Birth Center vs. Homebirth: Things to Consider

One of the most beautiful things about birth is the fact that each experience is uniquely its own. You can never predict with complete certainty how a new baby is going to enter the world (even planned c-sections come with the occasional surprise), but one thing you can control (to some degree) is where and how you decide to deliver your baby. Hospital, birthing center, homebirth…there are quite a few options available and each has their benefits.

Homebirth vs Birth Center

birth center birth

If you’ve come to the conclusion that a hospital birth isn’t what you’re looking for, but you’re still unsure if a birthing center or a home birth would be the right fit for you and are looking for more information, then you’ve come to the right place. Having delivered two of my three babies at birthing centers and one at home, I’ve had the opportunity to see what each has to offer and am going to share some things you may wish to take into consideration.

Choosing a Birth Center over Hospital Birth

My first and third babies were delivered at a freestanding birthing center and I loved so many things about the experience. As a first time mama-to-be, I had planned to go the traditional hospital route, but after 18 weeks spent in care there, realized that it wasn’t the right fit for me. The environment was sterile, the doctors and midwives I met with were impersonal, and everything about it felt so clinical. That said, I also didn’t feel prepared to take on a homebirth as a first-timer and to be honest it felt a little too “woo woo” for me at that point, so I decided that the birthing center was the route I wanted to take.

Pros of Giving Birth at a Birth Center

Right away I was very pleased with my decision. The environment was far more homey than the hospital, but still had plenty of medical supplies on hand. There was oxygen available, pitocin to stop bleeding, and even nitrous oxide as a potential pain management option. The midwives were warm and friendly and I got to know them well, instead of being shuffled from person-to-person as I was during my time at the hospital. Everything about the process was sorted out for me and I didn’t have to plan for much at all and during my delivery and postpartum stay I received so much help and pampering.

The birth center was located very close to a hospital so I felt much more confident about a potential transfer in an emergency. There were midwives available for around-the-clock care during my two night stay, so I could ask questions about breastfeeding and get extra help as I was healing. I was also able to order delicious food and though it may not be the case everywhere (or many places), I also got to enjoy a postpartum massage. To be honest, it felt as relaxing as giving birth could possibly feel and was the perfect set-up for me as a first-time mama who was still trying to figure everything out.

Cons of Birth Center Birth

The downsides of the birth center experience were that as comfortable as it was, it still wasn’t my own home. I also really hated having to actually drive to the birth center – sitting in the car during contractions was terribly uncomfortable. The other downside was that although birth centers offer far more privacy than hospitals, there were still other women coming and going for pre and postnatal appointments and women laboring in nearby rooms so it wasn’t exactly 100% comfort level.

Choosing a Homebirth the Second Time Around

homebirth pictures

After my wonderful and empowering birth center experience, I decided to opt for a home birth for my second baby and there were also many of things I loved about that experience. The first thing I loved about the experience was the fact that all of my midwife appointments took place AT MY HOUSE! This isn’t the case with every practicing midwife, but it was for mine. Having a toddler at home, it was so nice on those days when I felt super exhausted to not have to load up a little one for a midwife appointment. I literally wore my pajamas for many of my midwife appointments.

Pros of Homebirth

I also loved being in the comfort of my own home and having everything I needed. I didn’t have to pack anything, which was wonderful, because all of my clothes, snacks and baby supplies were right at my fingertips. I was able to watch my favorite shows during early labor and walk around in whatever state I wanted, knowing I wouldn’t have to hear anyone else in labor and no one else would hear me. Also, the inflatable birthing tub was amazingly comfortable! At the birth center, I had a water birth in a jacuzzi style tub and while I loved giving birth in water, the tub was hard and uncomfortable. The inflatable tub I used at home was infinitely more comfortable for kneeling in, and while we’re talking about comfort, it was so much nicer sleeping in my own bed. I also really liked being able to have friends and family visit us at home right away.

Cons of Giving Birth at Home

The downsides of home birth were that there was more planning involved regarding supplies to buy and there were less medical supplies at our disposal. I also didn’t have the luxury of around-the-clock care as I did at the birthing center. While my midwifery team did stay for a few hours after the delivery to monitor and to help clean up, I was on my own pretty quickly. This was fine for me since it wasn’t my first rodeo, but could’ve been a bit overwhelming if I had no idea what to expect.

Heading Back to the Birth Center

For my last birth, having both a birth center and home birth under my belt, I opted to go back to the birth center. My home birth experience was a bit difficult for me to process since my son ended up being absolutely gigantic (10 pounds 8 ounces and 23 inches long) and it was an exhausting and difficult experience. Because of that, I needed a change of scenery—to go back to a place where I had experienced birth in a wonderfully empowering way—and for me that was the birth center where I had my first child. As a mom with two kids already at home, it also didn’t hurt to think about not having to cook or clean for anyone for an extra day or two.

