Here’s another surprising fact you might not know about hospitals; you can’t directly pick the hospital where you want to deliver your baby. That’s right! Once you pick your ob-gyn, believe it or not you’ve already picked your hospital. The hospital where a doctor has “privileges” is the hospital where you will deliver your baby.
Hospitals are our beacons of safety and well-being. We are fortunate they are there for us when we need them, but not all hospitals are the same, nor do they provide the same level and quality of care to their patients.
Get picky about your delivery site
It clearly benefits women to get picky about their choice of doctors and hospitals-with an eye toward ending up at a teaching hospital if at all possible. Here are some specific questions to ask any obstetrics professional you interview about the hospital to which he or she is affiliated:
Is it a teaching hospital?
A 2016 study1 revealed that teaching hospitals report a lower rate of life-threatening incidents among pregnant women than do other similar institutions. These hospitals, which are usually privately owned, tend to have level 3 or 4 newborn nurseries (more about that below) and they excel at delivering low-birth-weight babies.
What is the level of the newborn nursery?
Level 1 nurseries are for healthy newborn babies, while Level 2 nurseries are for babies born at thirty-two weeks and up who require special care. Levels 3 and 4 nurseries are neonatal intensive care units, employed mainly in births under the thirty-two-week mark. While we all hope for a routine full-term delivery, anything can happen. Particularly if your pregnancy is high-risk in any way, you’ll want to make sure your hospital is equipped to handle any complication that may arise.
Does the hospital routinely deal with the delivery of low-birth-weight babies?
Questions two and three go together, of course. Hospitals with Level 3 or 4 nurseries report a higher percentage of successful outcomes with low-birthweight babies. They deliver more of them, so it stands to reason that they are more proficient at it.
Is the hospital privately owned?
There are two kinds of hospitals: private and public. Private hospitals tend to be more up-to-date in their methods and technology than public hospitals. They also tend to be smaller and admit fewer patients, and their staff-to-patient ratio is more favorable. The downside is this: Because they are privately owned, they can turn away patients who are not experiencing an emergency; are more particular about the forms of insurance they accept; and cost more in general.
What is your protocol if a woman starts losing too much blood after delivery?
“Protocols” are precise and rigid plans of action for a specific problem. Since hemorrhage after childbirth is life threatening and currently a leading cause of maternal deaths, it’s important to know how your healthcare team might deal with it. The kind of answer you are looking for can be – we weigh and count a woman’s pads after birth to track blood loss and recognize hemorrhage sooner.
Even if you aren’t pregnant right now, you can certainly plan ahead. Consider an ob-gyn for your ongoing reproductive health care who has privileges at the hospital that might match your personal needs, insurance and accessibility. When you do decide to have a baby you’ll already have a good relationship with a doctor with admitting rights to the kind of hospital that will work best for you.
1. Elizabeth Howell, MD, MPP; Natalia N. Egorova, PhD, MPH; Amy Balbierz, MPH; Jennifer Zeitlin, DSc, MA; Paul L. Hebert, PhD. Site of delivery contribution to black-white severe maternal morbidity disparity, United States, Am J Obstet Gynecol 2016;214.e143-152.
