About your care provider:
Do they understand your birth desires? Sometimes there is no planned time to share what your desires for your birth are with your doctor or midwife. If it is not a scheduled appointment, then ask for a longer appointment time so that you can discuss your desires. Sometimes this is done really late in the pregnancy and it becomes apparent that they may not agree with your desires. But early in pregnancy you may not have formulated your desires yet. So, changing providers, although an option, is not one many people want to do. But don't be afraid to share your desires and your plans expecting them to honor your wishes even if it is not what they would normally do. This is a consumer driven industry and you do have a say in your birth process. The law says they must give you informed consent. Ask questions, you have to live with the repercussions of the decisions.
What is the induction protocol at your provider's office? There are many doctors and midwives that don't even start doing vaginal exams until the 41st week. Then others do them at 36 weeks and arbitrarily do stripping of the membranes each exam thereafter. While others will schedule your induction date after you have gone 40 weeks. You are due between 38 weeks and 42 weeks- that is when you are "late." So, ask ahead of time or before an exam is done what they plan to do. Even better, ask in mid to early pregnancy what their normal protocol is.
What about malpresentations? Does your doctor perform external versions if the baby is breech? Will he let you have a trial of labor for a vaginal breech if you have had a previous baby and have a "proven" pelvis?
If he or she is a solo practioner, who is the back up care provider? Many times you select a solo practitioner and then you find out that he shares weekend call with some other solo practitioner. So much for knowing who will be at your birth. Ask ahead of time about this and set up a time to at least meet the back up, just in case.
About breastfeeding preparation:
What shape are your nipples? If you plan to breastfeed you can overcome problems ahead of time if you make sure you do not have flat or inverted nipples. There are preparation techniques that will help to make it easier to breastfeed. Don't wait until the baby is born to address those issues. Go to La Leche League meetings while you are still pregnant. I can't stress the importance of meeting with other women who are nursing before your baby is born. A pound of prevention is worth a ton of cure!
Do they expect a large or small baby? There are weight limits that cause certain protocols at different hospitals. If so, having a lactaid or SNS system in your labor bag would help to assure if the baby needs supplement due to low blood sugar, you can do so while having the baby at the breast, not a bottle. The best thing to do is not have the baby weighed until you have had a chance to nurse the baby at both breasts. The colostrum goes a long way to raise blood sugars.
What is your pediatrician's stand on breastfeeding? Will he come to the room while you are still hospitalized so that the exams can be done there and your baby can avoid going to the nursery? Did she breastfeed, or did his wife? How long? Even if you do not know how long you plan to do so, it is helpful to find out how positive the environment will be beforehand.
About baby separation:
What is the hospital's protocol regarding baby procedures? Have a baby plan- tell them what you want. Again, they respond to consumer demand. Write a letter to the head of nursery staff and have a copy of it upon arrival. Let them know what you need- a delay in the bath, or eye ointment, or Vitamin K, no circumcision, no immunizations, etc. This is your baby. You decide what you want to have done if the baby is healthy. Routine procedures don't have to be so routine. Room your baby in so that you know what is being done and so you can have bonding time with your baby.
If you want a lactation consultant, ask as soon as the baby is born to have your name on the list. Do they have 24/7 lacatation consulting? Doubt it. Do they have weekend help? Doubtful as well. All the more reason to go beyond the lactation class or books you have read to the attendance of LLL meetings.
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