Having the choice of maternity is certainly a privilege that not all French regions enjoy. But when the choice exists, another problem arises: how to differentiate one maternity from another. Future parents often feel a little lost and helpless.
So, beyond the advice, sometimes contradictory and subjective, from girlfriends or word of mouth, here are all the objective questions to ask yourself …
What is the distance between the house and the maternity ward?
“This is one of the first questions you have to ask yourself when choosing your maternity ward,” recalls Dr. Bernard Maria, obstetrician-gynecologist. “Apparently innocuous, this question is nevertheless essential. Geographical accessibility must be easy, this is one of the first tips in terms of security. »Use your common sense. Security is a maternity hospital that stays close to where you live.
Does maternity level 1, 2 or 3 matter?
This indication has no relation to the quality of maternity, but with its level of equipment for taking care of babies.
Level 1 is intended for pregnancies without foreseeable risks. If a problem arose, the baby and/or the mother would be transferred to a level 2 or 3 maternity unit, structures working in a perinatal network.
A word of advice, however: before registering, ask which facility the baby would be transferred to in the event of an unforeseen problem and whether or not the mother will be able to accompany him.
Level 2 and 3 maternities welcome pregnancies considered to be at risk. Level 2 has a neonatal service, which concerns 6 to 8% of pregnancies, and level 3 has neonatal resuscitation (most often integrated into a CHU), necessary only in 1 to 2% of pregnancies. . “Remember that 98% of pregnancies go well and that level 1, therefore, offers a sufficient level of security for the majority of them”, specifies Dr. Bernard Maria. Besides It is not uncommon for mothers who have given birth in level 3 maternity hospitals for a normal pregnancy to end up being disappointed with the little attention that has been shown to them from a human point of view, with medical staff busy managing more serious cases. Better than a level 1, where you will be more pampered …
Is there an obstetrician-gynecologist, pediatrician, and anesthesiologist on site 24 hours a day, 7 days a week?
Continuity of care is a guarantee of safety. So that these three health professionals – gynecologist-obstetrician, anesthesiologist, and pediatrician – are present permanently, it is necessary to choose an establishment practicing at least 1,500 births per year, it is the law which imposes it on them.
As a precaution, to know the workload of the anesthesiologist, ask if he is attached only to the maternity ward or if he also works for other departments of the establishment. Important detail so as not to wait hours for your epidural …
Read also: The epidural, anesthesia to give birth without pain
Is there a preferred size of establishment?
Establishments providing 1,500 to 2,000 deliveries per year should be chosen as a priority. Several reasons for this: the reception of mothers is more pleasant and the results are better there in the event of normal pregnancy.
In establishments where more than 2,500 deliveries are performed per year, parents see motherhood as “a baby factory” and often criticize the lack of support, while in maternity hospitals with around 1,500 deliveries per year, parents teams are no longer available.
In addition, a study by Audipog (an organization that collects data from maternity hospitals) shows that there are fewer hemorrhages, fewer cesarean sections, and fewer traumatic injuries in these medium-sized maternities.
Choose a public or private establishment?
One of the fundamental differences between the public and the private is the coverage rate. In a public establishment, all medical expenses are 100% covered by the Primary Health Insurance Fund, provided that you do not opt for a private consultation. and with the exception of the additional cost related to the single room, the telephone line, and the television. It should be noted that fee overruns are frequent in private establishments.
Check with your mutual insurance company to find out if it covers them.
An advice : in private maternities, do not hesitate to ask for doctors’ fees, hotel costs and various supplements. Some clinics also charge for the baby’s sheets, diapers, sanitary napkins, etc. The easiest way is to ask for a quote to avoid unpleasant surprises.
If you absolutely want to be followed and given birth by the same person, the solution of the private clinic where your obstetrician-gynecologist gives birth is essential. By giving birth in a public hospital, you risk being seen by two or three different midwives and if everything goes normally, they and they alone will give birth to you without the intervention of a doctor.
What are the institution’s episiotomy practices?
We have long thought that episiotomy (incision of the perineum) facilitates the passage of the baby and prevents tears. This is incorrect! Today, the National College of French Obstetricians and Gynecologists condemns systematic episiotomy, which has been practiced for too long.
This intervention should only be considered on a case-by-case basis. The episiotomy rate is, therefore, an important figure, reflecting the existence of abusive practices.
Read also: Episiotomy is not mandatory during childbirth
“The announced targets for the average episiotomy rate should be around 30%. In other words, if an establishment in practice today more than 50%, one can say that it does not meet the current requirements in the matter ”, assures Dr. Bernard Maria, gynecologist-obstetrician.
What about the trigger rate?
The objective for you is to know if the triggers performed in the establishment are for medically founded reasons or if there is a systematic policy linked to reasons of organization of the maternity hospital. “The average trigger rate is 20%.
If a level 1 maternity exceeds this bar, it suggests a practice of convenience triggers. However, the latter exposes, in the event of a normal pregnancy, to the doubling of the rate of cesarean section and to more infectious complications ”, insists Dr. Bernard Maria.
What is the cesarean section rate for the maternity ward?
Today, the average cesarean rate is around 20%. “If a level 1 maternity hospital reaches a rate greater than 20%, we can assume that she performs cesarean sections excessively and unnecessary”, assures Dr. Bernard Maria.
To read also: How to manage the post-cesarean section?
“On the other hand, if it is a level 3 following pathological pregnancies, it is normal for the establishment to carry out more cesarean sections. However, if this rate reaches 50%, there is cause for concern! ”
What is the rule when it comes to epidurals?
The rate of epidural or locoregional anesthesia varies from one maternity unit to another from 70 to 90%.
- Below 70%, it is legitimate to wonder about the availability of the anesthesiologist: perhaps he is not present on site 24 hours a day, which is not favorable to a good intake. pain burden.
- Above 90%, we can imagine that little room is given to natural childbirth and that the teams are rather interventionist.
Do you have personal comfort requirements?
More personal questions are also taken into account in the choice of motherhood. Think carefully about the more subjective criteria that are essential for you and your comfort.
Do I favor a more natural childbirth?
Beyond the numbers regarding the epidural rate, ask the medical staff about the alternatives offered to manage pain and labor.
Read also: Choose natural childbirth?
Is it possible to take a bath or a shower? To benefit from acupuncture sessions? To walk during work? To use balloons to help the baby’s descent? Are other delivery methods accepted: in a swimming pool, other positions (on the side, standing, on all fours, etc.)? Read also: Prepare for childbirth in a swimming pool
Am I ready to try other types of birth preparation?
Apart from the classic method, some maternities offer preparations such as autonomy, reflexology, sophrology, prenatal singing, acupuncture …
Read also: The classic preparation for childbirth, instructions for use
Find out before registering and check where the sessions take place (important detail that we do not always think about and which becomes essential at seven months of pregnancy!).
A wider range of preparations testifies to a team concerned with more personalized accompaniments.
Can someone take care of my child at night?
Childbirth is a unique moment, but also intense and tiring, and some mothers want to be able to rest for one or two nights without their child by leaving it to the nursery.
Find out if a nursery nurse is present at night and if there is a nursery in the structure, which is not always the case.
Note that some maternity hospitals only take care of the baby the first night.
Ask how the nursery is organized and how many babies are accommodated.
Can the father actively participate in childbirth?
If your husband wants to be more involved, ask if he will be able to stay next to you, if he will be able to accompany you to the operating room in the event of a cesarean if he will be able to cut the umbilical cord or be present during the first toilet.
Also ask about the possibility that he will stay with you the first night.