Choosing a delivery location

choosing a birth location Monday, November 26, 2018

Factors to consider and questions to ask

Whether you intend to deliver your baby at your local hospital or birthing center, or you are considering a home birth, there are many details to weigh before making your decision.

“Arming yourself with knowledge in advance is the best way to secure the right place for you and your baby,” says Stephanie Ros, MD, MSCI. Ros is an assistant professor, obstetrics and gynecology, and she is the maternal fetal medicine residency program director at Morsani College of Medicine.

It’s a good idea to talk to your doctor about selecting a delivery location to make sure they have delivery privileges.

Consider the facility’s resources

If you are experiencing a high-risk pregnancy, it is important to choose a hospital that has all of the resources that baby will need for care after delivery. Sometimes that means a neonatal intensive care unit (NICU)—a place for babies born with complications and require critical care—sometimes that means a pediatric surgeon, or a pediatric cardiologist,” says Ros. Not all hospitals have these services available.

Be prepared for a possible early delivery

“You may want to look for a hospital with a NICU when there is a risk that your baby will need to be delivered early for unpredictable reasons. In any high-risk pregnancy, it is also important to find a hospital with a maternal-fetal medicine specialist who can coordinate the care of the patient and her fetus,” says Ros.

15 questions to ask when choosing a delivery location

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  1. Is the hospital a reasonable driving distance from your home or place of work?

  2. What are the standard procedures when a woman arrives in labor?

  3. Is there an anesthesiologist on duty in the birthing/obstetrics unit, or is the anesthesiologist on call? This may be important if there is an emergency or if you want pain relief. It will take longer to get relief if the anesthesiologist must drive from home to get you the medicine versus if they’re on duty at the hospital.

  4. Is there 24-hour staffing of labor and delivery by an obstetrician/gynecologist (OB/GYN)?

  5. What is the nurse-to-patient ratio? According to the American College of Obstetricians and Gynecologists (ACOG), 1 nurse per 2 women during early labor, and 1 nurse per woman in the pushing stage of labor, is ideal.

  6. Does the hospital have perinatologists or neonatologists on staff? Some hospitals do not have doctors who specialize in high-risk pregnancies (perinatologists) or pre-term babies (neonatologists).

  7. Does the hospital have a NICU?

  8. What is the hospital’s cesarean rate? Epidural rate? Does it differ when considering the specific condition of you or your baby?

  9. Has the hospital taken care of a patient with your (or your baby’s) condition before? What outcomes have they experienced?

  10. In what situations does the hospital have to transfer either mom or baby or both to another facility?

  11. What types of resources are available for women who need to be hospitalized for long periods before the baby is delivered?

  12. Does the hospital allow "rooming-in"? Rooming-in means the baby can stay with you in your room. Or, does your baby have to stay in the nursery? Can you have your baby stay in your room most of the time, but go to the nursery if you need help?

  13. Does the hospital have a 1-room option (birthing room or suite) in which you can be in labor, deliver your baby, and recover all in the same room?

  14. Will you be given a private room for your stay?

  15. Is there a lactation consultant on staff? Will you automatically be scheduled to meet the lactation consultant?

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