Have you asked your doctor how long they are comfortable with you laboring at home?
The key to this question is understanding if your doctor wants you to come to the hospital as soon as labor starts, or if you will be “allowed” to stay home where you are still able to eat, drink, sleep comfortably, go on long walks, shower and bathe, etc. If this is your first pregnancy or your first vaginal delivery, often labor will be a very long process, so staying home until you are progressing in the 4-1-1 manor is best. I say “allowed” because, you should always remember, the power is in your hands. Yes, you want a doctor aligned with your beliefs of birth, however if a doctor says, I want you to come in right away so we can get you hooked up to monitors, etc. Your follow up question should be why? Then you should be getting a second opinion, and then you can make an informed decision about how long you plan to stay home.
Have you asked your doctor if you will be free to walk around the hospital during your labor?
The answer is often, “Well, I need you to stay on the monitors, so you will have about 3 feet around the bed that you can walk around” Find out why, if you don’t see their answer as being acceptable, find a second opinion. As with anything, don’t settle for “it’s the hospital’s rules,” research and see what options you may have. Walking and working with gravity especially for an unmedicated woman can make a huge difference in the length of labor and the progress of a baby, allowing space in your opening hips to labor down and put pressure on the baby to turn and push lower in to the hips. It also is one of the most comfortable things for many laboring women to do.
Have you asked your doctor how long they are willing to let you go before scheduling an induction?
This answer often shocks my clients. With one expectation that 42 weeks is the standard, often doctors will recommend 41 weeks or less. Find out the reasons, find out if they do say 42 weeks now what may change their mind as things progress.
Have you asked if you are able to get into a comfortable position during pushing, or if the provider has any restrictions for you during pushing?
Standard of practice for coached pushing in a hospital is for a patient to lay flat on their back and pull their own legs up as they push. However, even with an epidural, often pushing on all fours, pushing on your side, or pushing in a squat with a squat bar can work better with your body as well as allow gravity to help with babies positioning.
Have you brought in your birth plan or a bullet point list of birth preferences for your doctor? Ask specifically, “Is there anything you see in my birth preferences that will be an issue for you? Can you explain why?”
This is where a great conversation is started about how realistic your goals are. This will set realistic expectations for your doctor as well as you and your partner. Some important things to include are: Immediate hep lock/IV upon arrival, continuous monitoring, rupturing your membranes (procedure/common practice – ask the why, what, when and how that may change your restrictions), use of the shower or bath, who else you can have in the room during your birth, and anything else that is important to you.
Have you asked if the hospital allows birth tubs? If they have them and if there are restrictions to when you are able to use them?
This is an important one because often (and I do mean often, we have 2 local hospitals as well as 2 hospitals I have worked with out of town) that show a birth tub in their tour and don’t allow it to be used during labor. Many hospitals will even say it’s great for laboring but then you find out it’s broken, unavailable or your doctor won’t allow it when the day comes. So, ask the question, this can help with your expectations and help you truly visualize your birth with all realistic options that are available to you.
More and more hospitals are working hard to change this standard every day, however sometimes plans change or things happen to affect this. Make sure you understand procedures after vaginal deliveries as well as cesarean deliveries so there is no confusion on the day of your delivery.
…And even more importantly, do you support natural birthing options?
Whether you are doing the Bradley Method, Hypnobirthing, hiring a doula, or just interested in a natural vaginal delivery, it’s important to know the doctor or midwife you have decided to be there with you supports these decisions. Knowing they support these methods will also offer a more open conversation about how you want your birth to go. You should never feel like you are scared to ask or mention certain things…if those red flags are there, you should already be considering a new provider. Asking your provider for doula referrals also allows for a great birth team if it’s someone they already enjoy working with.
If I only plan to allow cervical checks from you or the doctor or midwife on call, will that be an issue at the hospital? Some hospitals have a standard check in the hospital by the nurses in triage. Sometimes, it’s nice to know what your options are. If the doctor tells you they won’t be at the hospital to check you right away, ask if you can go to their office instead.
Your options change once your water breaks, ask thorough questions regarding this. Secondary questions would be: If I am GBS positive do my options change? If my water breaks and I’m not having any contractions what do you recommend?
So, you have asked all the questions…now what? Are you left with even more questions? Take notes and ask them during your next visit or call your provider. You should never be left feeling incomplete about your birth. If you have a bad gut feeling about anyone in the practice, vocalize it. When I was pregnant with my twins, I asked one of the doctors in the practice I was going to what his plan was if either baby stayed breech or turned breech after 36 weeks. Much to my panic and dismay, he said he would not do a vaginal delivery. I explained that I had heard if baby B was breech, vaginal deliveries were still safe. He said, it was not something he was willing to risk. During my next visit I saw the owner of the practice, whom I chose the practice for, he said himself and one other doctor in the practice would do a delivery if Baby B was breech (which did end up happening). He actually was kind enough to give me his cell phone number to guarantee I did not end up with an unnecessary cesarean. Asking questions can change everything. Don’t be afraid to ask the tough ones!