All of the years that I spent leading hospital tours, I took my job to give those tours seriously. I recognized that the tour often was the big tipping point for any family shopping around for birthplace options. There were certain things I knew they would like to see, and a few things that I would cringe at if I had to bring my tour through and they were happening. So, while a hospital might try to wow you or end up underwhelming you with decor and room size, these are the things you want to notice and questions you should ask, but won’t see on any list.
1) Where are the nurses and care providers?
Every hospital has the main nurse station laid out a little differently, but if you see a large number of staff sitting around at the desk, chatting, ask yourself, “Who is taking care of the moms?” If you want to be a little more forthright, you can ask the tour guide (in front of the desk if possible), “Do the labor nurses spend much time in the room while mom is laboring?” And if you don’t see any doctors or midwives there (though it may be hard to tell just at a glance), ask if any care providers are on the floor 24/7 and what kind.
2) Do you see large monitors with full screens of moms being continuously monitored?
If you see what looks like every room being continuously monitored, this means that either a) All patients get continuously monitored (a routine intervention that does not improve outcomes for babies and only raises the chances for other interventions) or b) everyone has gotten an epidural. And, in some cases, in might be indicative of not have enough staff to care for the patients.
3) Do staff smile when they see your tour coming?
It should be obvious, but if you’re not welcomed when you’re trying to decide on care for your birth, you might not get the nicest treatment when you’re having your baby.
4) Are there a lot of babies in the nursery (if they have one)?
The evidence is clear: Babies who are in nurseries are exposed to more germs and moms have a harder time getting breastfeeding established. Oh, and moms don’t end up getting more sleep. I used to tell tours this: While you are in the hospital, take the time to learn how to take care of your baby, and not have someone else do the work. When you get home, you won’t have help at the push of a button. Keep your baby with you and enjoy your baby.
5) If they do waterbirths and you are remotely interested in having one, ask questions
With the recent expansion in number of places that offer waterbirths, it’s important to ask how often moms actually get waterbirths. Ask them for numbers per week. Ask when moms are allowed in the tub. Ask about the restrictions, as they do vary from place to place. And ask what they do if more than one mom is in labor at once and want to use the tub. Some places only have portable tubs, some have plumbed in tubs with back up portable tubs, and some only have one tub of either kind.
6) Do you see birth balls and squat bars?
Birth balls and squat bars are very important tools in Healthy Birth Practice #2 and Healthy Birth Practice #5. If you don’t see any, ask where they are kept. If the tour guide doesn’t know, make sure she finds out. If the nurses don’t know…
Well, you might want to cross that option off your list.
7) Don’t be afraid to ask ALL of your questions!
Listen. This is your chance to kick the tires. I loved questions. It meant the parents were doing a good job of making a very conscientious choice about where to give birth. I was lucky to work for places that were very open about their stats and made sure I had them. And if I didn’t know the answer, I worked hard to find the answer while they were on the tour. So ask your questions, and if the tour guide doesn’t know, ask him or her to find out or ask who you can talk to to find out.
With some planning, positive births can happen in hospitals, at home, or at birth centers. My hope for every birthing mother is that she finds a respectful, caring place with good, quality care providers. A baby is only born once, and no matter what other choices are made during the birth, a caring environment is non-negotiable.
Those are my thoughts. Are there things you would add? Was there something on your tour that either sealed the deal or made you run for the hills? Share in the comments below!