In the end, I’ve realized that every birthing option has its pros and cons, but what is most important is to choose the environment where you feel most safe, supported and comfortable. Hospital, birth center or at home; each has their benefits and drawbacks. The very best advice I can give is to do your research and then follow your heart.

This post was written by Lauren Hartmann who shared her birth stories here and here. You can find her on her blog, The Little Things We Do. Photos in this post are by Coeur De La Photography.

Birthing Methods and Philosophies

Different Birthing Methods and Philosophies Plus Finding the One that’s Right for You

You’re pregnant. Congratulations!

Once you’ve moved past the first stage of pregnancy, in which you are so preoccupied with your body’s absolutely wonderful and amazing ability to build and sustain another human, you hit the next stage: contemplating the dizzying prospect of this human baby coming out of your body. For many of us, this thought of actually giving birth is a bit terrifying. Fortunately, education is a way of dispelling fear. And thus, the childbirth education class was born. (See what I did there?!?)

Selecting a Childbirth Class

Actually selecting a class proves to be another daunting prospect. There are so many possibilities to choose from! As a doula, I’ve helped many clients try to figure out which class to take. Here’s a handy little graphic I put together, which will hopefully help you sort through your options:

childbirth education options

In any class you sign up for, you will learn some of the same basic information: what are the stages of labor, what is a contraction, common interventions, when to call your care provider, etc. The differences are in the basic philosophy of the class.

Hospital-taught or Independent Classes?

Your first choice is between taking a class offered by a your hospital or care provider, or choosing an independent childbirth education class. Hospital/care provider classes tend to be focused on helping you be a good patient of that hospital or practice, which can be great if you feel very confident that your hospital or care provider has your best interests in mind. For example, women who plan to deliver at a particular birth center may find that the class they offer in-house helps them to know what to expect in that environment and with those caregivers. Another advantage of this type of class is that the cost tends to be much more affordable than an independent class, since the cost of the class is often heavily subsidized by the hospital or practice.

However, many birthing couples choose to pay a higher price to take an independent class, since the instructors of these classes can freely discuss options in birth without pressure from their employers. For example, a group of OBs or hospital administrators may not want mothers to deliver their babies in any position other than flat on their backs, and so they would not allow an educator in their employ to include information on upright pushing positions. If you want to be sure that you are educated on all of the options available to you, you may want to look into taking an independent class.

But once you choose to go outside the system, so to speak, that’s when things get really confusing. There are so.many.choices. How to decide which class is right for you?

doula taught group class

Which Birth Philosophy or Class is Right for You?

Independent classes can be subdivided into two groups: classes adhering to a specific philosophy of birth and employing methods that correlate to that philosophy, and classes that are more of a mash-up of methods.

In the specific philosophy camp are: Hypnobirthing®, Hypnobabies®, The Bradley Method®, Birthing From Within, Birth Boot Camp®, and many others, though the ones I’ve listed seem to be the most popular options going. Again, all of these will include some information on common interventions in birth, but they all share the goal of helping mothers avoid intervention in general, and pain medication in particular. An exception to this may be Birthing From Within, as it emphasizes acceptance of what comes, more than focusing on a specific (unmedicated) outcome as best.

Let’s go through them one by one, with a brief overview of each philosophy:

Online Childbirth Classes

If you have a busy schedule or simply prefer the idea of sitting in your own home while you learn, you may want to consider an online childbirth class. In my many years of teaching childbirth classes and serving as a doula, I found that many moms were looking for a childbirth course that wasn’t tailored only to unmedicated births so I partnered with Bryn here at The Birth Hour to create an evidence-based course called Know Your Options that addresses all types of childbirth—unmedicated, epidural, cesareans, and more. This course takes you all the way through postpartum, breastfeeding, and even going back to work after baby. You can find this course here.

Hypnobirthing and Hypnobabies

Hypnobirthing® and Hypnobabies® share a lot in common. They both use guided relaxation scripts and self-hypnosis techniques as a means of coping in labor. Hypnobirthing® has been around longer, and there are more instructors out there teaching in-person classes. Hypnobabies® is newer, so it may be more difficult to find an instructor in your area. Hypnobabies® does offer a home-study course, while Hypnobirthing® does not, though it is possible to buy a book on Hypnobirthing® to read on your own.

The Bradley Method

The Bradley Method® has the subtitle “of Husband-Coached Natural Childbirth,” which gives you a good idea of what this method emphasizes. Bradley Method classes focus on keeping mothers low risk, and on the partner taking a very active role in helping her stay relaxed, and thus able to cope with the intensity of labor and achieve a low intervention, unmedicated birth. Important to note: Bradley classes are required to be 12 weeks long, so if you are interested in this philosophy, sign up early.

