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Choosing Where To Give Birth – Not All Hospitals Are Equal

When I was pregnant, I had exceptional insurance that allowed me freedom in choosing where to give birth. Since I lived close to a metropolitan area, I had quite a few options.

At the beginning of my pregnancy, I thought I had selected the “best hospital” – a facility with luxurious birthing suites and the ability to order a steak dinner after giving birth. That sounded pretty awesome!

I started questioning my hospital selection about five months into my pregnancy.  

I hired a doula, and she quickly addressed concerns about my decision to birth at the posh hospital. She knew I desired an unmedicated childbirth and wanted to help me have the best chance at obtaining that outcome.

We talked about home birth, but I didn’t trust my body’s ability to give birth.

Then she mentioned the local birth center, but their BMI restrictions didn’t allow me to go there.

Lastly, she talked about two local hospitals with strong midwifery practices; University Hospital and Denver Health.

a hospital for choosing where to give birth

Denver Health is a county hospital, and I remember thinking early on in my pregnancy that I was glad I had good insurance and wouldn’t have to birth there.

When it came to choosing where to give birth, I equated a “great hospital” to its amenities. I didn’t realize there were far more important factors I should be taking into consideration.

My doula put me in touch with a midwife at Denver Health who, at the time, was managing their midwifery program.

My husband, Chris, and I arrived at a newer wing of the hospital with kind staff. The noticeable difference was plastic chairs rather than the nice padded ones at my OB-GYN's office.

When we met with Eliza Burelle, Chris and I both fell in love with her. There’s truly no other way to describe our reaction. She exuded compassion and made us feel at ease immediately.

The thing that stood out the most was when Eliza said there was only a 17% c-section rate within her hospital, and it dropped to 6% within the midwifery program.

My selected hospital had a c-section rate close to the national average of 30%. It also had a 90% epidural rate.

Until Eliza shared that information, I never realized how important it was to know. I knew because of my weight, I had a higher chance of ending up with a c-section, and wanted to do all I could to lower my risk.

I had no idea that the biggest risk factor for having a cesarean birth wasn't my plus size body.

“The biggest risk factor for getting a c-section is not actually your medical risks or your personal preferences. It’s which door you walk through – it’s which hospital you go to.” – Dr. Neel Shah

Following our visit with Eliza, we took a tour of the labor and delivery floor. We were shocked!

The suites were larger than the ones at our other hospital. They were really nice and the bathroom had jetted tubs to labor in. The nursing staff who gave us the private tour was so excited about my desire for a natural birth and talked about the supportive tools they provided (AKA important amenities).

Chris and I left Denver Health with a BIG reality check!  We also had a NEW hospital and care provider.

Switching to Denver Heath was the best decision we ever could’ve made because a few months later, I gave birth, and it was life-changing. The compassionate care I received will forever stay with me.

Aside from when I was admitted, I wasn’t strapped to any monitors. I received intermittent fetal monitoring via a portable Doppler. This provided me with the ability to move about as I desired and labor in the tub for as long as I wanted.

My care team encouraged me to eat and drink throughout labor.

When I was ready to push my midwife suggested I climb up on the bed on my knees and that’s how my son was born!

plus size woman giving birth on her knees

My son needed extra care following his birth and it was very reassuring to know there was an onsite NICU.

From my desire to have an unmedicated birth to being a woman of size, I felt incredibly supported and respected throughout my experience at Denver Health.

Being in a facility that doesn’t judge you because of your weight is a game changer!

Denver Health provided me with larger gowns and a bigger wheelchair without saying anything about it. They made me feel normal and just as special as any glowing new mom.

I’ll forever be grateful to our doula, who opened our eyes to other possibilities and to Eliza for welcoming my husband and me to Denver Health. Eliza provided me with outstanding prenatal care but wasn’t my midwife during my son’s birth. She did stop by to congratulate us afterward, and that really touched our hearts.

Denver Health midwife

Another fantastic midwife named Magi was the one who helped my husband to catch our son. Eliza had told Magi all about me and was hopeful if she couldn't make my birth then Magi would.

I feel incredibly lucky to have received care from two midwives who helped me to develop a new relationship and trust with my body. Remember that steak dinner, I was informed you can now get that along with amazing care at Denver Health!

Questions To Ask When Choosing Where To Give Birth

When you're selecting where to give birth, here are some helpful questions to ask!

1.  Do you have a midwifery program?

Even if you’re not interested in working with a midwife, the collaboration of OB-GYNs and midwives brings about better birth outcomes.

2.  What are your c-section and epidural rate?

If your care provider or the medical facility doesn't have the exact answer to this question, then it’s safe to assume their cesarean birth rate is around 30%, and the epidural rate is close to 90%.

3.  What is your Vaginal Birth After Cesarean (VBAC) success rate?

If you’re desiring a VBAC this is a critical question to ask.  If you’re not, it’s just good information to pass along to your loved ones who might be interested.  Anything above 20% is outstanding.

4.  Does your hospital policy allow eating and drinking during labor?

There’s a very low risk you could vomit and aspirate while under general anesthesia for a c-section. More and more care providers agree that the risk of aspirating doesn’t outweigh a person's need for proper fuel and hydration during labor. So, be sure to inquire about your selected facilities' policy on eating and drinking during labor.

5.  Is your hospital baby-friendly?

To encourage medical facilities worldwide to have better breastfeeding outcomes, UNICEF and WHO launched the Baby-Friendly Hospital Initiative. If that's important to you, learn more.

6.  Do you allow intermittent fetal monitoring?

This question is especially for people planning to have an unmedicated birth as continuous fetal monitoring is a contributing factor to medical interventions.

Be sure to ask anything else that’s important to you!  

If you want someone to take pictures during your labor and birth, then ask. Some facilities do not allow pictures to be taken while the baby is born.

If having many people in the labor and delivery room is desirable to you, be sure to see if there are any limitations.

Remember, just like you have the right to fire your care provider anytime, you also have options for choosing where to give birth. With insurance limitations, this can be challenging, and you might have to switch care providers. However, speaking from experience, I can share it is worth any headaches!

I created the video below interviewing a nurse, a chief of obstetrics, and a midwife (Eliza) to highlight Denver Health and show thanks for all they did for me. Please take sixteen minutes to watch it and learn a lot about the midwifery model of care.

Jen McLellan, CBE
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Alyssa S

Monday 6th of June 2016

Thank you so much for this inspirational post. My husband and I are TTC and I have been wondering which hospital to give birth at. I work at the Anschutz Medical Campus, but have heard the midwives and OB's do not communicate which frightens me since I want a midwife, but an OB nearby if anything does awry. I work with a Denver Health OB and she raves about their midwives and what a wonderful program they have there. I will definitely be getting my care from Denver Health... who knew, a county hospital, I never would've guessed I'd be picking Denver Health.

plussizebirth

Tuesday 14th of June 2016

I never thought I would've picked Denver Health either but honestly it was one of the very best decisions I've ever made in my life!!! I LOVE Denver Health and the midwives are outstanding. Try to see Eliza if you can ;)

Amber Talbott

Friday 9th of August 2013

This is awesome! I had a natural birth because of my doula who was my greatest supporter. It's so empowering and I had the stamina to last through 63 hours of labor despite my size. I agree with all your comments and questions but also ask them of your doctor and their practice.

plussizebirth

Saturday 10th of August 2013

63 hours of labor?! You're a rock star! I completely agree these are critical questions to ask your care provider as well. I'd also add about 10 more questions to ask your care provider but that's a whole new blog post. Thanks for reading my blog Amber!