BIRTH PLANNING: QUESTIONS TO ASK HOSPITAL-BASED NURSE-MIDWIVES
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- What is your philosophy about birth? (Ask if they have a “Mother-Friendly” and “Baby-Friendly” Approach)
- Where did you receive your education and training?
- For how many years have you been a nurse? A nurse-midwife?
- How many nurse-midwives are in this practice? Which one of you will deliver my baby?
- Where will prenatal visits occur?
- Does hospital have one room available for labor delivery and recovery? How many? What happens if someone is occupying it? Is it always staffed?
- What’s the nurse/patient ratio? (ACOG guidelines are 1 to 2 in labor and 1 to 1 in pushing).
- What’s the hospital’s c-section rate? ( step 2 of the MFCi encourages transperancy about medical intervention rates; C-section rate should be no higher than 10- 15%).
- Do you allow me to have my family, friends or a Labor Support Professional/Doula? (Step 1 of the MFCI encourages women to have labor companions of the choice including professional midwives, doulas and family and friends)
- If I have a cesarean how many people can be present?
- Can I keep the baby with me after surgery? (Steps 8 & 10 of the MFCI encourages babies and moms to remain together, even after a cesarean section).
- Do you do Vaginal Birth After Cesarean? What is the rate of mothers who deliver vaginally after a previous cesearean? (Step 6 of the MFCI recommends is 60-75% VBAC rate)
- What is your epidural rate? (Step 7 of the MFCI encourages non-pharmacological methods of pain relief such as massage, baths, showers).
- Do you encourage women use non-pharmacological approaches (i.e, water immersion) instead of medications for pain relief? (Step 7 of the MFCI encorurages non-pharmacological methods of pain relief such as use of showers and baths).
- Do you offer waterbirth?
- Can I walk, squat, labor on toilet, push in any position I like? (Step 6 of the MFCI encourages mothers to use any upright position for labor and discourages the lithotomy – flat on back– position for pushing).
- What happens if I go past my due date? (Step 6 of the MFCI and the March of Dimes encourage elimination of non-medically necessary inductions before 39 weeks, and an estimated fetal weight and bishop score before inducing).
- Do you allow walking to speed up slow labors instead of augmenting labor with pitocin? (Step 6 of the MFCI discourages augmentation and induction of labor unless medically necessary).
- Do you have lactation consultants at this hospital? Are there breastfeeding classes/instructors in maternity ward? (The Baby-Friendly Hospital Initiative developed by UNICEF encourages hospitals to provide lactation support for all mothers).
- Do you have rooming in with infant? Can I keep the baby with me for 2 hours after the birth (see the Step 10 of the MFCI which is to implement The Baby-Friendly Hospital Initiative)
- What percentage of mothers who are breastfeeding upon dismissal? (Ideally, 100% of mothers should be breastfeeding upon dismissal)
- Do you have lactation consultants or a breastfeeding center with support groups I can attend after I leave the hospital? (See Step 10 of the MFCI)
- Can baby stay with me at all times? Is it okay to sleep with the baby in same bed? (baby-friendly approach – see step 10 of the MFCI)
- Can my partner spend the night in the room after the birth?
- Can my older children be present at the birth? When can they visit me? (Step 1 of the MFCI encourages families to be present at birth, including siblings).
- The Electronic Fetal Monitor policy: what is minimum amount I must be monitored? In what circumstances is constant monitoring required? Is remote monitoring required or is intermittent acceptable? Do you have telemetry in this facility? If MD or CNM approves, can doppler be used instead of EFM? (Step 6 of the MFCI encourages intermittent monitoring of low-risk mothers during labor).
- How often do you use internal monitor? What circumstances require it?
- Does this hospital do fetal scalp ph sampling to confirm fetal distress before doing a c-section?
- What is your policy on the IV? Can a Heparin Lock be substituted for the IV? What about if I am a VBAC? Can ice chips and/or water or juice be taken? Can I eat in early labor? (Step 6 of the MFCI encourages elimination of routine medical procedures such as IVs, enemas, shaving, etc.)
- Can we take our placenta home? (To bury in our yard and plant a tree for the baby or Encapsulate).
For answers to your childbirth related questions