Monday, May 23, 2011

Hospital L&D Tour


Yesterday I went with my doula client on the tour of her hospital's labor and delivery unit. I've wanted to do this in the past, so I was excited to do it, especially at a hospital I hadn't been a doula at yet.


Unfortunately, both my client and I had heard that this particular hospital was not majorly doula-friendly. I had also heard that it was not a natural birth-friendly place, and had a high cesarean section rate. Oy. 

The first thing we did was sit around a table in a classroom while she told the group what procedures they could expect during labor, during and after delivery, and postpartum. The nurse leading the tour spoke in the most patronizing way - like she had a lifetime of experience of talking down to her patients. This wasn't just my opinion - my client agreed that we were being spoken to like we were children! And the voice and mannerism never let up - it was like the nurse talked like this all the time without realizing it. Very odd.

She also spent a lot of time on strange details like how any cameras or laptops that we brought had to be battery-powered because although there were outlets in the room, we can't use them in case they were needed in an emergency. I found that an odd 3 minute rant... She also spent time talking about how if you have a dog at home, you need to take home your baby's first hat (the one covered in vernix) and give the hat to the dog so they can get used to baby's smell. It makes sense, I guess, but relevant to knowing what the labor and delivery experience will be like? Nope.

She did not leave an open atmosphere for questions, or solicit questions.

We visited the labor and delivery floor to see a room, and I noticed the floor was totally empty. Not one room's door was closed. The place was totally empty! The nurse emphasized how "homey" the room felt, with all its wood instead of metal. The L&D room looked just like the room I had seen in one other hospital, which happened to contain the most irritating L&D nurses yet (yelling and "if you're breathing you're not pushing!" kind of thing). I wonder if there is a correlation between the hospital's effort to make the room feel "homey" and worse L&D experiences. 

Then we went up to the nursery on one of the postpartum floors. The nursery only had 2 babies in it! Granted, the hospital practices rooming-in, which is great, but only 2 babies in the nursery and 0 women laboring on the delivery floor made the hospital seem like a ghost town. The postpartum room was small, just like all the postpartum rooms I've been in, with an uncomfortable couch for the partner to sleep on.

Luckily, the hospital seemed very pro-breastfeeding. She repeated several times that they want the baby to be skin-to-skin as soon as possible because it helps with breastfeeding success. Unfortunately, who knows how long the skin-to-skin will last, and how helpful the postpartum nurses and lactation counselors will be. Someone asked about Lactation Consultants and the nurse said you could "request" one. I'm guessing that means its not standard that everyone see one, and that the LC is not there all the time.

At the end of the tour we asked if the newborn procedures (APGAR, heel prick, eye gel, vitamin K, etc) could be done with the baby on the mother's chest. The nurse thought for a really long time and said she really didn't know, no one had ever asked before and she had never seen it done (not good odds that it will occur then). She assured us it all gets done in "a blink of an eye" while mom is going to the bathroom anyway, so we won't even notice. I've never seen it happen in a blink of an eye, I've seen mothers and fathers peering sadly over at the other side of the room wanting to see and hold their newborn that they worked so hard for and who just got whisked away. It usually takes as long as it takes for the doctor to stitch the mom's perineum if she has torn, which is a while. We also asked about rooms with showers and tubs, which the nurse said are only in two of the room, and are reserved for the mother's who want to go natural. This makes me sad.

I was nervous to ask irritating questions about epidural and cesarean section rate, as I was there with my client, and I didn't want to further give doulas a bad name.

What questions should we have asked? Have you been on a hospital tour with your doula clients?



A blogger at Science and Sensibility just posted a blog about taking a hospital tour - If you'd like to check it out, click here.

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