6 Things to Consider When Selecting a Hospital for Delivery
So, you got you're first positive pregnancy test. Your heart is either screaming for joy or you're wondering how this happened. No shame in the second one, trust me, I have been there THREE times. Yes three, but that's another story.
Now what? You may already have your perfect birth plan envisioned... where you will deliver, with whom and how. If you're like I was when I was in my early 20's, I had absolutely no plan. I simply went to the OB that my mom told me she used. I didn't know anything about her, or the hospital that she delivered at for that matter. I had each of my kids with 3 different OBs and at 3 different hospitals.
Either way, if you have decided on a specific doctor or midwife to deliver your baby, you have ultimately decided on the hospital that you will be delivering at.
Here are some things to consider:
1. Will I give birth and then get to stay in the same room?
There are some hospitals that have a labor/delivery and postpartum suite all rolled into one. Most hospitals in the Houston area have a labor and delivery area that you move out of a couple hours after baby is born to a smaller postpartum room. This is where you will stay until you are discharged.
2. How many laboring women is each nurse in charge of?
In Houston, each hospital works a little different in regards to nurse to patient ratios. There are some hospitals like The Woman's Hospital of Texas, Texas Children's Pavilion for Women, Children's Memorial Hermann Hospital, etc. that assign one patient for each nurse to care for. That means that the hospital staffs enough nurses to allow each nurse to care for one single patient at a time. Other hospitals will assign multiple patients to each nurse. Usually though, once a laboring mom gets closer to delivery, her nurse will focus more on her and ask another nurse to help cover her patient that may be in the early stages.
3. What are the hospital’s policies in regards to skin to skin after baby is born?
Things have definitely changed since I was having babies 10+ years ago. Many local hospitals are now doing a great job of keeping baby with mom as much as possible. There are so many benefits to being mom and baby centered. Most hospitals will encourage immediately placing baby onto mom's chest as soon as it's born. (as long as baby is doing okay) Plus, they like to keep them there for at least an hour to allow immediate bonding and to help regulate baby's temperature. One good thing to ask is whether they will do baby's vitals while staying with mom. Some hospitals will encourage skin to skin, but then want to move baby to the warmer to do vitals. Other hospitals will assess baby while on mom's chest. These are all good questions to consider when touring your hospital.
4. How many support people will be allowed to be with you in the room while laboring and through delivery?
This is something that many moms do not consider and become disappointed when they go through their hospital tour. Some hospitals don't have any limits as to how many people can be in the room. Other hospitals, like Memorial Hermann Memorial City, don't have regulations while mom is laboring, but will send people out when it is time for delivery. Then, there's hospitals, like The Woman's Hospital of Texas, that only allow two other people in the room at all times besides the spouse. Even going as far as releasing a set amount of badges for each delivery room to keep track of how many people go back into the labor and delivery ward.
If you have a long list of supporters or friends and family that you would just like to be there to watch, you may want to check your hospital's policy. If you have your spouse, doula and/or birth photographer, those numbers add up quick. This may cause disappointment among grandparents that expected to be there OR it could give you an excuse to get space while you labor. :)
5. What are the policies in regards to photography and/or videography?
When I first starting doing birth photography, there were many hospitals that allowed photography, but nothing during the actual delivery. There are still some hospitals that shy away from it like Willowbrook Methodist Hospital, but most of them allow it as long as the doctor allows it. However, there are still some hospitals that will not allow videography during the actual delivery. If you have your heart set on being able to document your baby coming into the world, whether by hiring a professional birth photographer, or by having a friend/family member do it, you may want to double check the hospital policy.
More and more hospitals, doctors and nurses are becoming aware of the notion of there being a birth photographer present. Where this used to make hospitals nervous, I have found that they have become to trust our professionalism and know that we will not push boundaries. I have walked into hospitals where the nurse is weary and I was able to explain that I know that if at any time the nurse or doctor wants me to stop shooting, that my camera will be put down. This not only puts them at ease, but opens them up to allowing me to shoot more than what they originally would have.
6. What are the hospital's policies in regards to intermittent monitoring, mobile fetal monitoring and IVs?
Did you know that just because you are in a hospital that you do not have to have constant monitoring of baby or that you do not have do be immediately hooked up to an IV? What??
Although they would love to have constant monitoring of contraction patterns and baby's heart rate, some hospitals allow for intermittent monitoring. This means that you do not have to be hooked up to the monitors at all times and will just be required to be on the monitor at given intervals and durations.
Another option is for mobile monitoring. The Woman's Hospital of Texas is one hospital that has mobile monitors that work like stickers placed on mom's belly. It not only allows mom to be mobile at all times, but allows for fetal heart tracking and contraction patterns. The downside to this is that they don't always work as expected and do have a short range of distance (in case you plan to walk the halls). If you plan for his option, know that it may not work as planned which will require you to go back to the "old school" method.
Also, just because you are delivering in a hospital does not mean that you have to immediately be hooked up to an IV. If you are not having an augmented labor or other things going on that require fluids, you can request for just a hep block to be placed. This allows you to be more mobile, while still giving the hospital quick access to an IV line in the event of an emergency.
Aside from these 6 questions, here are some other things to consider when choosing your hospital:
Can baby stay with me 24/7?
Will the baby's siblings be able to attend the birth?
Can my spouse/partner stay with me in the room? What sleeping accommodations are there for them?
Are lactation consultants available?
What is the visitation policy after baby is born?
Will I be allowed to take my placenta?
Will I be able to labor in the shower/tub?
Ultimately there is no wrong answer and each hospital offers different experiences. If delivering in a hospital is your choice, my mission is to help you understand that you have options. You have choices. Ask questions. The worst thing they will tell you is no.