There are so many moms that pick their birth location because of convenience.  This hospital is closest to us.    Or it is where their primary care physician is a member of.  When I suggest a different hospital, they feel it is inconvenient.

It is hard for me to really express how different hospitals can be with their birthing “rules”  There are 4 hospitals near me.  I would only suggest 1 of them.  2 are ok and 1 I would never go to.

Here is a blog by a L&D nurse who was caring for another L&D nurse from a neighboring hospital and you can really see the difference between the hospitals and their “rules”

A good point was brought up by Karen in her post looking at her hospital birth and following the rules.   She realized that they don’t know HOW to support an un-medicated mom.  This is why it is so important to choose your birth location wisely.  If you are planning an un-medicated birth in a hospital a doula may be your best investment.

Edited to add another post from a nurse supporting this topic.

ASK your hospital questions about their routines.  Go on the hospital tour, or call the L&D floor.  Be wary if your OB says that is up to the hospital and the hospital says that is up to your OB.  If they don’t know that would throw up some red flags for me.

I always suggest to moms to ask their local doulas for hospital and care provider recommendations.  They see what happens and have a good idea of where the best hospitals to birth at are.

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7 Comments

  1. I have had three in-hospital natural births, and have seen quite a bit of variation. I am currently 14 weeks pregnant and still haven’t settled on a provider or birth setting for this birth (have moved since the last one…) I went on a tour of the nearest hospital this past week, and got a lot of good information–I asked a lot of questions. The best thing that came out of it was an interview with an OB. I had asked the nurse leadng the tour if they had any providers who would do a squatting delivery, and she gave me a name. She pointed out that she cannot recommend one physician over another, but she was willing to answer questions about who might support a specific practice. Fabulous information, and in this case well worth going on the tour early in pregnancy–usually it is recommended in the third trimester, but I don’t want to put off major decisions until then! Other questions I was able to get answered included are children allowed (yes, outside of flu season and if provider is OK with it); do they have squatting bars (yes); are babies taken away for observation after birth (no, only for PKU screening later on, but a parent is welcome to come along); policies on food/drink during labor–clear liquids are OK, they have juice, popsicles, jello, or you can bring your own; the nurse suggested eating before you come in if you feel like it; oh, and yes they could scare up a sandwich and salad for me if I delivered at 2:00 AM and was ravenous afterwards (I always am….). I also asked about transfers out if baby needs NICU attention (this is a small hospital without a NICU). One question did not get a satisfactory anwer–I asked about the possibility of bringing a birthing tub for labor/delivery (there are no tubs at the hospital). The nurse was not aware of any policy against it, but when I interviewed the above-mentioned OB she said one of her patients had tried to arrange to bring a rented tub and the hospital had vetoed it, OB was fine with the idea. I have several months ahead, so I might be able to work with the hospital on that if I decide it is important…Oddly, I was the only one on the tour who asked many questions–or any questions.
    I agree with the idea of asking local doulas about hospitals, they can also be good sources of OB recommendations (that was how I found my last OB). And remember for your actual labor and delivery, the nurses can be your best advocates; do take a birth plan, keep it straightforward and non-antagonistic. I’ve had the triage nurse look at my birth plan, step out of the room and come back to announce they had the perfect L&D nurse for me–one who was very supportive of natural birth; it made for a great hospital birth experience.

    enjoybirth Reply:

    Great example of how much you can learn on a tour… IF you ask questions!

  2. I wish I’d known this before my second birth. I thought going over things with my OB was good enough. Although he was not exactly supportive of most things I wanted, he did tell me that rooming-in with my baby after the birth was fine. After the birth I learned that the hospital requires advance notice for rooming-in, and the OB hadn’t “warned” them. (Apparently they feel that moms who room-in require more work from the nursing staff, so they have to make sure there are “enough” nurses on duty to handle it.) The OB didn’t tell me that, and it wasn’t part of the registration process. I didn’t have any idea until a hospital admin was threatening to call security to take my (perfectly healthy) baby from my by force and bring him to the nursery — because the nurses were “too busy” to let me keep him.

    So, yes, I totally agree with you. Ask the hospital about EVERYTHING!

  3. And that is exactly why I chose a CNM and a new hospital at 37-weeks pregnant. It was scary going somewhere new so late and my husband was not thrilled but in the end we were very happy with our decision.

  4. I gave birth to my son in a hospital that had an in-hospital birthing center one floor down. It was the only hospital that I could find on short notice that had an OB-Gyn that accepted my insurance (Medicaid) and that would take me as a patient after my former hospital turned out to have lied to me about policies on separating newborns and infants after birth.

    I was the first woman for my labor nurse that had chosen to have a natural birth, in her 20 years at the hospital. No wonder. Their policies were not very conducive to going natural. Fortunately I didn’t get there until I was 7cm dilated and in no mood to cooperate with things that didn’t seem essential to my son’s safety. Monitoring, fine. Laying down for it? No. Figure out a way to strap the monitor to my belly while I’m standing. Thankyouverymuch.

    I ended up birthing in that classic “on your back, legs up” position. But I think that if I’m put in that position again, of having the hospital and care provider chosen for me through the limitations of insurance, I’ll simply inform them “look. I’m sorry. I’m doing it my way. If you want to call hospital security, feel free. But chances are pretty damned good that by the time they get here you’ll have caught my baby no matter what position I’m in. And by the way, the media would LOVE to hear about the hospital and doctor that called security because the mom wanted to give birth on her hands and knees.

    I think I’ve become cranky in my old age. Or rather, I’ve become furious at all the moms that are forced/coerced into doing things just because care providers choose to learn such a limited range of techniques that they’re not able to monitor a woman who is dancing at the bedside, and they’re not able to catch a baby if the mom is squatting.

    I tell every pregnant woman to call her hospital ahead of time and ask to speak to the patient’s advocate. Find out your rights. Find out what official hospital policy is, and what your right is to disagree with certain aspects of it during labor and delivery. Often “policy” is something that the nurse or doctor invented themselves just because it’s how they prefer to do things.

  5. (Oh, by the way- I switched hospitals at 38w pregnant. And oddly enough, I switched from midwife care to ob-gyn care.

    The hospital policy wasn’t the only issue I had with my original care providers. The midwife clinic I had been going to seemed to be operating in a perpetual state of terror of having their licenses pulled. They insisted that I do a three hour glucose test after I got “borderline” numbers on my one hour glucose test, and after that test made me severely sick for a week and my son far less responsive for two days.

    I ended up monitoring my blood sugar levels as I would have if I had been diagnosed with gestational diabetes. Doing this, i found that I had issues with corn sugar. (dextrose) but was fine with all other types of sugar, particularly when combined with proteins or complex carbs. Not surprisingly, the “glucose” drink that they used to test me was that Trutol orange drink which is sweetened with.. dextrose. :p

    The point being.. Sometimes we don’t have the luxury of “choosing” the hospital, or the care provider. It’s a miserable situation to be stuck in.

    Honestly, I’d choose a home birth with a midwife any day. Unfortunately state medicaid doesn’t cover any home birth midwives. And if you pay $5000 out of pocket to a midwife, you risk losing your medicaid benefits since it’s against policy to allow you to pay for any of your care. Not that you can afford $5000 out of pocket when you’re on Medicaid anyway.

  6. Thank you for your advice. I could not agree with you more. Finding a good hospital can mean the difference between a memorable and precious birthing process or a nightmare. Sometimes, in rare cases it can even make the difference between having a successful delivery and or experiencing dangerous complications. It is really worth the time and effort to check out a few different hospitals as well as getting recommendations from friends and possibly a Douala.

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