After you’ve settled on an OB-GYN and know where you will be delivering your bundle of joy, you’ll probably have a lot of questions. Even if you’ve given birth before, things may have changed due to the coronavirus disease 2019 (COVID-19). A good time to ask questions is during your maternity hospital tour, most of which are done virtually these days. You also can contact your maternity hospital and ask a nurse or staff member to answer your questions. We consulted three people who work in Maternity Services at UNC Rex Hospital to see what moms-to-be should be asking.
Questions to Ask About Labor and Delivery
Do you offer classes for new parents on birth, breastfeeding, infant care or other topics?
During pregnancy, you can take online classes to help you prepare for birth and parenting. Ask hospital staff if they offer classes or can recommend some.
“We now offer breastfeeding and newborn classes online, as well as our Birthing and Labor Support class,” says Wanda Adams, RN, perinatal services manager at UNC Rex. The virtual classes are interactive, so participants can ask questions of the perinatal instructor staff.
“We teach you how your partner can help you through the process and how to practice labor positions,” Adams says.
What birthing and pain management options do you offer?
If you already have a birth plan, make sure your hospital can accommodate it, especially if you want a hydrotherapy tub for labor or a water birth. If you are still figuring out your birth plan, learn what options are available.
Also ask about pain management options such as epidurals or nitrous oxide.
“Sometimes, moms go into labor with a certain plan in mind, and for various reasons that plan can change,” says Anne Reklis, RN, labor and delivery team leader at UNC Rex, who has been helping deliver babies for 14 years. “It’s important to be aware of these options ahead of time, so you aren’t having to make decisions based on information you are hearing for the first time during delivery.”
Questions to Ask About COVID-19
Do you require or recommend that I quarantine before my due date?
COVID-19 prevention is one of the top priorities for healthcare institutions, so find out what your birthing center is asking mothers to do leading up to delivery. This may depend on the infection rate in your area and could change depending on declining or increasing case numbers. The current common recommendation is that mothers quarantine for two weeks ahead of their due date.
Will I be tested for COVID-19?
Know your hospital’s policy on COVID-19 testing in case you have to do this ahead of time. UNC Rex, along with many other hospitals, performs these tests on moms when they arrive at the hospital for delivery. If a mom is not showing COVID-19 symptoms, a test is used that produces results in four to six hours. If a mom is showing symptoms or a fast answer is needed for another reason, a rapid test is used.
What happens if I test positive for COVID-19?
“Not a lot about your birth experience has to change if you test positive for COVID-19,” Reklis says.
It’s good to mentally prepare for what could happen in this situation. UNC Rex requires a few changes to the delivery process if mom tests positive for COVID-19: Mom and her visitor have to remain in her room during their entire stay, and the baby will stay isolated with mom in her room instead of going to a nursery, unless the baby has a health issue that needs to be cared for.
“We still encourage breastfeeding and mother-baby bonding even if mom tests positive. That doesn’t change,” Reklis says.
Can I have visitors during labor and after delivery?
“Traditionally, we try to make labor and delivery an open and family-friendly environment,” Reklis says. “But, due to the pandemic, we really have to monitor how many people are passing through our doors on a daily basis.”
Each hospital has its own protocols, which are subject to change as the pandemic evolves. It’s important to know your hospital’s policy, and be sure to check again closer to your due date to see if the policy has changed. Currently at UNC Rex, one visitor is allowed; this could be your partner, a family member, a friend or a doula, for example. The visitor undergoes a COVID-19 screening for symptoms before he or she is allowed in the hospital.
At UNC Rex, once inside with mom, the visitor is allowed to leave once during a 24-hour period. The visitor cannot be swapped out for other people; the visitor you choose at the beginning of the delivery process must remain the same.
Who is required to wear masks and when?
Know your hospital’s policy on masks to prepare yourself and your visitor(s). Most hospitals require visitors and patients to wear masks when entering the hospital, leaving patient rooms, and when a staff member is in your room with you. Masks help protect you and your family, as well as hospital staff and others in the facility.
