How does your hospital stack up for maternity care?
(BPT) - As you get closer to your delivery date, many decisions lie ahead, all centered around care, maternity leave and even decorating the baby’s room. But one question may rise to the top: Where will you give birth?
If you are like most expectant mothers, you will be giving birth in a hospital. In spite of the rising popularity of home births, most moms choose hospitals to have their babies. The most recent statistics released by the Centers for Disease Control and Prevention show that fewer than 2 percent of babies born in the U.S. are born in a home setting.
When you’re looking at where to give birth, expectant parents should consider the following while choosing a hospital, according to the Blue Cross Blue Shield Association (BCBSA).
Where does your doctor go? The place to begin is with your doctor. Most women go to the hospital where their physician has admitting privileges. So when you choose your doctor, the hospital where your baby will be born is tied into that. Discuss your birth plan in detail with your physician and make sure you both are at an understanding. If you have specific preferences, ask your doctor if they can be accommodated. For example, if this is not your first child, and you want to try a vaginal birth after cesarean (VBAC), have that discussion in detail with your physician. And while doctors are on call after office hours, it’s always a possibility that your doctor cannot attend your birth. Know who would take the place of your doctor if those circumstances arise.
What’s the rate of C-section? If you're proceeding along in a healthy pregnancy, you may be planning a vaginal delivery. But a cesarean section is something to be aware of because one third of U.S. births are delivered by C-section, according to the Blue Cross Blue Shield, The Health of America Report. It turns out that the city you live in can have a big impact on how you give birth. Some cities see rates as high as 50 percent, however, cities like Albuquerque, New Mexico, have rates as low as 22 percent. It’s important for patients to be aware of this because C-sections raise complications for both babies and mothers, and experts say these should be used only when medically necessary. In addition, vaginal births cost $4,000 less than surgical births.
How does your hospital stack up? The Blue Distinction Centers for Maternity Care program evaluates hospitals on several quality measures, including the percentage of newborns that fall into the category of early elective delivery, an ongoing concern in the medical community. The program is meant to identify facilities that offer maternity care safely and affordably. The maternity programs also must offer family centered care, such as promotion of breastfeeding.
If you’re interested in a list of hospitals that deliver quality maternity care, visit bcbs.com/healthcare-partners/blue-distinction-for-providers/ and select “maternity care.”
Which amenities are available at the hospital? Not all hospitals are alike, so take time to review what it has to offer. Some maternity centers offer birthing tubs and fold-out couches. Knowing whether the hospital has a newborn intensive care unit may be a consideration, depending on the circumstances of your delivery and birth. If the hospital does not have a neonatal intensive care unit, ask your physician how these newborns are evaluated and transferred to other facilities. If you are interested in breastfeeding, ask if lactation consultants are available and how and when you can seek assistance.
The birth of your baby is a monumental event, and the choices you make today could have a long-term impact on the life of your child. One of the many important decisions you will have to make during your pregnancy is where you will give birth to your child. If you have decided that you would like to welcome your baby to the world in a birthing center rather than in a hospital, you are halfway there, and locating the right birthing home for you and your baby is the next step.
There are a few important steps you can take to ensure that you make the right choice in choosing a birthing center. As well as choosing according to what feels right for you, there are some things you will need to know to watch out for, as not all birthing centers are the same. By making an informed decision about where you will deliver your baby, you can have peace of mind during the birthing process.
#Make sure you definitely want to deliver your baby in a birthing center rather than a hospital. These facilities are not for every pregnancy, and there are a few accommodations that they lack compared to a hospital ward. Consider the following questions before committing to a birthing center.
In some places, such as in Australia, there are birthing centers in the hospital grounds, which are known as "hospital affiliated". Should complications arise in this situation, you are within the same grounds and just a few elevator rides or corridors away from medical assistance. Looking for a birthing center attached to hospital facilities may prove to be an excellent method for calming any concerns you have about use of a birthing center. However, do be aware that hospital affiliated birthing centers may have the hospital attitude you may be trying to avoid, such as rupturing your membranes, inductions and vaginal inspections during labor. And if the birth center is crowded when you come in, you may be "bumped" into the hospital ward.
If you don't have the possibility of a hospital affiliated birthing center, is the freestanding birthing center located near a hospital? In the event of complications, a hospital must be close by in order to properly handle any emergencies or risks that arise.
Contact the birthing centers in your area and schedule a time to tour the facility. Take a close look at the facility. Ask questions and take note of how well the facility is run and how prepared they are for complications.
Are they licensed by the state, province or relevant national authority? In order to receive a state license in the United States for example, the birthing center must have licensed nurses and midwives. The requirements will vary from jurisdiction to jurisdiction, so inquire about your local licensing laws.
If you're in the United States, find out whether they are accredited by the Commission for the Accreditation of Birthing Centers. This accreditation is a major telltale sign that it is a properly run facility. In order to receive accreditation by the CABC, they are required to have charts on birth outcomes, proper sanitation, proper pH in the jacuzzi, etc.
Is the facility clean? Is its informational literature ordered neatly? Is the staff caring and kind?
Select a birthing center that makes you comfortable. Assuming you have selected one that has passed the above checklist, then you might want to ask yourself a few additional questions that tap into your own reactions to the birthing center, such as:
Do I like the atmosphere of this birthing center? In many cases, women choose birthing centers because of their home-like settings. There are often whirlpools in which to relax, showers or baths, kitchens where the family can gather, soft lighting, a double bed made up like a home bed, exercise balls to rock on, plenty of space to move around in, etc.
