Maybe you’ve been taking the hospital childbirth education class and as part of the last session they take you on a tour of the labor and delivery floor and the postpartum unit. Or maybe you took an outside class but still want to see where you will be giving birth.
It’s time for the Hospital Tour!
One of the best ways to assure that you get the birth you want is to make sure that you choose a supportive provider and birth setting. Note: The majority of births occur in hospitals, and even if you are choosing home birth or a birth center, it can still be a good idea to check out the hospital in case of a transfer.
Something to keep in mind is that a hospital is an institution and a business, and while they are there to provide care, they are also there to make money. Hospitals are beginning to see that you can choose to go somewhere else for your birth and in fact people are more than willing to travel an hour, passing multiple hospitals on the way, to feel supported and get the birth they want.
I’ve been on multiple hospital tours as a doula – I like to see what my clients will experience and it’s a good way for me to visit a hospital I haven’t been to yet. Some of the tours I’ve been on started very abruptly with the nurse not even introducing herself. They don’t seem very interested in questions, but rather want to quickly go through the details of “what’s going to happen to you once you get here.” Sometimes they start by giving you a packet of information about how to register, where to park and enter the building, what the visiting hours are, and other logistical specifics. It may also contain information about their childbirth education classes, breastfeeding support groups, as well as advertising on other aspects of the hospital.
I’ve been on tours where I was the only one asking questions and I’m wondering if it’s because people do not know what to ask or they feel like they aren’t free to do so.
Here are a few questions you can ask on the tour and some things to watch out for as red flags that might mean there’s a chance you won’t get the support you are looking for in order to craft the birth experience you want.
Note: when you are interviewing your provider it’s best to use more open ended questions to get to the heart of their practice philosophy. You can read more about that here. A hospital operates mostly on policy so asking specific questions will give you an idea of whether you will be supported if you want your birth experience to contain things that go against that policy. Plus you are usually talking to nurses who do not have power to change policy, but often are required to make sure those policies are being followed.
“Who should I give my birth plan to when I arrive and what do you do with it?”
See what the response is to having a birth plan. Are they open to it – “We love birth plans. We’ll put it in your chart and make a copy for the nurses’ station” – or do they seem dismissive – “Most births don’t go according to plan, but I guess you can bring one in.”
“Eating and drinking during labor is very important to me. Will I be able to order food?”
See what the hospital policy is on this and anything else in your birth plan that is important to you. This can be things like delayed cord clamping, monitoring, skin-to-skin, wearing your own clothes, etc. Often they will tell you these things as they are showing you the facility. Make a note of all the things you want to know about and check them off your list when they answer it – then you’ll know what you still need to address.
“What is the average labor time at this hospital?”
This is a good question to ask to see if they have a time table they want you to be on – typically hospitals want you to dilate 1 cm an hour. Ask if they will let you labor at your own pace. This may also be a time to inquire about cesarean rates, epidural use, instrument delivery rates, etc. You can ask about other interventions and how often they are used. Get a feel for the culture and see if they tend toward medical and pharmacologic interventions or if they have non-medical options for you such as tubs, showers, birth balls, birth stools, etc. The nurse may not have this information on hand but should be able to tell you where to find it. Your state may have a Healthcare Report Card you can access too. You can find information about Illinois hospitals here.
“What breastfeeding support do you have?”
Find out how many lactation consultants they have on staff and what their support looks like after you leave the hospital. Ask under what circumstances they give formula and if donated breast milk is available instead. Are they a Baby Friendly Hospital – a WHO designation that promotes breastfeeding as a public health initiative? If you are planning on formula feeding, will they be supportive of your choice?
Watch out for phrases like, “you will not be allowed to…” These are red flags that you might not get the support you need. A lot of times hospitals will defer to “doctor’s orders” which means you may be able to find support from your provider; but keep in mind that your provider may not arrive at the hospital until you’re ready to push. You don’t want to have to “fight” for things along the way.