Questions About Your Hospital Stay and Logistics
What should I bring with me to the hospital?
There are many hospital bag checklists online, but your hospital will have specific suggestions based on what most parents need and what they stock for you. For example, most hospitals offer breast pumps, so you don’t have to bring yours from home.
At UNC Rex, if you end up needing something you forgot at home, you can have someone drop it off at a designated entrance to the hospital, and staff will be sure to get it to you.
Will I have to share a room with another mom at any point?
It’s rare that a hospital has a shared delivery room, but some do have shared postpartum rooms if a maternity center has a high number of patients. In the age of COVID-19, typical protocols may change. You should know if there is a possibility of sharing a postpartum room at your hospital.
Who will I encounter throughout my visit?
It’s good to understand who will be helping you through your birth experience, from check-in to labor and delivery to your hospital stay.
“Hospitals are trying to limit the number of people moms need to interact with right now,” says Megan Atkinson, RN, a clinical nurse supervisor at UNC Rex. “But, to ensure a safe and healthy delivery for mom and baby, there are a number of people who need to be involved in the process.”
How long will I be in the hospital?
You need to know your birthing center’s expectations for your care.
“Here, mothers usually stay two nights after delivery, and three nights after having a C-section,” Reklis says. “However, labor is an ambiguous time frame that differs with each mom. Come prepared that it may take 24 hours for your baby to be born, because that is a typical healthy labor timeline.”
What insurance does the hospital take, and how do I learn about billing?
The financial aspect of childbirth isn’t the most exciting part to think about, but it is necessary. Understand what your insurance will cover, including baby supplies, and know what your responsibility will be. If you have questions, ask someone at your maternity hospital to connect you with a financial counselor who can walk you through the process.
Questions About Newborn Care
How do you support a mom’s feeding choices?
You’ll likely decide before you go into labor whether you want to breastfeed or formula-feed your newborn, or do a combination of both. Staff in your maternity center can provide more education on feeding choices and how new moms are supported. If you are interested in breastfeeding, inquire about a lactation consultant and how to see her during your stay.
Is your well-newborn nursery open?
If you’re already a mom, you may have experienced the respite a newborn nursery can bring once you’re in your hospital room and in desperate need of sleep. In typical times, moms can send their babies to the nursery for a period of time, including overnight hours, to be watched by nurses while mom gets some rest. Because of COVID-19, nurseries may not be open at various birthing centers.
Do you have a neonatal intensive care unit (NICU)?
In case your baby needs extra medical care, know what your hospital is able to offer. The different levels of care are designated as 1 through 4, with NICUs starting at level 3. If your hospital doesn’t have a NICU, ask where the nearest one is, and what kind of relationship your hospital has with the NICU facility. How will your baby be transferred if needed?
What shots or vaccines do you recommend babies get?
The Centers for Disease Control and Prevention (CDC) recommends all newborns receive the first shot in the hepatitis B vaccine series shortly after birth. In addition to this vaccine, most hospitals give what’s called the “thighs and eyes” treatment, which includes a shot of vitamin K into the baby’s thigh and an antibiotic ointment in their eyes. Know what your birth center does ahead of time so you can educate yourself and have a discussion with your doctor if you have any concerns.
Do you perform a hearing screening or other tests?
Each state has laws regarding what tests a newborn should undergo, including hearing screenings and screenings for metabolic conditions and congenital heart disease. Ask your birthing center about your state’s laws, and what additional tests your center offers.
Is there a car seat technician who can help us?
Getting your baby’s car seat installed properly can be a chore, but it’s very important to make sure it’s done correctly. Some hospitals have technicians who can help you with this before you leave the hospital. If this service is not offered, you would need to have the car seat inspected by another source beforehand.
Is there anything else I should know?
This can be a good way to find out about things like newborn photography sessions or other special offerings at your maternity center. Tour leaders may provide details you forgot to ask.
Have all of your questions and concerns answered before you give birth by making an appointment for a hospital tour.
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