asking on the tour?" First, let us tell you how decision making works in labor, and then we will offer some suggestions for questions to ask.
It's important to know that when making decisions during labor, you will be working with two parties: the hospital and your healthcare provider. Both parties work together with you to determine your plan of care, and your healthcare provider can override the hospital (although, they do need to maintain a good working relationship with the hospital so they don't do this flippantly!) And of course, ultimately you get to be the final decision maker regarding your care.
With that said, be sure to bring along your birth plan to the tour, and use it as a guide to ask about policies relating to the way you want to give birth. The following is a list of general questions you might ask, and of course, we are there to answer specific questions you might have about which of these are important to you and your personal birth goals, and what to do with the answers you receive:
- What entrance and parking lot should we use during the day? During the night?
- What is your policy regarding water and food intake during labor?
- What is your routine policy for IVs?
- What is your routine policy for monitoring the baby during labor? Do you have a telemetry unit (a portable, wireless version of their electronic fetal monitor that allows you more freedom of movement during monitoring).
- What sort of non-medical comfort tools are available? Do you have a birth ball? Rocking chair? Peanut ball? Shower? A tub? Squat bar for the bed?
- If there is a tub, what is the policy for using it during labor? What are the restrictions?
- Is there a limit to the number of support people allowed in the room, and if so, does my doula count in that number?
- What is your policy for older siblings in the delivery room? Can they spend the night with us?
- Is there an anesthesiologist available 24/7?
- What is the hospital policy for getting the baby skin-to-skin at the birth, and how long do they encourage the baby to stay skin-to-skin initially? Can newborn procedures be delayed or done while the baby is still on my chest?
- What is the standard policy for administering Pitocin after the birth to prevent hemorrhage?
- What is the policy for releasing my placenta if I want to take it home with me?
- What level of NICU does the hospital have for newborns?
- What is the cesarean rate?
- If a cesarean is necessary, how many support people are allowed in the OR?
- Is immediate skin-to-skin available in the OR, or can my partner have skin-to-skin with the baby if I am unable to?
- What is your policy for new baby's to room-in, and is there a nursery for healthy newborns if I need a rest?
- Is there an IBCLC on staff who can come to my room, and if so, what are their hours?
- Are the rooms set up so that my partner can get some rest as needed during labor and after the baby is born? (Keep an eye out for ways to make the situation more comfortable too- can you bring a soft comforter from home?)
- What are your policies for Trial of Labor and Vaginal Birth After Cesarean? Are there any restrictions or special considerations, especially for monitoring and use of comfort measures such as the shower or tub?
- If you or your baby are considered high-risk, ask if you can speak with one of the neonatal nurses to get familiar with the NICU policies, including what to expect if the baby does need to spend time there, visiting policies, and policies regarding breastfeeding and skin-to-skin.
Remember that these questions are just a guide to help you understand what you might expect. At Tender Beginnings,we are familiar with the local hospitals in and around Cincinnati and Dayton, and can help you get a better idea of what options are available to you and how your birth plan might fit in. We can also help you navigate decisions once you are in labor, and remind you of what is available to you every step of the way.