Consider the hospital tour. Most parents take their tour with a hospital's admission class or towards the end of their pregnancy, as a formality. I took mine before I was ever pregnant. And here's why.
In my own childbirth ed class there was a couple. They arrived at our second-to-last class looking very upset. They explained that they had been on their hospital tour the previous week. There they had learned that mom would have an IV placed as soon as she was admitted, would be on continuous Electronic Fetal Monitoring, would not be allowed to eat or drink, and would be confined to a bed the whole time. In our class we had learned many techniques for dealing with labor pain, and almost all of them required being up and moving around. The couple checked with their doctor, who had previously agreed to their preferences for a non-medicated birth, lots of moving around, and as few interventions as possible. "Oh, right, but yeah, we have to follow the hospital's rules," he said when they confronted him about all the restrictions.
This mom was 38 weeks pregnant, so it was pretty much too late to switch care providers. Now, I don't know if their doctor actually DID tell them they wouldn't be able to have an intervention-free birth at their hospital and they just didn't hear it, or if he actively misled them. I went home that night and was so upset for them. "Why did they wait so long to go on their tour?!?!" I cried at my husband. "Um ..." he answered, in his best I'm-trying-to-say-this-in-the-nicest-way-possible voice, "because you're the only one who goes on hospital tours for fun."
If this couple had gone on their tour even a few weeks earlier, they would have had more options: they could have tried to switch to another care provider with privileges at a different hospital; they could have spent time negotiating with their current care provider or another doctor at that hospital for more flexible rules; they could have met with the nurse manager or head nurse at the hospital to discuss the hospital policies (and see if there actually WAS a hospital policy about laboring in bed); or they could have taken time to adjust their expectations for a non-medicated birth and prepared themselves for laboring in bed. And if this couple had gone on their tour MONTHS earlier, they would have definitely had timed to switch care providers and plan their birth at a hospital where their wishes would be respected.
So go on your tour. Now. Even if you're not pregnant yet. Ask lots of questions, and really listen to their answers. Listen to the kind of information they volunteer, vs the information that you have to request (e.g. if they are super excited to talk about all the TV channels they get in the rooms but are confused when you ask about pushing positions, then they are probably used to moms spending a lot of "alone time" chilling in bed). If anything sounds like it conflicts with what your doctor has told you or has agreed to, ask for clarification -- it may be "policy" to give an IV to every patient, except when a doctor has specified other arrangements in writing. Then negotiate where you can -- you may need to make a special appointment with a nurse or a member of the hospital staff to sit down and go through things in detail. Finally, if you really get a bad feeling from the tour, look into changing hospitals -- but be prepared that changing hospitals will mostly likely mean changing care providers as well.
Don't know what to ask? I've put together a (very) long list of questions for your hospital tour (and for your care provider -- make sure their answers match!).
Hospital / Birth Center Tour Questions
Name of Hospital / Birth Center:
Address:
Main Phone Number:
Maternity Dept Extension:
Date of Tour:
Tour Guide’s Name:
Arriving
at the Hospital in Labor
Can I pre-register or take home the paperwork I will need
now, so admitting will be easier/faster?
Is there a Triage process before admission (observation
on Fetal Monitor)?
How many people can be with me during Triage?
Do I need to be in Active Labor to be admitted? Is there
a minimum I have to be dilated?
Labor
and Delivery
Are there separate labor/delivery/recovery rooms, or just
one room throughout stay?
If separate, when does mom move from one room to
another?
How many Labor rooms are there? ___ Delivery Rooms? ___
Postpartum Rooms? ____
Are they private? Shared?
How many people can I have with me during labor? During
pushing?
How many people can I have with me during a Cesarean
birth? Can my doula stay in the OR with us?
Can I wear my own clothes? Or is a hospital gown
required?
If my partner/support person/doula is with me during
labor/birth, does he/she have to wear anything special?
What is your Nurse-to-Patient ratio during Labor?
During Delivery?
During Postpartum?
What will the nurse do to help me during labor?
Can I eat and drink while in labor? Before/after
epidural?
Is an IV required for everyone?
If IV is required, can a Hep-Lock be placed
instead?
What kind of fetal monitoring is allowed/required?
Continuous/Intermittent? Electronic Fetal Monitoring (EFM) or hand-held Doppler
monitor?
Can I move around freely during labor? Walk in the halls?
Or will I be confined to bed?
What things does the hospital have than can help with
labor pain? Shower? Tub? Birth Ball?
Is there any reason these things would not be
available to me when I arrive? (Restrictions? Complications? How many
balls/showers/tubs are there for everyone?)
Will I be able to push in any position that feels good?
Or will I be confined to bed?
What things does the hospital have than can help with
pushing? Swat bar? Birthing stool?
Is there any reason these things would not be
available to me when I arrive? (Restrictions? Complications? How many
balls/showers/tubs are there for everyone?)
Newborn
Care:
What immediate newborn
procedures are required (Vitamin K, Eye Ointment, weighing)?
Can these be delayed, and for how long?
When/where are these done?
What other newborn tests or procedures are required
before discharge (hearing tests, PKU test, regular weighing, bathing).
When/where are they done?
Do babies usually room-in or stay in the nursery?
Is there a NICU (Neonatal Intensive-Care Unit)?
What level (I, II, or III)?
If not, where is the nearest hospital with a NICU?
Is there a Lactation Consultant on staff? How are the
nurses trained in breastfeeding?
What is your breastfeeding rate? At discharge? At 6
weeks? At 6 months?
Postpartum
How long is the average stay after an uncomplicated
vaginal birth?
After a C-section?
Can partners/Dads stay over?
When can other children visit/stay over?
Other visitors?
Other
Statistics/Information
Are most deliveries performed by OBs? Midwives?
What groups (OB offices, midwifery practices, etc.) have
delivery privileges here?
What is your Cesarean rate?
Epidural rate?
Induction rate?
Augmentation/Pitocin (speed up labor) rate?
For a printable version, click HERE.
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