Going into labour is a huge experience for mothers and you may have questions on what to expect. It is best to clarify them with your doctor before going into labour as some decisions or requests need to be made beforehand. Moreover, it can be difficult to discuss some of these when you’re already at labour! Here are 10 questions to ask, broadly grouped according to the various stages of your labour process.
Going to the Hospital
#1 – When can I come to the hospital?
It is best to clarify this as hospitals may have slightly different guidelines before admitting you; for instance, some may allow you to be admitted once your water break or others have timings for contractions. In general, if you have contractions every five minutes for an hour, each lasting 30 to 45 seconds, it is a sign of true labour. Other signs of labour contractions are if they are getting closer consistently, stronger and lasting longer. If you have bloody discharge or experience a significant decrease of fetal movement over the last 24 hours, you should report to the hospital.
#2 – Who can come to the hospital with me?
You certainly have to decide before your labour and find out if it is acceptable for these family or friends to be around during your labour. There is space constraint as your doctor and nurses also have to be in the room and have space to help you. It can be distracting both for yourselves and them if too many people are watching. Check on their video filming or photography policies too.
#3 – Will my doctor be around?
You have been seeing your doctor (obstetrician) and likely you will be more comfortable if he/she is attending to your delivery. Clarify on when you can expect to see your doctor after you are admitted and when he will not be available. Ask what is the alternative arrangement and who will be attending to you if your doctor is away, in another emergency or performing surgery. Even if your doctor is in the hospital, it is unlikely that he will be staying with you throughout your labour – ask beforehand how long and at which stage you can expect to see him, and how you can contact him during your labour.
Comfort when in the Hospital
#4 – Am I allowed to shower, eat and move during labour?
Labour can take many hours, even up to a full day. Check beforehand whether you can eat, whether you can bring your own comfort food and whether there is shower facility. Ask about being allowed to walk around, move and change positions during labour. You may want to discuss this and have these requests documented so that you will not end up arguing with the medical staff attending to you on what has been agreed with your doctor.
#5 – What are the pain relief measures?
Pain relief drugs are usually in the form of pain killers and epidural. Pain killer may be via muscular injection and/or pain relief gas. Decide before labour if you are using epidural and ask how early/ late in the labour process you can request for one. Moreover, epidural is administered by anesthetist who may not be available immediately. Apart from drugs, there are also comfort measures that can be taken to help you cope with labour. For instance, changing position, a bath, massage and music.
The Childbirth Process
#6 – What are the percentages of cesarean births?
Unless due to medical reasons, a hospital should not be encouraging cesarean births or easily accede to requests in order to avoid pain during childbirth. A C-section is considered a major operation that should not be taken lightly. You may want to ask questions such as how long they will let you push before considering C-section, what are the percentages of C-section births (ideally not more than 10%) and what percentages of these mothers had vaginal delivery for their next baby (ideally more than 60%).
#7 – Will my doctor be using episiotomies, forceps or vacuum?
An episiotomy is a cut in the opening to the vagina to make it larger for birth. Forceps and vacuum are to assist in the delivery of your baby if pushing efforts are not successful. Discuss the risks of each of these and check with your doctor how routine he uses these – different doctors have their own views and preferences, it is best to discuss beforehand if you have reservations on these.
#8 – What are the risks of vaginal delivery?
You may want to discuss these beforehand, especially if you have certain medical conditions. The more common risks are (i) excessive bleeding, (ii) retained placenta due to failure of your placenta to separate, (iii) profuse bleeding up to 1-2 weeks after delivery due to remnants of placenta and (iv) inability of the episiotomy wound to heal.
#9 – What will the hospital do to help with breastfeeding?
Breastfeeding does not come easy for every mother, with problems like proper latch-on or issues with the nipples/ breast. It is studied that the first few days after delivery makes a difference in the success of breastfeeding. For instance, check if they have lactation consultant available to help in the first two days, if help is available to start breastfeeding within an hour your baby is born, whether you can bring your own breast pump or if the hospital has one to help stimulate breast milk production (in the event of latch-on difficulty) and whether your baby can room-in with you and nurse whenever he/she wants to.
#10 – If my baby has unexpected complication, will the baby be kept with me at the hospital or transferred?
As much as you don’t want this scenario to happen, you should check what are the medical facilities available within the hospital to cope with health complications of your baby. Understand more about the process if your baby has to be transferred and you may even decide to give birth in your hospital with more facilities and medical staff to cope with infant emergency.
Instead of going into labour with questions and getting frustrated that things do not happen as you expect, it is better to ask and get clarity before your hospital admission. It also helps to give you assurance and confidence about your labour.