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Questions for Hospital

post #1 of 12
Thread Starter 
We've been hoping for a homebirth but that might not be possible for us anymore.

I'm nervous about giving birth at a hospital, what are some questions I should ask when selecting a hospital? Some I've thought of are:
Do you require an IV or just a Heplock?
Does the baby have to be continually monitored?
Can I eat/drink?
Am I free to move around/walk? If yes, at what point do you require me stay in bed?
What vaccines are required? What if I decline?

Thank you for your help. Suggestions are very much appreciated! I want to still keep this "my birth experience" as much as possible.
post #2 of 12
I would ask about their c-section and episiodomy rates. Also, you want to make sure they room in (most hosipitals do now!) meaning that baby stays with you after being born. You should ask about standard newborn procedures to make sure you want them all (eyedrops, vit K shot, PKU testing, etc.)

You might also want to ask about their policies regarding time in labor. For example -- how long before you start augmenting labor? How long a labor do you consider "too long"? How long can I labor after my water breaks? How long can I push for?

Finally, some basic quesitons that you might want to know the answer to: Do I have to birth on the bed? What positions do women in your hospital birth in? How many people can be in the room during delivery? How long do women stay post partum? Do you have a lactation consultant on staff?
post #3 of 12
A lot of those are going to depend on your doctor. If your doctor orders the IV to be caped off the hospital will do it, if you get your doctor to agree to no eye drops they won't do them, etc. Vaccines vary by state so I wouldn't even ask that. The hospital I had DD at told me I could do Hep B there or at my 2 week doctor visit. I showed up to my 6 week doctor visit, said we were declining and that was that.

Ask how many people are allowed to be in the room with you if you have a C-section (dad and doula or just dad?), if you can birth in the bath tub or have to get out when you start pushing, if you'll have one nurse your entire labor or if they'll switch them, and the one I was concerned about, food after delivery! I wanted to make sure I'd get fed something better than a pbj sandwich if the kitchen was closed. I know it sounds stupid, but you work an appetite during labor and it's better to know if you're going to have to bring your own food if you deliver at 3am or if they'll order something for you.
post #4 of 12
I just had my hospital tour, and here are some questions I asked:

If I don't "click" with a nurse who is attending me, can I ask for a different nurse?

Do you allow siblings to visit and see the new baby?

How long do healthy women/babies usually stay after the birth? Can you leave earlier if you want to and everyone is doing well?

Do you have a NICU? If not, where do you transport any babies with unexpected problems that are more than this hospital is equipped to handle?

Do you allow the baby to have 24-hour rooming in with mom?

I thought seeing the reaction to the question was usually almost as telling as the actual answer! For example, the nurse clicking question was an easy "sure!" but the baby transfer if in distress question, I had to really push for an answer... like she didn't want to admit any babies there ever needed to transfer even though they don't have a NICU.

Good luck!
post #5 of 12
Quote:
Do you require an IV or just a Heplock?
Does the baby have to be continually monitored?
Can I eat/drink?
Am I free to move around/walk? If yes, at what point do you require me stay in bed?
I didn't ask any of those questions. I have no idea what hospital policy even was. I just informed my doctor and the nurses when I arrived at the hospital that I wouldn't be doing any of those things if I didn't want to do them. The hospital doesn't have the right to make you do anything. It is your right as a patient to refuse specific medical procedures or even to leave AMA. The hospital is legally obligated to provide you with care if you are in labor but they do not have the authority to dictate the terms of that care.

That said... a hospital birth is less stressful when your primary care physician is on the same page with you concerning standard interventions and is willing to make a notation of that in your chart in case s/he is not the doctor on call when you go into labor.

I wouldn't ask the hospital about "their requirements" for routine newborn vaccinations/medical procedures either. Instead I'd find out the law in your state beforehand. The only actual vaccination my daughter was offered was Hepatitis B which we had no trouble declining.

