For a Safer Birth
Labor and Fetal Monitoring
* Before going to the hospital, find out the minimum number of nurses that are supposed to be on duty at any time by asking the nursing office.
* When you first arrive at the hospital and at the beginning of each shift, find out if the number of nurses reporting for work matches the minimum number required. If the unit is short-staffed, ask the charge nurse to assure you that you will get all the attention you need. If you feel that the staffing level is unsafe, contact the hospital management and the health department.
* Make certain that the fetal monitor stays connected and that a nurse is checking it often.
* Ask your doctor to tell you the normal range for the baby's heart rate (number of beats per minute).
* Watch the monitor for the baby's heart rate especially during contractions (this should be the job of the baby's father or birthing coach). If the heart rate falls below or rises above the range set by your doctor (usually 120 to 140) during the contraction, get the nurse, tell her to call the doctor, and don't take "no" for an answer.
If you are thinking about using a natural birthing center with a nurse-midwife (some hospitals have them on-site), make sure the following conditions exist:
* Fetal monitoring must be provided during labor.
* There must be an agreement with a covering obstetrician (medical doctor) who will review the prenatal care with the nurse-midwife and provide medical intervention in case of any complications.
* There must be a hospital within a reasonable distance that can receive you and your baby (after delivery) and provide medical care in case of any unforeseen complication.
* There must be a fully equipped crash cart for resuscitation if needed.
* There must be a paramedic ambulance standing by or available within five minutes for transport.
* If you have decided to take a narcotic, be aware that there is a risk of depressing the baby's breathing at birth. Starting with the lowest possible dose would be prudent.
* If you opt for spinal anesthesia or epidural, be aware that it will increase the likelihood that forceps will be necessary.
* After forceps or vacuum extraction delivery, check the baby's head very carefully for any bruising or deformity. If you have any doubts, express your concern and ask for reassurance.
Complications After Birth
* Ask the doctor to examine your baby's color, alertness, and breathing upon arrival in the nursery.
* Check the strength of your baby's suck during the first feeding.
* If you have any doubts, speak up and don't stop until you get a satisfactory response.