Birthing from Within

Birthing From Within takes a different view of the role of partners—rather than helping them to become birth coaches, they view partners as “birth guardians or loving partners.” The role of the instructor in Birthing From Within classes is that of mentor, guiding the parents in their own self-discovery. Above all, Birthing From Within sees birth as a rite of passage, which, regardless of birth outcome, can be an occasion to practice awareness. I once had a birth client asking me for help in choosing a class tell me, “You should know that creating birth art is more terrifying to my husband and me than the prospect of the birth itself.” I steered her very firmly away from Birthing From Within.

evidence based childbirth class

Birth Boot Camp

Birth Boot Camp® uses a unique frame for their classes. They use a militaristic theme throughout their materials, and their tagline is “Training Couples in Natural Birth.” The military theme is clever packaging for some really serious preparation for giving birth naturally and for breastfeeding. This course is 10 weeks long, so be sure to sign up early if this philosophy speaks to you. They also have an online version of the course, for those who don’t have an instructor in their area.

Again, these are the main options for classes promoting a specific philosophy in birth, though there are others out there (probably someone wrote a new one while I was typing this). The other class options are those that use a mixture of methods and philosophies. These vary widely, because the instructor of the class often writes her own curriculum, or at least she adapts a model to suit her own experience and preferences. The class may include a guided relaxation script and/or an exercise in releasing fears, or it may not—it all depends on the instructor. Often these classes will not focus so determinedly on achieving a low intervention birth, but will guide the parents in evaluating the risks/benefits of each intervention and encourage the parents to advocate for themselves in making the choices that are right for them. There are loads of training and certification programs out there—Lamaze*, ICEA, Childbirth International, CAPPA, and many others.

Knowing your Options and Feeling Empowered

I hope this post has helped you to cut the confusion and choose a class that will suit your preferences and help you prepare to meet your baby, whether it is through self-hypnosis or boot camp, the hospital class or mindfulness practice. Good luck! You can do it.

*A note on Lamaze, since a lot of people think it is something it isn’t (or at least isn’t anymore): Lamaze has been around for a long time, and used to be known primarily for their breathing and relaxation techniques. But over the past 50 years, Lamaze has adapted its curriculum, dropped the emphasis on learning specific breathing techniques, and now focuses on helping parents have a safe and healthy birth through knowledge of their “Six Healthy Birth Practices.” Lamaze instructors can be found teaching both in hospitals and independently.

This guest post was written by Stephanie Spitzer-Hanks. Stephanie gave birth to her first child in the Netherlands, where the nurturing and encouragement she received from so many women there inspired her to become a doula. Now she strives to give unconditional support and evidence-based education to families so that they can be confident in making the choices that are right for them. She is an ICEA certified childbirth educator, an Evidence Based Birth® Instructor, a DONA certified birth and postpartum doula, a StillBirthday certified bereavement doula, and a certified lactation counselor through Healthy Children’s Center for Breastfeeding. On the side of all of that, Stephanie is an ordained minister in the United Church of Christ, and she serves as a chaplain at a hospital and writes and speaks about birtheology when she gets the chance. You can find out what she is up to at www.revdoula.com.

Sources
https://us.hypnobirthing.com/
https://www.hypnobabies.com/
http://birthbootcamp.com/
http://www.birthingfromwithin.com/
http://www.bradleybirth.com/
http://www.lamaze.org/

Should I Hire A Birth Photographer and How to Choose One

I know I’m biased. As a birth photographer based in Denver, Colorado, I’ve photographed over 150 birth stories. But as a mother, I’ve only given birth twice. On both occasions, we invited birth photographers into our birth space to capture what was undeniably two of the most important and meaningful days in our lives.

Your Birth Can Be A Haze

The day you give birth is the day you fall in love. It’s the day you see the little baby you’ve been thinking of and dreaming of for months, sometimes years. It’s the day that you do something harder than you’ve ever done before. It’s the day you push through fear and doubt to find the greatest light on the other side. It’s also the day where your brain shuts off to let your body do it’s incredible work. For that reason, many parents find that they don’t remember much from their birth days. The haze of labor is often incredibly strong. mama papa laboring

You Will Want to Look Back on those Precious Moments

When I gave birth to my first daughter, I found myself in a whirlwind of contractions. Each wave hit strong, and I sunk into a deep and quiet place to work through them. As I turned inward, I didn’t see the support that surrounded me—the touch of my husband, the prayers of my mom and sisters, and the care my nurses and doctor expertly provided. But when I looked through my birth photos, I found all those previously lost moments. And I cried such beautiful tears as I saw just how perfectly and completely my husband had loved me through that day. I’m also struck by my own strength, my own determination. I’m humbled by the gift my body gave us, by it’s strength and secret knowledge. As a woman who struggled with body image during my teen years and my twenties, my birth photos have healed so many wounds I inflicted on myself. They taught me to love my body in a way that no other therapy session or self-help book could.

