Written and verified by Savannah Gray, RN, MPH
Hi! I’m Savannah, Verdant’s content writer, a labor and delivery nurse, and a mom super-cheerleader! I am all about advocating for women and families in the labor and birth process, and I wanted to share some of the important conversations to have with your provider before you get to the delivery room.
“Will you be at my delivery? What happens if I go into labor early or you’re not available?”
Depending on the provider group, their hospital privileges, and your hospital for delivery, the provider you see most at prenatal appointments may or may not be present at your birth. If you deliver at a hospital with an affiliated physician group (such as in academic teaching hospitals), you may have any provider in that group attend your delivery depending on who is “on-call” (the provider who remains in the hospital to attend deliveries, usually for 12-24 hours). Discuss with your provider what their group’s call schedule looks like and if there is any planning to be done to increase the chance that they attend your delivery, such as if your labor is induced. If you have a private physician who has clinical privileges at your chosen hospital, you may also deliver with the OB hospitalist (the inpatient physician who attends deliveries not attended by private providers) in the off chance that your private provider can not make it to the birth. This is to make sure that the unit has a provider at all times and your baby is delivered safely! Discuss navigating the uncertainty and ways to stay informed about who will help you deliver.
If your provider is able to attend the delivery, sometimes they may be called in for your delivery either from home or their outpatient office after you’ve arrived and your labor has progressed. Since labor can take 1-2 days (or shorter if you’ve been in labor before), you may only see your provider toward the middle or end of your labor when labor intensifies and delivery is imminent. Discuss expectations for communication and frequency of face to face interactions during the labor course to put your mind at ease and reduce anxiety if you don’t see your provider more than a few times during the labor.
“Should I have a birth plan? What does that mean or look like?”
Birth plans are great ways to describe your ideal birth and lay out your expectations for the birth team! Birth is unique to each person and family, and having a full conversation about your preferences and options is very important before going into labor. Birth plans help guide your conversations with your provider about your expectations and the provider’s recommendations. (Note: they aren’t legally binding documents and while they inform the care you receive, they are subject to hospital policies, available equipment, etc.)
Birth plans include things like:
- food and drinking preferences during latent or active labor
- physical movement during labor
- fetal monitoring preferences
- clothing preferences (your gown vs the hospital gown)
- pain management options (ex: an epidural, IV pain medication)
- doula or visitor support
- lights (lights off, your own fairy lights)
- aromatherapy
- language used, verbal cues or triggers
- cord blood banking
“What are the expected routines or norms with a hospital delivery?”
This is an important question to discuss so you have a full understanding of what your birth experience may be like if you deliver in a hospital. Some hospitals have more stringent visitor policies while others have capacity to allow visitors overnight. You may or may not have medical or nursing students at your delivery, and you should discuss what their involvement may look like. Your provider may be able to address questions such as how often you’ll have a vaginal exam or if you’ll have an IV and why.
Believe it or not, this is also a good time to discuss discharge home after the birth! It’s always best to be prepared, so you know what to prepare for at home and you can think long term about recovery. See question #5 below.
“Can I have a doula?”
Having a doula is a personal decision for each birth person and family. Doulas can be paid support persons or can be a family member or friend who’s trained or knowledgeable about birthing support and advocacy. Discuss with your doctor about their past experiences working with doulas, if any, and what they envision that working relationship to be like. Also inquire with your physician or hospital if your facility will consider the doula a visitor in addition to the primary support provider (usually the father or secondary parent of the baby). Some facilities may allow for a doula to be present in addition to two other support persons.
“How should I prepare now for postpartum?”
Discussing postpartum while still pregnant will help you have a good understanding the birth process and the “4th stage of labor” (the first 24 hours after delivery). Postpartum can host problems of its own, including postpartum depression or anxiety, hemorrhage, infection, and others, and it’s best to have a game plan before birth with your provider and friends and family in case you encounter unplanned complications. Discuss exercise and daily physical limitations in the first weeks, as well as nutrition and supplements. Discussing breastfeeding and formula feeding will also allow your doctor to discuss your history and risk factors for low supply or baby’s need for alternative feeding (such as infection, medication, or breast surgery). We know postpartum depression and anxiety are not uncommon diagnoses - discussing honestly with your provider can help you identify and develop coping mechanisms, support systems, and social support if needed.
The information provided on Verdant is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen.
