How and Why to Choose Your Delivery Hospital Carefully

Perhaps many mommy-to-be manuals are lacking this key piece of information because of several factors that will pre-determine where you will deliver your baby such as location constraints and the hospital privileges of your physician. Because of this women often spend their time researching physician choices and neglect to research the hospitals themselves. But mommy beware - not all hospitals are created equal

I had the severe misfortune of delivering a pre-term child - two months premature - in a hospital without a NICU. Ill-equipped to handle such a case, they did not have all of the necessary staff to care for my daughter's needs or for my own - suddenly no longer pregnant, yet not leaving the hospital with a child in my arms. In the end my daughter thrived and is now a happy, healthy four year old girl, but the lessons that I learned from that experience were invaluable when choosing the OB to deliver my second child.

I spent at least as much time researching the hospital choices with the new practice as I did researching the practice itself. These are the questions I found important to ask when choosing the hospital where you will deliver your child.

1. Does the hospital have a NICU?

A NICU, or Neonatal Intensive Care Unit, is a specialized nursery that exists to care for only sick or premature newborns. There are four levels of neonatal care, and by visiting your hospital's website, you will see their nursery described according to that level. Level I is basic care for healthy newborns. Level II describes the ability to care for infants with moderate and quickly resolved health concerns. Level III provides care for those children born extremely early or is ill that they may require surgical care, and finally, Level IV is the most advanced NICU care, usually found in large, academic hospitals.

2. Does the hospital legislate surgical policies for religious reasons?

Some hospitals will not allow certain procedures to be performed in their facilities due to religious doctrine. For example, some hospitals associated with Catholicism will not allow tubal ligations to be performed.

3. Does the hospital allow VBACs (vaginal birth after Cesarean)?

With the increasingly litigious nature of obstetrics, some hospitals have chosen to not allow certain medical procedures that may have a higher rate of malpractice lawsuits such as VBACs. If this is a type of delivery that you are planning, you should check with your hospital first.

4. Does the hospital have a perinatal facility?

Perinatal wards provide care for women who need to be hospitalized during their pregnancy. For many of these women, their stay in the hospital will not end until after the delivery of their child. For this reason, it may be important to choose a hospital with both a perinatal care facility as well as delivery options that meet your needs.

5. Is there a lactation consultant on staff?

Many hospitals utilize independently contracted lactation consultants that visit the hospital only on certain days of the week. Due to the typically short length of post-partum hospitalization, it is possible in such a hospital to miss the opportunity to meet with a lactation consultant to discuss your breastfeeding concerns.

6. Who is allowed to be with you during labor and delivery?

All hospitals control the amount of people in the room with you during delivery to some extent, but some hospitals are far stricter in this respect than others. If it is important to you to have your new baby's older siblings present for his or her birth, for example, be sure to clarify the hospital's policy beforehand.

7. What policies are in place regarding the room facilities?

While some hospitals allow their mommies to both labor and deliver in the same room, others will ask that you move to a separate facility for the actual delivery of your child. This can be very disruptive both to you and to your labor support team. Also, many hospitals are now offering private postpartum rooms, but they do not all guarantee that a private room will be available. Finally, if it is important to you that your husband and/or newborn be allowed to stay in the room with you overnight, be sure to ask your hospital about that possibility prior to your arrival.

8. What is the hospital's visitation policy?

Some maternity wards do not allow young children to visit their mothers and new siblings. Be sure to check for any age specific restrictions in your hospital's visitation policy.

9. Does the hospital have rules regarding fetal monitoring?

Again, due to the increase in obstetrics lawsuits, some hospitals are now requiring fetal monitoring throughout the duration of labor and delivery, thus inhibiting your movement.

10. How many women share one labor nurse?

Your delivering doctor may not arrive to your labor and delivery suite until shortly before your little one makes his debut in the world. Your nurse will be your one medical constant during this journey, and it will become very important to you very quickly if you find that you are sharing her with many other laboring moms-to-be.

11. Last, but certainly not least - does the hospital employ a round-the-clock anesthesiologist for their maternity center?

When you hit six centimeters and want the epidural ten minutes ago, you'll be happy you asked.