Once in a Lifetime Moments

And then, of course, the moment you meet your baby is a high unlike any other. The joy is intense and unexplainable. There aren’t words for that moment…and so pictures can capture what human language fails to do. In both of my birth photos, the moments where we met our daughters are full of emotion that I doubt we’ll ever see again in our lives. Our love for them is so loud in those moments, pulsing with the intense energy that birth brings. We cry, we laugh, we embrace our babies so fully, and then we embrace each other. Those images are my family. They’re the beginning of our story. They’re everything to us.

The Details are Easy to Forget

My birth photographers also captured all the little details that filled up their birth days. Details that might have easily been forgotten as years past, but are now preserved for days when my husband or I need a reminder of the beauty of parenthood. The soft hair on their shoulders, the thickness in their cords, their tiny footprints, their wrinkled noses, their eyes opening for the very first time. Newborn babies change so quickly. Not just in the first few months, but in the first day, the first hours, the first seconds. We look back at their birth photos and marvel at just how much they’ve changed and also how much of their personality we can find on day one. I love my wedding photos, but I treasure my birth photos. They are real—no posing or artifact. They are passionate—the depth of love for both my children and my husband captured. They are irreplaceable, the best two days of our lives. vaginal waterbirth

Questions to Ask Your Birth Photographer

If I’ve convinced you to hire a birth photographer, I’d love to offer you a few suggestions on how to choose one:

Ask about her experience.

You can be an incredible wedding photographer, but that doesn’t mean you know birth. Lighting can be incredibly challenging, as is working with the unpredictable nature of birth. Hire someone who has photographed several births, in several different environments (homes, hospitals, birth centers). You want to find someone who understands that birth follows very little rules but demands that those who enter the space preserve it’s sacredness and safety.

Make sure she has a back-up.

Birth rarely goes as planned. Find a birth photographer who has an established back-up relationship. In the event your birth goes earlier or later than expected, in the event of sickness or a family emergency, make sure your photographer has a plan in place.

Ask about her equipment.

Entry level-equipment doesn’t do super well in birth.

Ask about her birth and photography philosophy.

A good birth photographer blends into your birth team, allowing your birth to take center stage. They capture what they need to capture while respecting the work of your care providers and the sacredness of your birth day.

Browse through her birth photography portfolio.

Do you like the images they’ve captured? Are you drawn to their style? Do you like how the editing?

Meet her. Spend an hour with her. Grab coffee.

Do you feel comfortable, safe, understood? It’s important to bring the right person into your birth day. If you feel even a little bit uncomfortable, keep on looking.

Realize it’s an investment worth making.

No, hiring an experienced birth photographer isn’t cheap. But remember, your birth photos will be one of the greatest treasures of your life. Your birth photographer will be on-call for you (24/7) for weeks. She’ll leave birthday parties, holidays. She’ll wake up at 3am to sit with your family for hours. She’ll bring thousands of dollars worth of equipment. She’ll move through your birth space with grace and skill. She’ll capture the big moments and the small moments. She’ll edit each of your images carefully. She’ll weave together your story…a story you’ll hold onto for the rest of your life. Hiring an experienced birth photographer is worth it. I promise. This post was written by Monet Moutrie. Monet is a birth photographer based in Denver and co-founder of Birth Becomes Her

Natural Coping Techniques for Labor

Coping Techniques to Aid in a Natural Labor

As a doula who has witnessed many women give birth, I can tell you that the most valuable tools for coping with labor contractions are not stuff you could pack in a bag (although I will get to those!). Your biggest assets by far are your head and heart, and the heads and hearts of the people you surround yourself with. Your best tools are:

Breathing

Soft, steady slow breathing that takes you from that first uncomfortable cramp all the way through to the fundal massage after baby is born.

Moving

Shifting with the tides of your contractions, rotating your hips, leaning over the back of the couch, rocking back and forth on your hands and knees.

Firm pressure

Your partner’s hands on your lower back, your doula’s double hip squeeze, your midwife’s hand with her permission to squeeze as hard as you need to.

Believing in your body and in birth

Your mantra repeated to yourself under your breath with each contraction, your partner telling you how strong and brave you are, your nurse encouraging your pushing efforts, your banner of affirmations made by your sisters and friends and hung with care in your laboring space.

Relaxing into a rhythm

Releasing the tension in your muscles between pushes, sinking into the bed and dozing off between contractions. (No really! By far the most important thing you can do to cope with labor is to find a way to rest in between contractions, especially in the early phase. If you don’t do this, you will be worn out by the time you get to active labor, much less pushing the baby out.)

