What to Ask When Expecting

The man who asks a question is a fool for a minute, the man who does not ask the question is a fool for life.
-Confucius

When it comes to your own health or your family's health, there is no such thing as too many questions! You should question everything!

First, how is this related to my current enrollment in chiropractic school? Because as any health professional it is unrealistic to think you will never come across any infants or pregnant women. I hope to work with them daily when I graduate as family health education is my passion! So even if you are not comfortable giving advice or discussing any of these particular topics in depth at least you are aware of what they are!

If you know me personally, I may take this to the extreme. I think it is important to research any product, medicine or procedure when it comes to my family. It never hurts to know more, but it can definitely be detrimental not to know enough.

I'm currently 38 weeks pregnant and still ask new questions every time I see my midwives. Naturally, I have had people ask me what I ask my midwife or physician. Below is a list of questions or topics I think is important for parents to become familiar with and have an opinion on! I'm sure I'm missing some! Fill me in below with anything I missed!

I have decided to keep my own opinion to myself on most of the topics because I think it is important for people to do their own research and consult medical professionals! I am always open for any one-one conversations though based on my own experience or research! As I am writing this I am also realizing many of these topics could be their own blog posts!

Again...

DISCLAIMER: This is not medical advice. These are simply my own thoughts and experiences with my two pregnancies. Consult your licensed medical professional on what is best for you!

PRENATAL:

-Payment: Make sure your insurance provider is aware where you are going; also if you plan to pay out of pocket... how much is it going to be? There are usually prenatal care fees and hospital fees. Make sure you look into both. This just reminded me to call my insurance asap to get preauthorized before I go to the hospital for birth. Also, if you have 2 insurances, many places only submit to one; therefore you would be responsible for submitting to secondary insurance for reimbursement.

-Supplementation: What supplements do they recommend? How often? I was not a heavy supplement taker in either of my pregnancies, basically just because it made me feel more miserable than I already was. It was more important for me to focus on a well-balanced nutritious diet.

-Chiropractic care: Do they have anyone they recommend for Webster technique? Chiropractic care can be used prenatal, during labor, and postnatal. It is so beneficial for YOU & BABY postnatal.

-Genetic testing: What is available? How much? This might also warrant a call to your insurance company to see what they cover. I choose to do non-invasive genetic testing available, I feel the more prepared I am the better. Also, it is completely non-invasive and is just a few vials of your blood.

-Ultrasound policy: typically it can be one for confirmation, a 20 week anatomical scan & possibly one at the end for growth, fluid levels and placenta condition. I personally wanted as few as possible!

-Fetoscope: Do they have access to one or the ability to use one? It is a specialty stethoscope to listen to baby's heartbeat instead of a doppler or ultrasound. I opted for a fetoscope for this pregnancy! Here is picture below from my midwife office.

-Glucose test: What are your options? I opted out of the mainstream drink. Below are the alternative options my midwives offer. I personally fasted overnight, got my levels tested, ate 10 Twizzlers in 5 minutes then got my levels tested exactly an hour later. I wish I would have did the most natural option of the jelly beans, but of course I forgot to go to Whole Foods and get them!

-Vaccines during pregnancy: Flu vaccine and DTAP. Do they require or mandate it? Some practices don't offer them at all. Check out safety studies, ingredients and side effects to make an informed decision.

-Hospital tour and classes: Are there any mandatory classes you need to attend? Mandatory hospital tour? Many times for first time parents both are mandatory. I found the free classes offered when I was in North Carolina valuable and fun. I also think if you are able to do a hospital visit, you definitely should so you have an idea of what to expect. I did not have to take any mandatory classes this time around being my second, but it was mandatory for me to take a hospital tour in order to give birth in the alternative birthing rooms.

-Doula: Do they recommend one?

-Breast pump prescription: Just something to be aware of so you can get it ahead from your midwife or physician! Generally, all insurances cover an electric breast pump with each pregnancy. There are plenty of great companies to go through that deal with your insurance. This time around I went through a company called Pumping Essentials. It was seamless and painless!

Hospital bag: Anything they recommend on bringing? My midwives suggest extra pillows because they said they never seem to have enough! I would have never thought of that without them suggesting it. Also, are they cool with you brining your own hospital gown? Essential oil diffuser? Flameless candles? Music?

Cervical check/membrane sweeps: Do you have to do them? When do they start performing them? Just as a reminder, you don't have to do anything you don't want to do! That is why confidence and research is so important! My midwives are cool with doing them or not doing them at all. Be in charge of your own care!

DELIVERY:

-When to come: Where should you go to the hospital or birthing center?

-Rooms: Do you have to share a room under any circumstances? Are the birthing rooms different from the postpartum rooms?

-IV policy during labor: It is mandatory at my hospital due to me hoping for a VBAC; however they would not mandate it if I was not a VBAC and was a low risk birth. I have to have one in but it does not have to be hooked up to anything. Personally, I would not want one at all if that was an option.

-Students: Do you care if students attend your birth or prenatal visits? Sometimes this is an option and they usually ask you ahead, but may put one way or another in your birth plan.

-Induction policy: What is their policy? Most settings will not let you go past 42 weeks. Induction to me is meant for emergency situations or last resort.

