Nine questions to ask your healthcare provider

Doula, lactation educator, hypnotherapist and author Giuditta Tornetta shares this checklist about things you should know before childbirth.

1. Who can be with us during labor and birth? Mother-friendly birth centers, hospitals and home birth services will let you decide who you want to have present at the birth. They will also let you have with you a person who has special training in helping women cope with the contractions and the birthing process. This person can be a doula or a labor support person. She never leaves the birthing mother alone. She encourages her, comforts her, and help both of you and your partner understand what is happening both medically and emotionally.

2. What happens during a “normal” labor and birth in your setting? If they are natural birth-friendly, they will tell you how they handle every part of the birthing process. For instance, ask about their philosophy on speeding up the birthing process? Do they let labor progress on its own or do they feel they need to intervene if it doesn’t follow a set schedule. Do they induce labor at 40, 41 or 42 weeks?

Many studies have been done on this subject and there are many conclusions. Yet, if everything is “normal” and there are no major complications in the pregnancy (due to the fact that it is very difficult to estimate exactly when the conception took place, waiting 41 weeks before even considering induction is the norm. Now is the time you want to establish the type of organization and doctor that you are choosing for your care. Also ask for the percentage of cesarean done at their facility and the percentage of episiotomies.

If their percentages are more then 15 percent, be aware that they might be a medical-intervention friendly hospital. It is up to you to decide what you really want in your doctor. Also, many doctors and hospitals lie about their percentages. When I say lie, I guess it is more correct to say they don’t really know, they have not calculated their percentages. Best is to ask around about that particular doctor or institution reputation. Ask your local doula about the institution. Chances are she knows the real policies there.

3. Will you be able to walk and move around during labor? In mother-friendly settings, walking around and moving around labor not only is permitted but encouraged. Moving around and walking promotes an easer and more expedient labor. Mother-friendly places will not put a woman flat on her back with her legs up in stirrups for the birth.

4. Can they help you find childbirth classes, breastfeeding classes and/or any agency in our community who can help you before and after the baby is born? Mother-friendly places will have a specific plan for your pre- and post-natal care.

5. What is the routine procedure once a laboring woman enters your facility? Make sure that this organization will be open to accepting what have been proven to be the best methods for a natural labor and delivery. If the mother is healthy, the baby is healthy and there are no special medical reasons, here is a list of things you should be able to request:

  • A. “Can we have the baby’s heart beat monitored from time to time and not constantly with a machine called the electronic fetal monitor?” To keep the monitor on all the time has not proven to be of any help, and it will prevent laboring moms from managing their contraction with position changes and walking around.
  • B. “We do not want the bags of water broken early in labor.”
  • C. “We do not want to use an IV.” This also limits movement.
  • D. “I would like to eat and drink during labor.” Labor is like running a marathon — you wouldn’t do it on ice chips alone. Hospitals usually only give you ice chips because, once again, they prepare the mother for a cesarean.
  • E. “Unless it is a cesarean birth, I don’t want to be shaved or given an enema.”

6. How do you help mothers stay comfortable during labor, aside from offering drugs? People who care for you should know how to help you cope with labor with alternative comfort measures such as position changes, a warm bath, massage and soft lights and music. Mother-friendly institutions will not try to convince you that drugs are the only alternative to labor management. All drugs affect the baby.

7. As much as we do not want to focus on what can go wrong, it is important to be prepared. What if the baby is born early or has special problems? Mother-friendly places will encourage you and your family members to touch, hold and breastfeed and care for the baby as much as it is possible. They will encourage this even if the baby is born early, or has a medical problem. The baby will know your voice, smell and touch. He or she will need you especially if he is going through the trauma of an incubator. So, unless there are specific medical reasons to do otherwise, you should be able to talk to, hold and feed your baby.

8. Does this institution circumcise babies as a routine procedure? Medical research does not show a need to circumcise baby boys. If, however you are going to circumcise your boy, make sure you know who will do it and when it will be done.

9. How does this organization help mothers who want to breastfeed? First, you want to find out what their philosophy and knowledge about breastfeeding is. The World Health Organization has made a list of ways birth services support breastfeeding :

  • They tell all pregnant mothers why and how to breastfeed
  • They help the mother start breastfeeding within one hour of the birth.
  • They show how to breastfeed and they instruct the couple how to keep the milk coming in even if the woman has to be away from the baby for work or other reasons.
  • Newborns should have only breast milk, unless there are specific medical reasons to use formula.
  • They encourage the mother and baby to stay together all day and night. This is called rooming-in.
  • They encourage you to feed the baby on-demand, which means every and any time the baby wants to nurse, rather then at pre- appointed times.
  • They should not give pacifiers to breastfeeding babies.
  • They encourage you to join a breastfeeding support group, and they provide you with telephone numbers of breastfeeding organizations such as the La Leche League.
  • They have a written policy on breastfeeding. All employees know about and use the directives of the policy.
  • They teach employees the skills to carry out these steps.


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