All of these intangible things are really the most important and useful tools. At some births they are all that is needed. At other births, there are some physical tools that can come in handy.

Here’s my list of items to have on hand to aid in a natural labor/birth

  • A birth ball: Every laboring woman needs a ball! Lean over it on hands and knees or standing next to the bed, sit on it and do hip circles, throw it in the shower so you can rest your legs while letting the hot water run down your back.
  • Water: access to a deep tub in labor is amazing, but a hot shower can also work wonders.
  • LED candles or twinkle lights: it is so important to feel safe and relaxed, and bright overhead fluorescent lighting is no one’s idea of cozy.
  • Unscented massage oil: a woman’s sense of smell is heightened in labor. Your favorite scented lotion may suddenly be unbearable, so have an unscented oil on hand to help your partner give you a back or foot rub.
  • A tennis ball or two, or your favorite massage tool: tennis or lacrosse balls (a little more give than a tennis ball) are great for counter pressure on your low back, especially for moms experiencing back labor.
  • A rice sock or heating pad: some moms have a hard time releasing the tension in their lower backs, and a little heat can do the trick.
  • Rebozo (or twin sheet): there are lots of ways to use a long strip of sturdy cloth in labor, but you will likely need a doula or midwife in the know to show you how.
  • A fan: every mom gets hot during pushing. A cool cloth (freeze wet washcloths ahead of time) to the forehead and a patient labor support person fanning her face can make this intense stage of labor much more bearable.
  • Snacks (toddler food, honey sticks, smoothies, broth): labor is hard work, and there is no medical reason to deny a woman fuel for her journey. Just a few bites here and there are likely all you will want, I recommend hitting the toddler food section in the grocery store and picking up some of those nifty pouches. They are just the right size and consistency for a quick labor snack.
  • Elastic hair band or clips: labor is sweaty. Your long bangs will get in your way, and your hair on your neck will be hot.
  • Lip balm: all that deep breathing takes a toll on your lips. I like this one for a long lasting and scent free option.
  • Your own pillow (with a pillow case that is not white or beige): when you need a spell of rest, it is so much nicer to have your own pillow beneath your head. Hospital pillows are flat, have scratchy cases, and are in short supply. Be sure to bring a colored pillowcase so your pillow doesn’t get mixed up with the hospital ones.
  • Shower shoes: because who knows who used the hospital shower before you?
  • Depends: believe me, when your water breaks, and keeps leaking for the duration of labor, you will be glad to have something comfortable to wear that will keep you dry.
  • Playlists + speakers (and maybe headphones): have at least two playlists: a quiet calm one for periods of rest, and one that gets you moving when it is time to push. Listening to birth affirmations and guided relaxation tracks are also a great way to keep your head in the right space.

It is unlikely you will use every tool in your bag, but you never know what you will find invaluable on your big day. But remember that surrounding yourself with people you trust who can help keep you calm and will cheer you on is what will make the biggest difference in your ability to cope with contractions. You got this, mama! I believe in you.


This guest post was written by Stephanie Spitzer-Hanks. Stephanie gave birth to her first child in the Netherlands, where the nurturing and encouragement she received from so many women there inspired her to become a doula. Now she strives to give unconditional support and evidence-based education to families so that they can be confident in making the choices that are right for them. She is an ICEA certified childbirth educator, an Evidence Based Birth® Instructor, a DONA certified birth and postpartum doula, a StillBirthday certified bereavement doula, and a certified lactation counselor through Healthy Children’s Center for Breastfeeding. On the side of all of that, Stephanie is an ordained minister in the United Church of Christ, and she serves as a chaplain at a hospital and writes and speaks about birtheology when she gets the chance. You can find out what she is up to at www.revdoula.com.

What to Pack in Your Hospital Bag

Packing a hospital bag is exciting, but can be a little overwhelming. Where to start? Think of it like packing for a weekend vacation, plus bringing along a few extra items. A large tote bag or small suitcase works fine. I like to use a carry-on suitcase with wheels, because it’s more convenient for my husband to help support me and easily wheel it behind him instead of having to also carry a heavy bag. Pack your bag about 3 weeks from your due date, and you’ll be ready when those first few contractions start.

Snacks

If the hospital allows it, snacks are nice to keep on hand to munch on during labor, to keep your energy up while waiting for baby. Your partner might want some too. After delivery, food is essential. I am always starving after all that hard work and depending on the time of day, the cafeteria might be closed. Keep a few substantial protein-filled snacks on hand.

