Birthing Center Tour: what to ask?

On Saturday my husband and I will be touring a potential birthing center. A couple of weeks later I have an appointment with a potential OB/GYN. I can’t shake the feeling that I am starting on this search way late but it couldn’t be helped, with the move and all.

I feel even more unprepared because I am not sure what all to ask the staff there. What questions did you ask your hospital/birth center? What things did you look for in your OB/GYN?

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20 thoughts on “Birthing Center Tour: what to ask?

  1. I asked questions mostly as things arose on our birthing center tour. They mentioned, for example, that during the worst periods for viruses (winter… which is when my last baby was due) they had a special section of the center for mothers who had to give birth whilst ill. I asked to see it. We asked questions about everything from admissions policies, where we would be sent if all beds were full, what I should do if I was assigned a midwife who didn’t speak good English (we live in Sweden), etc. I am sure there are lists available online with good questions to ask (particularly if you have some kind of birthing plan- we used Hypnobabies in preparation for birthing, and they suggest certain things you can ask for/about specific to that method of birthing)… and also that you can do as we did as well and ask things as they spring to mind. All the best to you! 🙂

  2. My kids were both born at a hospital, not a birth center, but I very much wanted a vaginal delivery and limited pain meds so I asked about the availability of a tub for labor, alternative laboring options, etc. Ultimately my first was born by emergency C-section because he was in fetal distress and as much as you don’t want that to happen, it is a possibility. I would also want to know how it works if you do end up needing an emergency C-section? How fast can that happen if there’s a problem? What if the baby’s in fetal distress? What if if you change your mind and want an epidural? How close is the nearest NICU if it was needed? Sorry to be a downer, but I’m a lawyer — I deal in worst-case scenarios all the time.

    I’d also ask how soon they’ll send you home. Insurance will pay for 2 days for a vaginal birth and 3 for a C-section but some independent birthing centers send moms and babies home in as little as 6-7 hours after birth. That may sound attractive, but I was so overwhelmed after having my first (and in pain from the C-section) that I was so happy for the help amd imsight from the nurses (we had fantastic nurses) and gladly accepted when they fenagled an extra day out of my insurance! pay close attention to the nurses– they will make or break your stay. We had a fantastic experience because we had wonderful nurses but I have a ffriend who was discharged a day early AMA because she had a bad experience with the nurses at her hospital. And of course– do they take your insurance! 🙂

  3. Also, how do they handle newborn vaccinations and testing (certain tests are required by state law)? And if you’re going to be there more than a few hours, baby will probably need to be examined at the center so you’ll have to make sure your pediatrician has privileges there. Or ask for a recommendation of some pediatricians who do have privileges. If you plan to circumcise, they usually won’t do it until baby is 24 hours old, so find out how that works.

    If it is an independent center, I’d ask what they do if baby’s bilirubin is low (ie jaundice). That’s really common.

  4. In an OB/GYN, I’d be wary of anyone who wants to schedule an induction too close to your due date. If they want to do it less than a week after your due date, I’d be suspicious. Also if they even suggest scheduling a C-section on your first baby–totally unnecessary for a normal pregnancy. And if they’re skeptical of a non-medicated birth, I wouldn’t be excited about them. Personally I also liked that my OB/GYN was part of a group. There is absolutely no guarantee your doctor will be on call when you go in to labor but because my doc had 6 partners I was guaranteed someone from the practice would be on call and I met all of them before my son was born,

  5. I also changed providers (from an ob/gyn to a midwife) kind of late in my pregnancy. When I was looking for a new provider, I was interested in finding a someone who was part of a practice (my midwife is in practice with three other midwives and 4 ob/gyns) so that someone familiar with me would be at my delivery. I also looked for someone who was supportive of my desire to have an unmedicated birth (we’re using the hypnobabies program) and wouldn’t push interventions. I know you just moved, but if possible I would ask for recommendations from people in the area.

    As for birth centers, for me that was totally dictated by my practitioner. The practice I go to only has privileges at one hospital (sadly, not a birth center). Luckily, and probably not coincidentally, that one hospital has a great reputation for maternal care. I wish I could help on the birth center questions, but I really can’t since I didn’t choose that for myself. Things I did ask on the tour were things like how many support people the hospital allowed in labor and delivery, what options they had for natural pain relief, and policies related to patient controlled environment (like dark-ish room, music, etc.). When it comes to procedures (like fetal monitoring, cord clamping, etc.), those are controlled by my midwife, so I wasn’t worried about hearing the hospital’s take on them.

    Hope this helps! Good luck!

    • Thank you! San Francisco is the birthplace of Yelp and that’s where I found the OB/GYN I am going to try out. She works out of the birthing enter I am looking at tomorrow. She comes with glowing reviews, the birthing center is still new so there’s not much out there about it. Hoping to get some more insight tomorrow during the tour.

      Thanks a lot for your suggestions and information. Adding them to my growing list of questions/concerns list I have.

  6. I’m not sure if you’re asking this, but one thing I hadn’t realized when I went looking for an OB/midwife & hospital/birthing center is that when you pick your doctor you’re essentially picking where you want to give birth, or vice versa. The setting of the birth is very important to me so I began looking at hospital birthing philosophies and free-standing birthing centers first. I discovered that there were no birthing centers within an hour’s drive, and that I did not feel comfortable with a home birth because of my age (I’m 35 & first baby). So I began looking at hospitals within an hour’s drive and narrowed them down to 2 based on their website (both had a satellite office very near my home and both would be covered by my insurance). I didn’t have time to visit them beforehand.

