(Please note that we also cover preparation for Home Birth in class)
The place where you choose to give birth, together with the caregiver of your choice, are the two factors that will most impact on the course of a normal labor and your satisfaction with your birth experience. These may be difficult choices for you and, while you may hear a variety of positive and negative experiences from friends and acquaintances, your choices are personal and reflect who you are and what you want out of your birth experience.
The following list contains suggested questions to ask the hospital on the tour. Before you use this list you should have an understanding of the pros and cons of these choices. While you may hear many of these issues addressed on the tour, if there are questions which still remain unanswered, make sure you ask them. You might wish to do a hospital tour during your childbirth course, as all of the issues listed below are addressed in your course in an objective, non-biased manner to give you a deeper understanding of the issues. Remember that the hospitals want your business. Obstetrics is a major source of income for the hospital and, while they will not tell you things that are not true, the reality is that you may be attended by a hospital midwife who doesn’t share your philosophy of birth and who may deviate from the “sales pitch” you heard on the hospital tour – for good or bad. Decide what your ‘red lines’ are, i.e. what points are most important to you and ask if all the attending midwives will respect your choice on those particular issues.
Remember, too, that all hospitals in Israel are subject to the “Patient’s Rights Law”, a law passed in the Knesset which gives you the right to refuse any treatment. If your labor is normal and you and your baby are healthy, you should ask for more information when an intervention is suggested and decide what choice is best for you.
Following are suggested questions to ask on the hospital tour. You may have additional questions which are not listed here.
LABOR:
- I wish to wear my own clothes.
- I want my husband/partner or the companion of my choice to stay with me while I’m being monitored in the admitting room.
- Will medical students attend to me or observe me in labor?
- I wish to eat and drink during labor.
- Is it your policy to routinely administer a heparin lock?
- I do not wish to be monitored continuously during labor unless a problem arises that necessitates continuous monitoring.
- Will the fetal heart rate be monitored by hand using a fetal stethoscope/wireless/waterproof monitor so that I can move around and possibly shower?
- I wish to have the freedom to choose positions in labor (such as walking, sitting, squatting, kneeling, using a birth ball, etc.).
- What is your policy regarding artificial rupture of membranes?
- What is your policy regarding the use of the artificial hormone, Pitocin, to induce labor or stimulate contractions?
- What is your induction policy if a woman’s membranes rupture and she doesn’t have contractions yet? After how many hours will she be induced?
- I wish to take lengthy showers for pain relief and for relaxation.
- What is your policy regarding birth pools? For labor AND birth? Do you supply a pool or do I need to bring one?
- What percentage of women have epidurals for pain relief in labor? (If most women have epidurals, it may be an indication of the hospital’s attitude toward natural childbirth).
- Do the midwives actively encourage women in labor to use pain-relieving drugs?
- I want my husband/partner or the support person of my choice to be with me all the time.
- I may wish to have an additional support person with me.
- What is the hospital policy regarding a Cesarean birth (without an attempted labor) for a baby over 4 kgs? Over 4.5 kgs?
BIRTH:
- I want to have my husband/partner with me during the birth.
- I may wish to have an additional support person with me during the birth.
- I want my husband/partner be with me for a Cesarean birth.
- I want to choose positions that feel right to me for pushing and for the birth.
- Does the hospital have a policy about time limit for the pushing stage? What if I want to push beyond the usual time limit if the baby and I are both fine and progress is being made?
- Will every effort be made to try to avoid an episiotomy?
- I may wish to touch my baby during the birth.
- I wish to have late cord clamping (after the cord stops pulsating).
- I want my baby to take his/her first breaths unassisted (no immediate suctioning, etc.) if everything is normal.
- I wish to have skin-to-skin contact with my baby immediately after birth.
- Can I breastfeed my baby on the operating table immediately after a Cesarean birth?
- I want my baby to remain on me instead of being moved to the warming table.
- Does the hospital routinely give an artificial hormone injection of Pitocin after the birth to expel the placenta?
POSTNATAL:
- How can I have my baby be with me at all times (including nights), i.e. zero separation?
- Is there breastfeeding help available if I need it?
- I may choose that my baby not be given eye drops or other routine interventions.
- Are husbands/partners restricted to hospital visiting hours? If so, what are those hours?
- Can I be discharged early from the hospital if I wish?