Birth Preparations

  • Birth plan: Keep a few extra copies of your birth plan in your bag for nurses and doctors, especially in case of a shift change. 
  • Birth Affirmationswords, quotes or phrases you’ve written down to encourage and empower you throughout labor.
    birth affirmations

Electronics

My first two deliveries were so unexpected we only had flip phone photos. So sad! Keep these electronics on hand and accessible, because anything can happen!

  • Phones and chargers
  • Ear phones if you plan on listening to a playlist or birth affirmations (wireless noise cancelling ones can be worth the investment)
  • Portable speaker
  • Laptop and charger
  • Camera, extra memory card, and extra battery charger

Clothes to bring to hospital birth

  • Robe: Hospital gowns are nice to wear the first day or so, as you are leaking and bleeding, and getting used to postpartum recovery. You don’t have to worry about getting your own nice clothes dirty. However, it’s nice to slip on a robe if you need to walk to the bathroom or around the halls, since they are not too modest in the back. This one is short and SO soft!
  • Sleeping/nursing bra: Although your milk will most likely come in in about 3-4 days, your breasts can still feel tender and engorged, especially as you are nursing often. It sometimes feels nice to have some support rather than nothing at all.  Make sure you bring something soft, breathable, and comfortable.
  • Socks: Hospitals can be cold, and it’s also nice to have some cozy socks to help you feel more at home.
  • Slippers: Merely a comfort item for walking around the room and for trips to the bathroom.
  • PostPartum Band: I have heard people swear by these, as they help support your weakened core muscles after birth and help you get back to pre pregnancy size sooner. It also can help with diastasis recti (the separation of abdominal muscles during pregnancy) as it encourages the core muscles to come back together.
  • Loungewear: Comfortable, loose pants are best. Maternity leggings are a great option too.
  • Sweater: Hospitals can get cold and you generally don’t have control of the temperature. This one is SO comfy, nursing friendly and comes in tons of colors. 
  • Large, comfortable underwear you don’t mind getting bloody
  • Your own hospital gown (optional): Advantages—you feel cute, you know it is clean and fresh. Disadvantages—you might get blood or bodily fluids on it. This is a great option! 
  • Coming home outfit for mama: choose something extremely comfortable. Stay away from tights or skinny jeans, especially since you’ll be wearing large pads and underwear. Stick to a simple nursing-friendly maxi dress or lounge pants.hospital bag

Toiletries for Hospital Birth

  • Hair supplies: It’s so nice to get that first shower after delivery. If you can, skip the hair washing and use some dry shampoo to save time.
  • Hair tie or clips
  • Lotion or moisturizer
  • Makeup: You will be basking in the glow of meeting your baby and women look like goddesses after giving birth! If you feel comfortable with some makeup on, by all means pack your favorite items! 
  • Hand mirror: In case you want to have someone hold it so you can watch as your baby is being born!
  • Make-up removing wipes: These are golden to keep on hand when you want a fresh face but are holding the baby, nursing, or just too dang tired to get up.
  • Toothbrush and toothpaste
  • Nipple cream: some hospitals provide this, but if you have a brand you prefer, or your own for home, bring some to apply. We love this nipple balm and this lanolin option. 
  • Cold gel packs: These can really help in those first few days when your nipples feel raw and sore as they are getting accustomed to breastfeeding. They also help with engorgement.

Entertainment

  • Books/magazines/kindle
  • iPad for watching Netflix if you end up waiting around a lot

For Baby

  • Nursing pillow: You may stack a few pillows on top of each other to assist in nursing, but if you’d rather bring a boppy or my breast friend, feel free.
  • Wipes: many hospitals these days do not have wipes available, either because they irritate baby’s skin or because they are trying to cut costs. I’ve heard both reasons. Bring some unscented and sensitive skin brands just in case.
  • Binky: hospitals tend to use soothies and if your baby doesn’t like them that could be frustrating. I like this one and this one for newborns far more than soothies.
  • Coming home outfit: Bring two in case the baby has a blowout. Make sure they are comfy and soft and have the hand covers to keep him from scratching himself. I love these gowns. Include socks (or stay-on booties) and beanies to keep him nice and warm.
  • Blankets: bring a swaddling blanket so you can practice swaddling with the nurses, and a medium weight blanket to spread on him in the car seat for the ride home.

Happy Packing!

This post was written by Austyn Smith.

How to find a good OB & Questions to Ask BEFORE You Hire Them

You’ve decided to go with an OB/GYN. There are several advantages to using an OB for your care and delivery. Physicians tend to have experience with and knowledge about high-risk pregnancies and complications. If you know you are high risk due to advanced maternal age, diabetes, or any medical condition, you can have peace of mind knowing your OB is equipped to handle it and to manage medications if needed. If your intuition is telling you that you feel more comfortable knowing you have access to all the medical procedures and personnel a hospital offers, this is the route to go. OBs have access to advanced medical testing and screenings, and are connected in a network of specialists and colleagues. If you’re still considering a midwife, there are many midwives that work in collaboration with OBs so you don’t necessarily have the rule that out either. Talk to your care providers and come up with a plan catered to all of your needs.