    I went to my first pre-natal appt at one of the satellite offices who claimed to have a midwife on staff and realized almost immediately that I would not be coming back. I did not feel comfortable at all. First, the midwife had left the practice and they had not replaced her yet. Secondly, they kept talking about how wonderful their NICU was even though I didn’t ask about it. And generally talked about birth in medical terms (big focus on safety issues!- which I don’t like 🙂 ) rather than as a natural process. Third, they did not obtain my insurance info before I arrived and made me wait at least one hour in a little office while they contacted the insurance companies (throughout my interactions with the practice, the staff kept assuming for some reason that I was on medicaid?). Then they did a glucose test (the one that takes an hour) without having told me they planned to do that. Finally, when I met with the Nurse Practitioner on duty she was not at all friendly or personable, and we did all my medical history in the exam room. At that point I knew I wasn’t coming back but wanted to have an exam because it has been several weeks since my last visit with my infertility doc who had confirmed the pregnancy.

    I went to my second pre-natal appointment at the office of an OB associated with the 2nd hospital (which also has a NICU). My options were limited because only three docs of their group come to the satellite office, and even then it is only once every other week. I picked my doctor based on her bio on the hospital’s website. I see both her and her NP (who has been with her for 25 years). The whole experience was much more professional and personable. They had obtained my insurance info before arrival. I first met with the NP in her office (not the exam room) to discuss the pregnancy and my medical history. Then she did an exam. I really, really like her; she gave me lots of info without being pushy. One bad thing was that I didn’t get to meet my doctor until after my 20 week ultrasound because of scheduling issues. I like her too, but like Katie said above, she might not even be the one to deliver. I haven’t met any of the other docs in the practice and don’t plan to. But they do recommend that I do a birthing plan, so I feel comfortable that my wishes will be honored. One thing I was worried about was that I had tested positive for Group B strep early on (at the first, bad place) and so my doc recommended that I do antibiotics during labor. And although I am not a “safety first” type of person, I agree with her based on the risks on not doing it. Because I do not want pain meds (and no IV) I asked if they could do a hep-loc (?) to administer the antibiotics so that I could move around freely and my doctor said it wouldn’t be a problem. I feel that this practice is a good match for me because my overall wish was that I have as natural a birth as possible, but in a hospital setting (or close to one) in case something goes wrong (I’m anxious because of my age).

    In the end, I did not have nearly as many options as I wanted because of where I live. The availability of services (such as a midwife my insurance would cover) were few and far between. I hope you have better luck! But would advise you to think about what you want the experience to be like overall and see which practice best matches your own philosophy. I had never really been to doctors before trying to conceive and the way the system works was a big wake up call for me. Also, similar to you, I was in a new place & had no social network to help me think about the pros & cons of their experiences. Every “choice” seemed much more complicated & constrained than I could have imagined. Good luck!

    • It looks like we want the same kind of births. Thank you so much for sharing your experience. Coincidentally the OB/GYN I found (and liked from her online profile) delivers at the birthing center I’m looking at. Hoping they will be a great fit for me. I’m feeling very prepared to interview them with all the assistance from everyone commenting.

      Thanks again. I greatly appreciate it!

  7. Sorry if this is a double post!

    Trying to think of things that haven’t already been said! If you are interested in a drug-free birth, definitely ask if they have tubs and what are the rules governing use – do you have to be a certain # of centimeters dialated, can you give birth in the tub if you want, do you need to take a class first (you have to take a class to use the tubs here!).

    Find out if there is a nursery available or if the hospital does the rooming-in thing? What kind of security measures do they take to make sure your baby is not mixed up? Are there times when your baby will be taken away from you visually?

    The pediatrician question is a great one. You might not want your child treated by someone not in-network.

    They should tell you this on the tour, but take note of the after-hours L&D entrance if there is one. You might be unable to access the main entrance if you come in the middle of the night.

    That’s all I can think of now that hasn’t already been mentioned!

  8. The point about security is a great one. That’s something that the nurse on my hospital birthing center tour mentioned without being asked just because it’s such an important thing.

    This is a little off-subject, but if you’re really serious about having a natural birth, I HIGHLY recommend getting a doula. I used one with my second because I really, really wanted to VBAC and I so wish I’d had her there with my first. Ask you doctor or birth center for recommendations. You want the doula who’s really familiar with your doctor and the birth center and knows all the nurses by name.

  9. I would ask them to take you through what will happen. Say “So I start getting contractions, then what?” and have them explain their process and you ask questions as they come up. Also, check out the hospitals. You’d be surprised how many are set up to go intervention-free. I second the thought about having a doula there for you. We worked with a doula for each of our births and both were great experiences. Also, ask if your OB/midwife is always on call, or how they split the time. Our practice split weekends with another practice, which wasn’t ideal, but it ended up being fine. One more thing…go with your gut. Someone might look great on paper, and give you the ‘right’ answers and not be the right fit. Make sure you are comfortable with your choice. Good luck! Can’t wait to see how it goes!

  10. Hi Melizza! I had to drop my OBGYN and go 100% birthing center (midwife). I just never felt he was as committed to letting me birth naturally as I’d like. Try to watch “The Business of Being Born”, as it’ll give you LOTS of ideas on what to ask and look for. We’re living in an age of rampant excuses for C- sections, especially us with some extra weight. I can only imagine the wondeful array of choices you have in SF! Best wishes and keep us posted.

    • There are great choices in SF. The OB/GYN I am going to meet with does do natural births but I definitely want to know about her preference when it comes to letting things happen naturally vs. speeding things up. I really don’t want to be induced.

      Today we visited the birthing center and I really really liked it. Just need to make sure they are definitely in-network. Because if they are, it’s definitely the place I was to give birth.

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