-Pain management: What are your options? Personally, I plan to use homeopathy and acupuncture before, during and after labor. I had to confirm that was okay with my midwives and the hospital before moving forward. Other options I'm bringing are my rebozo, tens unit & stability ball. The hospital also offers nitric oxide, squatting chair/bar and a birthing tub for more natural pain relief options.

-Fetal monitoring: What is the policy? At my hospital since I am VBAC I have to have constant fetal monitoring, but it is cordless and waterproof!

-Food: Are you allowed to eat during labor? Can you bring your own food? What foods do they recommend?

-Intervening: At what point do your midwives or physician feel the need to step in with other methods? When your dilation has stalled for a certain amount of time? When your water has been broke for so many hours without progressing? When baby isn't moving through the birth canal like they want (vacuum or forceps)? When you are bleeding to what extent? Personally, my midwives call in an DO if they feel it is absolutely necessary to use a vacuum, forceps, repair excessive tearing or an emergency c-section.

-Episiotomy: Do they perform them? Pretty outdated, but better to ask than not know!

-The Catch: Do they allow a significant other to catch the baby upon delivery?

-Visitors: Currently the hospital I am delivering at has a restriction on visitors due to the flu. I am only allowed 3 people my whole hospital visit. The 3 people must remain the same 3 the whole time. Also, no one under 16 is permitted. What is their policy? Do they care who you have in the delivery room?

POSTNATAL:

-ER Medicine: Is there a NICU available? What is the general procedure if there is an emergency situation for baby or mother?

-Delayed cord clamping: Delayed cord clamping is becoming automatic even in mainstream hospitals. The general rule of thumb is to not cut the umbilical cord until it stops pulsing (meaning all blood/nutrients have transferred to baby). This can even be done with c-sections! A longer duration of leaving the umbilical cord attached is called a lotus birth. The family chooses to leave the cord attached until it naturally separates, very cool!

-Vaccines: Vitamin K and hepatitis B vaccines may be given at the hospital. Do they try to mandate them? Are you allowed to delay? Many times they are given unless told otherwise.

-Antibiotic eye ointment: This is generally put on the baby's eyes after birth. Be sure to make it clear if you want it or not.

-Kangaroo care: Meaning no nursery? Bili lights available in room in case of jaundice? For me this means as much skin to skin with mom and dad as possible. This also means the baby leaves the room under no circumstances unless it is an emergency. Newborn screening can be completely done in the hospital room. It was with my son Steil and will be with my next baby. This involves a blood test for certain disorders and a hearing test.

-Bath policy: Recently a study came out showing that breastfeeding rates increase if a hospital bath is delayed. This is great, however I think this lacks to point out the importance of vernix. Vernix is the whiteish protective coating on the baby's skin after he/she is born. Neither of my children were/will be given baths in the hospital. I plan to wait as long as possible anywhere ranging from 5-14 days.

Link for study on breastfeeding rates & delayed hospital baths: breastfeeding-rates-rise-if-newborns-bath-delayed-cleveland-clinic-study-finds.html

-Supplementation and pacifier: Does the hospital supplement with formula? Do they give babies pacifiers? In most circumstances nowadays, the answer is no to both unless you say otherwise. I just make it clear- breast only, nothing else; so there is 100% no confusion.

-Pediatric evaluation: What does this all entail? This time around we are choosing to have a pediatrician from the outside come in after the baby is born. He does have privileges at the hospital and they call him immediately after baby is born. I am just more comfortable with the person who is going to be the baby's pediatrician after we leave the hospital doing the evaluation. Obviously in any emergency situation, all of this is out the window and baby's health is always #1 priority.

-Placenta encapsulation: If you choose to do it, does your hospital provide a cooler and ice? My first hospital provided a small tub and ice. My current hospital provides ice, but we will be bringing a small cooler. The person I hired will then come to the hospital to pick it up and start the encapsulation process.

-Lactation consultant consultation: Are they always LCs on staff? If you have a bad experience with one, DO NOT let that deter you from trying another! With my first Steil, I went through 3 different ones until one clicked! They are truly an invaluable resource in your breastfeeding journey. Also, many pediatric offices offer them as a part of your infant care.

-Lip/tongue tie evaluation: In relation to above, do they have qualified individuals to check your baby for a lip or tongue tie? A breastfeeding journey can be inhibited if these go unchecked. This was one of my questions at my last midwife visit. Also, if a tie is present, do they have the ability to correct it before leaving hospital or can they refer you?

-Discharge: How long do families usually stay? What if you want to leave early?

-General recovery: Pain management options? I know for my emergency c-section they sent me home with some heavy duty narcotics that I opted not to take. How long should you expect recovery to take in case of a vaginal or c-section delivery? What are the general maternity leave rules? This is also something you should consult with your employer! Also, find out your pumping rights for your work, so there is no confusion!

Other topics to research: Cluster feeding (this was the biggest shock for Brady and I in the beginning with Steil) it is truly invaluable knowing what to expect feeding a newborn, cloth diapers, glass bottles, etc.

I plan to share what I registered for this time around and what products I can't live without! In the end though, all I need is some cloth diapers and boobs! Also, what is in my hospital bag? I'll share when I actually get it done!

TELL ME WHAT I MISSED! I'd love to add it and give you credit. I would love for someone to be able to print this and just go down the list with their midwife or physician.

What topics should I expand on more? There are so many options! Let me know!

 

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