Where to start in finding the OB that’s just right for you? You’ll definitely want someone you feel completely comfortable with, and that you trust to take care of you and your baby. This is your life (and emotional well-being) and your baby’s health in someone else’s hands, so it’s a big deal. Here’s some ideas to help you get started.

Where to look first

Ask around. Your best bet is going to be word-of-mouth. Talk to everyone you know and trust about their OB/GYNs. What things did they like/dislike about them? What was their prenatal care like? How was their delivery experience? Would they go back to this same person? The more details the better, just start asking. Of course it’s important to keep in mind that not everyone wants the same type of birth experience so the doctor that was a good fit for your sister may not be right for you.

Join Facebook groups in your area. There are many Evidenced Based Birth local groups that you can join where the admins and members are knowledgeable about the OBs in your area and which ones follow evidence based practices. What is Evidence Based Birth?

If you don’t know many recent moms personally, get in touch with your hospital’s Childbirth Educator.  She or He should be familiar with doctors and nurses at the hospital, and know the ins and outs of the kind of care they give (and their bedside manners). She’d be able to give a few recommendations that you can then do more research about. Of course keep in mind that they work for the hospital so may not be able to be completely forthcoming.

Ask for statistics. Hospitals keeps track of things like induction rates, episiotomy rates and cesarean rates so asking for these facts will give you a good idea of hospital practices. Unfortunately, even if you love your OB sometimes the hospital policies limit their ability to provide the care that you may be imagining.

Do you currently have a gynecologist that you like? Do they practice obstetrics as well? Asking a few additional questions can help you get a feel for if it would be a good fit or not. If they don’t deliver babies, they could recommend some colleagues to you, that you could then check out. Keep in mind that prenatal and birth care is MUCH more involved than an annual exam so don’t just go with your current doctor because it’s convenient. You want to make sure it’s a good fit and that their maternity care is in line with what you want for your birth.

Once you have a few names of potential doctors, there’s a lot of things to mull over before the interview process.

Here’s a few considerations:

Your health history

Do you have specific concerns about your pregnancy that not every doctor would have experience with?  Plus-size pregnancy, previous recurrent miscarriages, diabetes, or trying for a VBAC (Read more in our post What you need to know about VBAC?) can be uncharted territory for some practitioners.  Look at the websites and reviews of doctors to find out if they have specific experience in the areas you are concerned about.

Physician’s philosophies

What does the provider value? What is their overall outlook on pregnancy, birth, and labor? Are they super medicalized or do they lean toward the more natural route—and which do you prefer? What are their opinions on certain medical procedures like continuous electronic fetal monitoring, scheduling inductions, episiotomies, and epidurals? Do they tend to take control of how a labor is progressing, or allow the mother to take the lead? How pushy will they be?

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Male or Female

Think about your past interactions with doctors and whether you’ve been more comfortable with a male or female physician. It may not matter to you, but if it does, then you can quickly narrow your search down as most health insurance databases have the option to filter your search results based on gender.

Personality

Do you click? Do you feel comfortable? I had a friend who went in for a breast exam and the doctor chatted for a few minutes and then said, “Okay, flash me.” That exchange made her feel so uncomfortable she never went back. Bedside manner and professionalism matter! Do you trust their experience and judgement? Do they listen to your concerns and questions or just plow through the appointment as fast as possible? Are their credentials up to date? What does your gut say?

Support

Are they supportive of you having a doula with you during labor/delivery? How comfortable are they with extra people in the room in general, and does your partner get a good vibe from them as well?

VBAC/C-Section Rates

This is public information that you can request from your hospital. However, doctors don’t usually post their own personal stats. You can get an idea of how things go by calling the front office and asking some questions. Many offices don’t give out specific numbers, or may not even keep track, but you can get an idea by saying something like, “Out of the last 10 deliveries this provider performed, how many ended up being c-sections?” Or “Out of the last 10 attempted VBACs, how many were successful?” Get an idea of how willing they are to work with you. Keep in mind that specific hospital rates are higher than others for cesarean. Which brings us to our next item…

Hospital Policies

What are the c-section stats? You can search online to find this info. In general, what is the hospital like? Do they have natural birthing accommodations and tools if you’d like to go that route? Birthing tubs to labor in? Is the hospital friendly to natural delivery? Do they require IVs, continuous electronic fetal monitoring? Do they have VBAC policies? What are their standard procedures right after the baby is born? Do you get to have skin-to-skin bonding for a while? Does the baby get to stay in your room? Calling the Labor and Delivery floor is your best bet to getting answers to these questions. A nurse can help you out, or refer you to someone else who knows the specifics. Nurses generally want you to be informed about the hospital policies so that there aren’t any surprises when you come in.

