Most of us would agree that childbirth is hardly easy.
At the same time, most parents-to-be tend to have a starry-eyed view of their pregnancy and delivery experience. Admit it: We pretty much gloss over those parts of our pregnancy and baby books that cover health problems or signs and symptoms of bigger issues.
It’s not a pretty thing to have to think about when you’re preparing for baby, but safety should always be a part of your pre- and post-birth plans, say experts. “Bad things can happen, although people never think bad things will happen to them,” said Dr. Paul Browne, a maternal/fetal medicine specialist at Augusta University Health.
Your top two questions
Before you ask about the best crib or even the best kind of car seat for your baby, make sure to ask about the best doctor and hospital for you.
When you’re planning to get pregnant, choose an OB/GYN who is board certified, which means that he or she has passed oral and written examinations to ensure they have the expertise to care for and deliver pregnant mothers.
While your choice of hospital tends to be limited to where your doctor makes his or her deliveries, check that the hospital delivers more than 500 babies a year, as these larger hospitals have more resources available for pregnant mothers. Ask too if the hospital runs quality management drills specifically for problems that could come up during labor and delivery, like running through the steps and equipment needed to take care of a mom-to-be with uncontrolled bleeding—and how often it does these drills. Also, ask if the hospital has a neonatal intensive care unit or other specialists available should your baby have unexpected health issues, such as trouble breathing, feeding or maintaining his or her body temperature.
You can also take a look at the list of the best hospitals in your area, as listed by reputable sources like U.S. News & World Report, which reviews community hospitals, or the University HealthSystem Consortium, which reviews academic medical centers.
One challenge is that today fewer hospitals deliver babies, since insurance companies have lowered payments and many just can’t afford an labor and delivery department. “In 1971, 21 out of 25 east Georgia counties had hospitals that did OB,” said Browne. “Today, three do.”
With more limited hospital choices, especially for families who live in rural areas, parents-to-be should also ask their OB/GYN what the plan is if, say, the mother suddenly has a dangerous spike in blood pressure, has heavy bleeding, or a fever and possible infection—either before or after delivery.
While urgent care is fine for colds, flus and other common health problems, women should do their best not to have these facilities be their go-to for a problem when they’re pregnant. The first step should always be to contact your OB/GYN—and many practices now offer secure, online portals where patients can contact their doctor via a private message. If it’s an emergency—even if you’re worried you’re overthinking what’s going on—call your doctor just to be on the safe side.
A new trend is the dedicated Obstetrics Emergency Department. This is an ED that’s dedicated to treating any emergency, urgent or unexpected problem for moms-to-be or for moms and new babies. Augusta University Health has the area’s first certified 24/7 OB ED to provide rapid evaluation and treatment for women having complications related to pregnancy, including pain or bleeding, pre-term labor, unusual breast conditions, bladder or urinary tract infections, or high blood pressure and similar conditions related to high risk pregnancy.
After the baby is born, new moms can also visit an OB ED for symptoms like: drainage from a C-section wound, fever (which could signal an infection), headache (which could be related to high blood pressure), increased vaginal bleeding or infection of breast tissue.
Being your own best advocate
For your safest delivery, the best thing that parents-to-be can do is to practice being an advocate for themselves and for their babies.
“The most important thing about advocacy is being well-informed,” said Browne. Along with baby books like the popular What to Expect series, parents can also visit the American College of Gynecology’s For Patients section for frequently asked questions and more on a variety of topics, including pregnancy and labor, delivery and postpartum care.
Pre-eclampsia, or dangerously high blood pressure, can happen both during pregnancy and after delivery, and can cause severe problems for both mom and baby, even death. Parents should know the signs, which include:
- Severe headache
- Vision changes, like seeing spots
- Severe swelling
- Abdominal pain with nausea
After you go home, also be on the lookout for signs of infection, which could include fever, shaking or chills, tender abdomen and discharge with a bad smell. While you should expect some bleeding, even over several weeks after delivery, it should get less and less. If you suddenly have heavy bleeding, go to the emergency room right away.
“And always ask questions,” said Browne. “While we will never have a zero mortality rate in the United States, what we do want is to get that rate as low as possible with good care both before and after birth.”