Are you having a baby?

If yes, then there are some things to consider before choosing your birth place. First of all, is finding the right medical attendant and that is an entirely different article so I am going to focus just on the birth place. Secondly, educate yourself as much as possible on the choices that are available to you. There are so many different ways of caring for a laboring woman and a new baby and education is the key. According to CIMS (Coalition for Improving Maternity Services), there are 10 questions to ask the prospective birth places.

1. "Who can be with me during labor and birth?"

This question is a very important one to ask. Some hospitals restrict the number of people in a labor room and that can mean you need to have this decision made before you go into labor and have to worry about hurting people's feelings. This can be especially important to those couples planning to have a Doula or Labor Assistant present.

2. "What happens during a normal labor and birth in your setting?"

They should offer information regarding their use of medications and interventions. Additionally, you should be able to inquire freely about the birth place's C-Section rate, which is calculated every year. Also, the staff should be helpful in explaining how they feel about the birthing process and if they let labor and birth happen on its own accord.

3. "How do you allow for differences in culture and beliefs?"

Find out if your prospective birth place is sensitive to a mother's culture. They should know that mothers and families have differeing beliefs, value and customs regarding childbirth and hopefully it is respected.

4. "Can I walk and move around during labr? What position do you suggest for birth?"

In a mother-friendly environment, a laboring woman should be allowed to walk around and move as she chooses. A woman should be able to choose the positions that are most comfortable to her during labor and birth.

5. "How do you make sure everything goes smoothly when my nurse, doctor, midwife or agency need to work with each other?"

This would be helpful in a situation where a laboring woman must be moved to a different location. It is helpful to discuss how the birth place will handle this sort of situation.

6. "What things do you normally do to a woman in labor?

This is one of the most important questions to ask. You should be very familiar with the procedures and standard care you will expect to receive at your birth place. Being prepared when you come for birth, can make a difference in a delightful birth and one that is plagued with medical procedures and interventions.

According to CIMS, there is a list of things they recommend you ask about:

• Do they monitor the baby's heart rate at all times with a machine (Electronic Fetal Monitor)? CIMS recommends that it is best to have your nurse or midwife listen to the baby's heart from time to time and avoid continual fetal monitoring.
• Do they break your bag of waters early in labor? CIMS does not recommend this.
• Do they use an IV (a needle to put fluids into your veins)? This is not recommended according to CIMS
• Are you allowed to eat or drink during labor? CIMS states that they should not tell you that you cannot eat or drink during labor.
• Do they shave you or use an enema? These procedures are also not recommended by CIMS

7. "How do you help mothers stay as comfortable as they can be? Besides drugs, how do you help mothers relive the pain of labor?"

Understanding your birth place's philosphy on comfort measures can be incredibly helpful when making a decision. If the staff is not supportive of your choices and they do not help those achieving childbirth without the use of drugs, then it might be worth looking elsewhere. The people who care for you should NOT try to persuade you into choosing pain medication unless you need it to take care of a special medical problem.

8. "What if my baby is born early or has special problems?"

Discuss with your birth place the possibility of complications and how they handle it. Do they promote touching, holding, breastfeeding, and encourage mothers to care for their babies as much as they can?

9. "Do you circumcise babies?"

Mother-friendly birth places, according to CIMS, discourage circumcision unless it is for religious purposes.

10. "How do you help mothers who want to breastfeed?"

The WHO (World Health Organization) made a list of ways birth services support breastfeeding.

• They tell all pregnant mothers why and how to breastfeeding.
• They help you start breastfeeding within one hour after your baby is born.
• They show you how to breastfeed. And they show you how to keep your milk coming in even if you have to away from your baby for work or other reasons.
• Newborns should have only breast milk.
• They encourage you and baby to stay together all day and all night. This is called "rooming-in".
• They encourage you to feed your baby whenever he or she wants to nurse, rather than at certain times.
• They should not give pacifiers to breastfed babies.
• They encourage you to join a group of mothers who breastfeed. They tell you how to contact a group near you.
• They have a written policy on breastfeeding. All the employees know about and use the ideas in the policy.
• They teach employees the skills they need to carry out these steps.

To get a copy of this information, go to www.motherfriendly.org or write to:

CIMS Naitonal Office PO BOX 2346, Ponte Vedra Beach, FL 32004

222-282-CIM or email: info@motherfriendly.org.

REFERENCE: "Having a Baby? Ten Questions to Ask" brochure provided by CIMS.