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Office Protocol—Questions to Consider

  • What is the OB clinic experience like?
  • How easy was it to get an appointment?
  • How many doctors are in the practice?
  • Are you a number who is shuttled through the routine, or are you treated like an individual?
  • How long do you typically wait in the office?
  • What are the after hour policies?
  • Will your OB be the one to deliver you, or do they rotate who is on-call, and will that bother you?
  • Is there an on-call nurse that is available to answer questions?
  • What is the staff like?

Think about how you feel about all of these things.

Once you’ve thought about all of these issues, and researched a few doctors, narrow it down to a couple. You can either take the plunge and make your first appointment with the one you want, or you can be even more thorough and schedule a consultation, where you can bring your list of questions.

Above all else, keep in mind that you are not stuck once you make your choice. If at any time you start to feel uneasy about your care giver, or feel like you don’t align with their philosophies, shop around. It’s completely acceptable, and it happens all the time. If you feel uncomfortable firing your OB, simply call the front desk and ask them to transfer your files to your new doctor. You don’t even have to speak to the doctor you are leaving. This experience will be one of the most important of your life, and you deserve to feel as safe and as comfortable as possible. Follow your gut!

Interview Questions for Potential Obstetricians

General Basics

  1. What is your general philosophy on pregnancy, labor, birth, and postpartum care?
  2. What is your role as physician? What is your role during labor and delivery?
  3. How long have you been practicing? How many births have you performed?
  4. How many births do you anticipate attending month? Is there a limit to the number of patients you take on?
  5. What is the chance of you delivering my baby? Who delivers when you are not available?
  6. What is your c-section rate?  
  7. If there is a complication beyond your expertise, who would you refer me to?
  8. What is your after-hours policy? Are you reachable during an emergency?
  9. How often am I required to meet with other doctors?

Pre-Natal Care

  1. How much time do you spend with each patient during an appointment?
  2. Are you available in between visits if I have a question or concern?
  3. What is your view on nutrition and weight gain?
  4. What prenatal tests do you require and/or recommend?
  5. What childbirth education resources do you recommend?
  6. How do you feel about birth plans? Do you help with writing them?  
  7. What experience do you have with high risk pregnancies?  
  8. What would the procedure be if I become high risk?

Labor and Delivery

  1. When will you arrive on scene? Who will support me in the meantime? How often will you be with me during labor?
  2. If you have two simultaneous labors/deliveries, what do you do?
  3. How do you feel about a support team? A doula? Other friends and family?
  4. What if I approach my due date without going into labor? How long will you let me go past? What is your induction policy?
  5. Do you ever recommend induction for an estimated large baby?
  6. How long will I be able to labor after my water breaks if no signs of infection?
  7. What routine policies during labor do you recommend/require? What does the hospital require? (Continuous fetal monitoring, IVs, etc.)
  8. Am I allowed to move around during labor? Eat and drink?
  9. What are your views on pain management during birth, both medicated and unmedicated? Will you recommend different positions and coping techniques?
  10. What percentage of your patients deliver without an epidural? What resources are available to me, should I want to labor without drugs?
  11. What percentage of your patients get epidurals? What is your view on epidurals?  
  12.  How do you handle a “stalled labor”? What do you consider a stalled labor?
  13.  What birthing positions do you allow for labor and delivery? What is most common for you?
  14.  Do you perform episiotomies? How often? How often do you use forceps or vacuum extraction?  
  15.  Do you encourage and support VBACs? How many VBAC attempts have been successful? (60-80% is norm). What is the hospital policy for VBAC?
  16.  At what point in labor do you recommend c-sections?
  17.  Have you ever performed a vaginal breech birth? Twins?
  18.  What procedures do you perform on the baby? What can wait?  
  19.  Is delayed cord clamping okay?
  20.  What happens if there is postpartum hemorrhaging?

Post-Partum

  1. Will I have uninterrupted skin-to-skin bonding time immediately following birth? For how long?
  2. Will the baby stay with me in my room?
  3. Do you assist in breastfeeding? Is there someone else available to help me?
  4. What if I hemorrhage?
  5. Can my partner stay in my room?

Questions to ask yourself after the appointment

  1. Do I feel comfortable with this person? Are they flexible?
  2. Do our philosophies line up? Or are they willing to work with me? (You want them to enthusiastically support your wishes not just be “willing to let you try that”)
  3. Do we have a mutual respect?
  4. Do I trust their expertise and judgement?
  5. Is the office staff friendly and helpful?
  6. What was the wait time? Did I feel rushed in and out?

 

This guest post was written by Austyn Smith.