BTW unless you have a high risk medical condition that may warrant IV medication or you're planning on getting pitocin, an epidural, or otherwise augmenting your labor even a hep-lock isn't necessary. I gave birth in a hospital without an IV or a hep-lock.
post #6 of 12
Thread Starter 
Quote:
Originally Posted by rparker View Post
I didn't ask any of those questions. I have no idea what hospital policy even was. I just informed my doctor and the nurses when I arrived at the hospital that I wouldn't be doing any of those things if I didn't want to do them. The hospital doesn't have the right to make you do anything. It is your right as a patient to refuse specific medical procedures or even to leave AMA. The hospital is legally obligated to provide you with care if you are in labor but they do not have the authority to dictate the terms of that care.

That said... a hospital birth is less stressful when your primary care physician is on the same page with you concerning standard interventions and is willing to make a notation of that in your chart in case s/he is not the doctor on call when you go into labor.

I wouldn't ask the hospital about "their requirements" for routine newborn vaccinations/medical procedures either. Instead I'd find out the law in your state beforehand. The only actual vaccination my daughter was offered was Hepatitis B which we had no trouble declining.

BTW unless you have a high risk medical condition that may warrant IV medication or you're planning on getting pitocin, an epidural, or otherwise augmenting your labor even a hep-lock isn't necessary. I gave birth in a hospital without an IV or a hep-lock.
Thank you for taking the time to reply! However, I want to say I'm aware that I can refuse any medical treatment and even leave if I choose to. But that's doesn't really help me as much as knowing what my options are and being informed of what a typical hospital birth experience is like. Some hospitals are just known for being more easy going, just based on their reactions to my questions I'm sure I'll pretty much know the answer and how they really feel. If I feel their not receptive or for some reason I don't like their responses/attitude, I can move on and check out other options.
I'd also like to have my OB sign off on a birth plan, I know that this doesn't guarantee my preferences will automatically be followed but at least it's something for them to go off of and they have a better idea of what I want and don't want. I have no problem being assertive (or aggressive) if that time comes but I'd like to help avoid it if I can.
Since I'm a FTM, I'm not sure how the whole process really works and what to expect. These questions and suggestions are helping me put together a general idea of some of the things I need to start thinking about and how I feel about certain procedures/policies. I just to be as prepared as possible.
It's so encouraging to hear that you had a good experience with your hospital! I wish I heard more of this! Unfortunetly, I haven't heard a lot of positive stories.
I hope you have a wonderful pregnancy! Best wishes to you and your family!
post #7 of 12
I've had two positive hospital births! One of them with twins! In both cases I had unmedicated, natural labors, and in both cases I spend the next couple of days rooming in with my babies, co-sleeping (more like co-napping ), and exclusively breastfeeding. I've actually LOVED my hospital births. Really and truly loved them.

Some tips:

1. Birth plan (as you mentioned)...make sure your OB agrees to it, that you bring a copy with you to labor to share with your first labor nurse, and that if any conflicts come up you have them call your OB to reaffirm the plan of labor you agreed to.

2. Ask, right away when you arrive, for a labor nurse who is experienced in natural labor and who will not offer meds. Saying it right up-front at the check-in window helps the whole staff know what kind of labor you expect. If you're there early enough to be really with-it, ask early in labor for your room to have the tools you might need for labor...a birthing ball, extra pillows, etc. Ask what they have and what is at your disposal. My only early-labor experience was with my twins, but we used that early, clear-headed time to make sure our labor path was fully set.

3. In your birth plan, have your baby plan written as well. Bonding time, no eye ointment until x-time, no vaxes, exclusively rooming in, exclusively breast-fed...make it short and simple (I bullet-pointed my most important wishes).

4. Ask for a minimum of interruptions...ask for no extra nurses or doctors in the room during labor (students, assistants, etc.), ask for miminum disturbances during the hospital stay, and if you're going to try to sleep for a while, ask for a period with no disturbances (nurses, sanitation workers, whatever) for the next x hours.

5. Be friendly. It's amazing how quickly you can bond with labor nurses and post-partum nurses. Even though they were strangers to me, I still really loved the people who worked with me and dh during our labor/hospital stay. Some labor nurses are pretty incredible women...so empowering, so knowledgeable.

