Where to give birth? Questions for your hospital visit

One of the first decisions that you’ll make on the road to parenthood is where you would like to have your baby. If you’ve decided to opt for a hospital birth, the decision doesn’t end there. What kind of birth are you hoping for? Minimal intervention with a natural or water birth? An epidural as soon as possible? Or perhaps a c-section with general anasthetic?! For some of us our choices are restricted by our individual medical circumstances, and for even the most meticulous birth planner it’s very important to keep an open mind as hiccups along the way can affect the type of birth that you’re hoping for. However what you can do is to explore all of the options that are available to you; to visit the hospitals that are closest to your home, ask friends about their experiences and above all ask questions to the hospital staff themselves.

Feel like you don’t know where to start? We don’t blame you, but don’t panic just yet, as there is help at hand… Which? Birth Choice is a free website, supported by the Royal College of Midwives, to give expectant mothers all the information they need to know in one place so they can plan the birth they want. It brings together all the facts about local maternity services and provides women withresults based on their preferences.

Which? Birth Choice shows expectant mums the most suitable options available in their local area, based on their age, if they are a first-time mum, and any health risks. They are able to compare services in detail based on information provided by the Heads of Midwifery, including information on the different pain relief available, whether there is access to a birthing pool, facilities for partners to stay overnight, and the cost of private rooms.

The maternity unit pages on Which? Birth Choice give lots of information about facilities and care at local maternity units, and once you’ve taken a look at the best options for you, you can also find out more by visiting the unit itself.

Here are some questions that Which? suggests you might want to investigate about a maternity unit before you plan to give birth there.

Questions about how the care is organised

What type of maternity unit is this? For example, is it a labour ward (obstetric unit), and does it have an alongside birth centre? Or is it a freestanding birth centre?
Do I have to live in a particular catchment area to be able to have my baby in this maternity unit?
How is the midwifery care structured?
Will I be looked after by community midwives or by hospital midwives? Does it make a difference whether I live in the hospital catchment area or not?
Where will my antenatal care take place? Can I choose where?
Will I be able to get to know the midwives who will care for me during the birth? Does this depend on where I live?
Will these be the same midwives who will visit me at home after the baby is born?
Is midwife-led care available?
Can I do birth preparation classes at this hospital? When would I need to book? Are these classes taught by midwives or NCT teachers? Are they provided free of charge?

Questions to ask if you are preparing to have a natural birth

What equipment is available to use during labour, e.g. birth ball, bean bags, cushions, floor mats?
Will I be encouraged to move about and to get into any position I wish during my labour? Will I be required to lie down for monitoring or internal examinations?
Would it be all right for me to rearrange the delivery room so that the bed is not in the middle, to give me more room to move about?
Are all midwives trained so that I can give birth in an upright position, or will I be encouraged to lie or sit on the bed?

Questions about pain relief

Does the unit have a dedicated anaesthetist and are epidurals available 24 hours a day?
Which pain relief drug does this unit use: pethidine, diamorphine or meptid?

Questions about birth pools

How many birth pools are there in the unit?
What is the likelihood of being able to use a pool when I am in labour?
Are all midwives in the unit trained to attend to women labouring or giving birth in water?
If not, how many midwives on any one shift will have the skill and confidence to attend to a woman using a pool?
How many women have used the pool for pain relief in the last two years?
How many babies have been born in water in this unit?
May I bring a hired pool into the unit?

Questions if you have had a previous caesarean

Will I automatically be offered another Caesarean, or does this unit encourage women to give birth vaginally (known as VBAC, vaginal birth after Caesarean, and pronounced Vee-Back)?
If I choose to have a VBAC, will my labour be managed in any way? For example, there may be a policy of continuous monitoring for women who have had previous Caesarean births, because of the slight risk of the previous Caesarean scar opening.
If I am continuously monitored, how much will that affect my mobility? Will I be required to labour lying down?
What proportion of women trying for a VBAC succeed in having one?

Questions if you have special requirements

Is information available for women with hearing/sight problems or limited mobility, for those who are autistic, and for those who don’t speak English?
Does the hospital provide an interpreting service for women who would prefer to speak their own language?
Is there easy wheelchair access to the delivery suite and the wards?
Does the hospital provide equipment to help disabled women in labour?
Are female doctors always available?

Questions about breastfeeding

Does this maternity unit have a Baby Friendly award?
Does this maternity unit employ a breastfeeding specialist or counsellor to help me breastfeed my baby, either while I am in hospital or after I have gone home?

Questions about postnatal care

Assuming there are no problems, how long will I stay in the unit after my baby is born?
Will I be moved to a ward? If so, how many women will be in the ward?
Are private (amenity) rooms available? How much do they cost?
What are the visiting hours for my partner?
Can my partner stay overnight with me after the baby is born?

It’s worth bearing in mind that the answers to some of these questions will be on the Which? Birth Choice website, but a visit to the unit itself is likely to make you feel reassured that you’re making the right decision for you, your partner and your baby.