Do I like the staff? It is always important to feel comfortable with the people who will help deliver your baby. It is an extremely important experience for the both of you, and staffing issues should not stand in the way of you and your peace of mind.
If births are happening at the time you are visiting (often highly likely), what does the atmosphere seem like? Do you feel a sense that this could be the right place for you too?
Inquire about how long you will be permitted to stay after the baby is born. The length of time for postpartum care varies according to the birthing center's rules and needs. You do not want to find out that you have to leave after 24 hours if you were expecting to be able to stay for 48 hours. In some birthing centers, you are encouraged to leave within hours of the birth provided you're in a totally healthy condition; in this case, you may want to consider shifting to private hospital or other care if you'd like more rest or to have family and friends (or even hired help) ready to help you at home for the first few days back.
Don't see an early leaving time as a problem. In line with the philosophy of birthing centers to keep everything as natural and seamless as possible, an early return to home is viewed as a key way to get you into the rhythm of caring for your baby innately, rather than feeling as if there is a hospital routine being imposed upon you. Some women love this; others are terrified of the thought of no rest so soon! Plan according to how it works for you but it is wise to have helpers ready to lend a hand for at least your first week back at home.
Find out what their visitation policy is. Some birthing centers have no restrictions and allow unlimited visitors to come and go as often as you would like. Others have specific guidelines for how many visitors can be present at one time and during what hours visitors are welcome. Some may even limit visitors to immediate family members only. It is best to know their policy ahead of time rather than find out when your guests, who traveled hours to see you and your new addition, are turned away at the door.
It is possible that the idea of having visitors gawk at you when incapacitated is not one that interests you in the slightest anyway. Having people shuffle in and out to see how you are in your hospital bed is not the way of birthing center, which is one reason it appeals to women who use them.
Make sure that it's fine for your partner, spouse or birthing partner to be with you throughout the birth. This is an important aspect of birthing center philosophy. Of course, if you don't want anyone else than midwives present, that is also your prerogative.
Find out if you're appropriate for the birthing center. It isn't all your choice––you have to be a low-risk pregnancy and a reputable birthing center will do tests, with a doctor monitoring your progress throughout the pregnancy, to ensure that you are low risk. A reputable center will advise you if you're a pregnancy at risk of complications and will refuse to take you or will ask you to change your plans later on if they have already accepted you but the risks change during the pregnancy. Also, stay in touch with your treating doctor to ensure that you are getting proper monitoring throughout the pregnancy by an independent source.
The arrangements for being allowed to bring your regular doctor or [Choose an Obstetrician|Midwife] into the birthing center during delivery will depend on the birthing center's policies and local rules, so ask in advance what is possible and what is not. Also ask about bringing in your independent midwife, if this is something that you want to do.
The answers to these questions may determine your decision.
Book early. If you do want to use a birthing center, realize that most of them are in high demand and can be booked out during your due dates if you leave it too late. Moreover, reputable birthing centers will expect you to be monitored regularly by their staff and will also ask you to undergo training for having a baby, especially if this is your first baby or there has been a long gap since you last had a baby. If you leave it too late, you might miss out and the choice will be made for you to go to a hospital facility instead.
Be honest about your health history. Birthing centers screen potential patients for prior pregnancy complications or multiple births. If the center determines that your condition may be too risky, remember that it is for the safety of you and your baby.
Attend orientation classes at the birthing center that you select. During these classes they will walk you through what you need to know to prepare you for the procedure. Attending the classes will allow you to ask any questions you might have in advance. In many cases, they will even give classes and demonstrations on postpartum adjustment, early childcare, and breastfeeding. One of the biggest advantages to this is the fact that you can get to know the staff, and learn important facts about your coming newborn and how to care for it. It is important to note that these facilities do not use local or general anesthetic. They will be using natural and alternative means of pain management, as well as utilize light narcotics. What they do have that most hospitals will not, are comfortable, relaxing facilities.
In Australia, hospital affiliated birthing centers are covered by Medicare. Freestanding ones must be paid for by you but check to see whether your private insurance covers it and whether Medicare will refund anything.
The most important thing to watch out for when searching for any birthing center is accreditation. If a birthing center is unaccredited, then the facility did not pass very basic safety requirements that may put you and your newborn at risk. Only use birthing centers that are accredited. Make sure that all midwives and nurses are licensed.
You will hear all sorts of stories. Some of these come from people petrified about birth and who are poorly informed. Don't let hearsay put you off making a birthing center choice for yourself; investigate first hand, ask direct questions and find out about the potential for complications and how these will be treated. A reputable birthing center will tell you if you're not an appropriate candidate for using their facilities.
Acknowledge the worries of family members who might not wish you to use a birthing center. They have your best interests at heart but are probably not well informed and may have read one too many sensationalist stories. Explain to them that you have done the research, that you're happy with the center and that the staff are all highly skilled and easily accessible. Ultimately, remember that it is your decision to make and it is you who needs to be comfortable; avoid getting stressed about other people's preferences.
What you will need:
http://kidshealth.org/parent/system/doctor/birth_centers_hospitals.html – research source
http://www.childbirthconnection.org/article.asp?ck=10358 – research source
http://www.wikihow.com/Choose-a-Birthing-Center -- article source
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