Brian and I took a maternity ward tour yesterday. We took it pretty early because it is only offered on Tuesdays at 1300 (1pm) and I don't want to miss work and I start next week.
So Bethesda is a pretty cool hospital when it comes to delivery. I am pleased after the tour. I feel like they are a happy medium when it comes to policy. Here are the highlights.
I will labor, deliver and do a few hours of recovery in the same room. All rooms have one bed, a rocking chair, a birthing ball, squat/birthing bars, a small fold out couch (the nurse recommended air mattresses over the couches), a few chairs, a spacious bathroom with a walk-in, sit-in shower, the baby's hospital bassinet thingy, TV, and probably anything else you can think of except for a birthing tub. The rooms themselves are very spacious and could probably hold 4-5 people comfortably even with staff coming in and out. They showed us how they take apart the bed for delivery and explained how it helps when baby comes out. They have posters of suggested positions for the birthing ball, allow you to labor in the shower for a bit (not birth there), require 20 minutes out of every hour to be on a monitor (but I can move around when not on the monitor).
Since the staff is there on rotating shifts and you can't guarantee a specific provider for your delivery, no one is in a rush so they can go home, go on vacation, etc. The surgeons and anesthesiologists are on the same type of shift schedule and most are military. None are paid by the procedure so there is no pressure for epidurals or csections although their csection rate is close to all the other hospitals in the area.
Babies stay in the room with mom at all times except for a few exceptions: weighing (out in the hall) and a few standard tests/procedures that we can accompany if we want. All nurses and main staff members are trained to assist with breastfeeding, latching, etc and lactation consultants are available about 14 hours a day during the weekdays. As a first time mom, I'll be required to stay for 48 hours before release even if everything is peachy. They provide everything that is needed for baby except the take home outfit/blanket and carseat (which they inspect to make sure baby fits into correctly before we are allowed to leave. They also highly encourage us to take the carseat with our car to the fire department just outside the hospital to ensure that the carseat fits right in our car and we know how to lock it in). They even encourage that we take home all the diapers, bulb syringe/nose thingies, brushes (great for cradle cap apparently but are OR brushes so they can't be bought), wipes, pretty much everything but their shirts and blankets.
It is a training hospital so there may be doctors in training helping with delivery and any other procedures. I get PAs, Nurse Practitioners, etc in training all the time so I'm not too concerned about this. When anything complex or important is happening, the (attending? is that the right word?) fully qualified doctor is there to supervise. For the less important stuff (asking questions, routine stuff like checking pulse and stuff) they might be there on their own, but the qualified doctor dude follows up. Some people seem concerned about this (one person asked "Can we refuse a training doctor?"), but it doesn't bother me really. I know I won't be their first patient. It takes a lot to get to that level. I don't know all the details of how, but I'm pretty sure every form of medical training requires education on childbirth.
Immediately upon birth, baby and mom get tagged with what they jokingly call baby Lojack. Babies don't even leave the room for the neo-natal intensive care unit (NICU) until this band is on. These tags will cause an alarm that goes off if the baby leaves the maternity ward. This alarm locks down the hospital and the entire post until all babies currently admitted to the ward are accounted for. The NICU and csection operating rooms, etc are all right down the hall in the same ward. So once mom is admitted she really doesn't leave the general area.
They reminded us all that they appreciate birthing plans, but that everything is driven by the mother's body and the baby and sometimes due to those two factors, they can't stick to the plan. Their policies are pretty liberal. I can have clear foods and liquids (Jello, sprite, popsicles, water, etc). I can labor in almost any position and even when being monitored, the cord is pretty long and will allow me to reach the ball, rocker, etc. We can rearrange the room in almost any way we want. They encourage the baby be delivered to the mother's belly/chest, dad can cut the cord if he wants, they do everything possible to get baby breastfeeding within an hour after delivery (usually sooner and they highly encourage breastfeeding).
Overall I feel very comfortable with this hospital and the setup/policies. I'm actually afraid I will be a bit spoiled with this, and with my next kid I won't have great facilities. For all I know though, this stuff can all be pretty standard. I just feel like I hear about some hospitals requiring a bunch of stuff to make life easier on the staff or because that is how it was done in the past and putting the mothers' wants at the bottom of the list. (Hell, they even has a snack room where they keep popsicles, jello, etc for us to use during labor).
