by Dr. Nicole Calloway Rankins
I’ve delivered babies at 6 different hospitals during my career. One thing I’ve learned is that the hospital where you deliver has a big influence on your experience giving birth (another factor is your doctor; you can read about that here). Your doctor actually isn’t there for most of your labor. Thus the culture of the hospital plays a significant role in your labor and delivery experience. You want to be certain you’re in a place that supports you and your vision for your birth. So read on to find out how to choose the hospital where you give birth.
Check With Your Insurance
You may be surprised to hear that your insurance might only cover deliveries at certain hospitals in your area. I’ve seen it happen many times that a woman doesn’t realize this until she’s well into her pregnancy. So check with your insurance early on to see what hospitals are covered.
Check With Your Doctor
Besides checking with your insurance, check with your doctor. You want to make sure she practices at a hospital that’s covered by your insurance plan. You also want to be sure she practices at the hospital where you prefer to give birth.
Do you Want An Unmedicated (a.k.a. “Natural”) Birth?
If you want an unmedicated birth, definitely do your homework. You should be in a place that’s comfortable supporting women who have unmedicated births. Ask your doctor and also call the hospital labor and delivery department and speak with a charge nurse or manager and ask:
It’s possible that the answers won’t be supportive of unmedicated birth (say for example 99% of women receive epidurals). In that case, consider looking for another hospital that’s more supportive, even if it’s a little further from your home. If you can’t go to another hospital, then be prepared to have your own strong support system for your unmedicated birth. That may include reading books on natural childbirth, taking classes geared towards natural childbirth, bringing your own equipment, and/or hiring a doula.
What About An Epidural?
If you plan to get an epidural, ask about the availability of the anesthesia provider. In many hospitals an anesthesiologist is not on site 24/7. That means if it’s the middle of the night, you’ll have to wait for someone to come in to place the epidural. Also, the anesthesiologist may have other responsibilities, such as caring for trauma patients. Sick patients who need care will always take precedence over an epidural placement, so you may have to wait.
The availability of the anesthesia provider isn’t necessarily a reason to cross a hospital off your list. You just want to have a realistic idea of what to expect.
Thinking About VBAC?
VBAC - Vaginal Birth After Cesarean - is not supported at all hospitals. If VBAC is something you’re considering, ask about this early in your pregnancy. Check with the hospital and your doctor, as not only are there hospitals that don’t support VBAC, some doctors don’t either. Unfortunately, you may have to travel some distance to find a hospital that supports VBAC.
Do You Want To Get Your Tubes Tied?
Most Catholic hospitals only permit sterilization in rare circumstances. So if you’re planning on getting your tubes tied, be sure you’re going to a hospital where the procedure is allowed. If your only option is a Catholic hospital, you may be able to petition for an exemption. In that case talk to your doctor.
Does The Hospital Support Rooming In? Does The Hospital Have A Nursery?
Your baby should be with you during your hospital stay. The majority of all exams and procedures that your baby needs can be done right in your room, including any exams by the pediatrician.
On the flip side, you may want to know if the hospital has a nursery. Many hospitals are eliminating newborn nurseries. Birth can be tiring, and it’s nice to have the option to send your baby to the nursery so you can get some rest.
Neither one of these is necessarily a deal breaker. If the hospital doesn’t routinely do rooming in, then be prepared to advocate for that during your hospitalization. And if there’s no nursery option available, have family or friends lined up to help watch your baby in the hospital if needed.
Is It A Teaching Hospital?
A teaching hospital is one where there are medical students and resident physicians. Medical students are in school getting their medical degree (MD or DO). Resident physicians are doctors in training who are learning to be ob/gyns.
It can be unsettling to have learners in your birth. But it can also be very rewarding. To help you understand how medical students and residents may be involved in your birth, I’ve created a free download of questions you can ask. Sign up below to receive it.
Once you’ve settled on a hospital, take a tour. That way you know what the facilities look like, and exactly where to go when it’s time.
I wish you a healthy and happy pregnancy and birth!