Deciding where to deliver?

Long gone are the days when heading to the hospital to deliver is the norm. There are so many options when deciding where to deliver. Will you choose a hospital, a birthing center, or at home? We did a lot of research on all three options and decided to go with a birthing center because it allows us the best of both worlds. 

 

5 Reasons we chose a birthing center. 
1.  It is located inside a hospital, so any technology or equipment that we need for normal delivery or the possibilty of something going wrong is at the doctors finger tips. Basically, you'll find all the comforts of home, along with the benefits of a leading medical facility.
2. It allows for the feeling of home with all the equipment hidden.  I know I am going to deliver a baby, but I need to be comfortable.  This stuff is painful!
3. The private birthing suites offer a homelike surrounding where moms and babies stay together from the time they arrive to the time they go home.  This was a key factor.  One of the centers we visited had you labor in one room and recover in another.  Once I get there, I don't want to move my things anywhere until I leave.
4. They support Kangaroo Care, which is a method of holding a baby that involves skin-to-skin contact. Kangaroo care is also found to be linked with easier transition to breastfeeding. 
5. They also offer a water-birth tub for mothers who choose this delivery option. I like having this option available, the only turnoff is deciding whether I can deliver with out drugs.  So far it's been two strikes.  The drugs were chosen over the water for my first two girls.  This will definitely be a last minute decision, all though it has always intrigued me.  If you receive an epidural you are required to stay in bed from that point forward.

25 Questions to ask when seaching for a Birthing Center
1. Does the birth center offer classes in childbirth education? Newborn care? Breastfeeding? Postpartum adjustment?
2. Does the birth center refer to community resources for childbirth education, breastfeeding support, and other concerns of mothers?
3. How much do services of the birth center cost? Are there possible extra costs that I should know about?
4. Does the birth center participate in [my insurance plan]? Note: you should check with your insurer to confirm coverage.
5. Does the birth center accept alternate payment arrangements, such as sliding scale or time payments?
6. What percentage of women who transfer have cesarean sections?
7. Will my midwife be able to remain active in my care?  (We didn't have one, but you may want to ask if you do)
8.  Could you give me some examples of emergencies that might arise during labor and birth and how you would handle them?
9.  Under what circumstances would my baby need to be transferred out of my room? Where would it be? How would I arrange to see the facilities and meet the staff?
10. Do you have any policies that limit the number of people who could be with me during labor and birth? (The center we chose not to go with only allowed three people, although those three could rotate) Can the baby's siblings be present? Is there an age restriction?
11. Do you have allow trained labor support (doulas) during labor and birth? Do you encourage use of doula care?
12. Would you monitor my baby with a doppler or fetoscope?  (These are both safe, effective options that may give you greater freedom of movement and reduce chances of having a cesarean birth, compared to using electronic fetal monitoring)
13.  What are you policies/practices in regards to:
        IVs (intravenous lines) in labor? (research supports avoiding lying still and supports mother's choice to move around)
       Eating and drinking during labor? (the hospital we chose only allows clear liquids, that includes popsicles, ice chips, water, ginger ale, jello)
       Birthing positions? (research supports avoiding back lying positions and supports mother's choice to move around)
14.  What is the usual care if labor is progressing slowly? (there should be a list of things before cesearen is decided)
15. What percent of the time do women giving birth here get an episiotomy ( a cut to enlarge the opening of the vagina just before birth)?  (research finds no benefit and various risks to routine use of episiotomy)
16. How do you recommend that I prepare for managing pain during labor and birth?
17.  What drug-free and drug measures are practiced for pain relief at this center?
18.  What happens if I decide to receive an epidural.  (The center we will be using requires everyone but the doctor to exit the room, the procedure takes approximately ten minutes, and then the team is allowed to return to your room. You are also then required to stay in bed and not allowed to move about the room)
19. What newborn care is routinely provided if baby is healthy?
20.  What are the reasons that the baby may need to be seperated from me immediately or shortly after birth?  (If healthy the only reason our facility provided would be for circumsicion, and with girl number three, we won't be needing this, once again)
21. What breastfeeding resources will be available?  (Our location has certified nurses, lactation consultants and also does home visits)
22.  Could my partner stay with me throughout the day and what accomodations will be provided?
23.  How long is the maximum stay after delivery? (With no complications and depending on delivery time, this should be around 24 hours)
24. What follow up care is provided once I leave the center?
25. Is there an option for home visit for breastfeeding support?

(Many questions derived from:

childbirthconnection.org)