Heck...with my second birth I arrived to the hospital practically in transition, had the baby 40 minutes later, and the labor nurse worked like you wouldn't believe to STILL make the birth follow my birth plan exactly! I needed/wanted a hep-lock for being GBS positive, and while she was getting that in, and trying to get a sense of my contractions, she was using every spare second to read my birth plan and re-adjust everything so the birth would go as I wanted it to. When our son was born, there were no questions asked. He was placed on my chest the entire time I was stitched up, the cord was cut at the end of the stitching process (long after it stopped pulsing), he was weighed quickly and returned to me, and then everyone left the room for over an hour. It was so quiet and so peaceful, that time with him. I think a couple of nurses had to come in and get the labor bassinet out (it wasn't needed for us, but someone else needed it), but they were quiet and went in and out quickly. An hour-plus later, the nurse came back in to do the eye ointment and check vitals. Bliss.

The hospital I deliver at isn't some beacon of natural birth, either. It's not even a hospital that gets a lot of attention or praise for being woman- or baby-centered. I don't think my experience is that far from what many women could expect giving birth at an average large hospital, as long as you have a supportive OB and find supportive staff.
post #8 of 12
Quote:
Originally Posted by RedOakMomma View Post

The hospital I deliver at isn't some beacon of natural birth, either. It's not even a hospital that gets a lot of attention or praise for being woman- or baby-centered. I don't think my experience is that far from what many women could expect giving birth at an average large hospital, as long as you have a supportive OB and find supportive staff.
ITA, I had a great hospital VBA2C. I second your entire list, especially number 5.
post #9 of 12
I'm shooting for a natural mom/baby-centered hospital birth with a midwife, so I appreciate reading these "positive hospital birth" stories. Keep 'em coming!

post #10 of 12
I interviewed several hospitals for DS's birth and some here for our upcoming pregnancy. Generally, things like episiotomy and csection rates is more dependent on the particular provider. They can be high overall, but sometimes one of their obs has really low rates. So stuff like that I would rather discuss with my potential obgyn/cnm (and make sure you know the rates of the backup-doc/cnm as well). All hospitals required that the birth plan be signed by my cnm or obgyn. But it never got to the point since I delivered at 37 weeks and the nurse I got was very supportive of natural birth and respected most of it. That hospital birthing center was particularly pro-natural though.

You should really ask if they provide labor and birth tubs, most don't. So ask.

Basically, your obgyn can overrule hospital procedure. And even if they don't approve, you can still say no. I was ok with a saline lock just in case I might hemorrhage, which I sort of did but didn't need more than Pitocin. I was ok with intermittent monitoring. All baby procedures (well, that we didn't want ANY) were respected. Nobody batted an eye, ever. But I made sure they read the birth plan and that DH would have a watchful eye.

I'd bring a doula though! I will next time if I end up in the hospital again.

Oh and as far as newborn procedures: they do not depend on your doctor. They solely depend on your wishes, unless you live in New York where they mandate vitamin K shots and eye goop, all other states don't (in CA I just signed a waiver). No state mandates HepB shots, absolutely none.
post #11 of 12
I was also going to ask if you had considered having a doula with you. I have just recently found out that I will have to have a hospital birth due to some possible complications with the baby's heart, so I have been scrambling to find a doula last minute. My twins were born in the hospital, and it ended up being a very positive experience--all-natural, just like I wanted. I give a lot of credit for that to my doula, however. As soon as I got into the room they told me I would be having a c-section, but my doula was so wonderful at reasoning with them, letting them know that we knew what was and wasn't really necessary, calming everyone down, and getting all my wishes heard while I was busy laboring. I know that I will definitely feel more comfortable having someone there with me who can stand up for me just in case I need that. Of course, Dh would be willing to stand up for me, but they might be more likely to listen to someone with a little more experience!
This thread has been really helpful to me in coming up with my own birth plan at the last minute, so thanks everyone!
post #12 of 12
Do you know any other women who have birthed recently in your chosen hospital? That may give you a better indication of what the environment is like. Doulas who attend a lot of hospital births are good resources for info as well.

We had a good experience at our hospital. We were very clear about what we wanted and they were very receptive. They have a reputation fir supporting natural birth though.

Good luck, I hope you have a peaceful, safe birth!
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