Go for it!!

You are so blessed! Please don't base your decision off what you think other people think you should do. Just continue doing what you were doing before and if you have more children, that's great! And if you don't end up having more you will never have regret of wondering what if. Also, seeing you share about your age is encouraging to me! Just recently had my first at 29

@@monicag.1527 , thank you so much for your encouraging words! ♥

Thank you for sharing! It is an encouragement to hear your experience as a 34 year old with the first on the way. ☺️ Hoping for a few more but society already makes it seem like Im at the “end” of my window.

Nurse Zabe hasn't responded to you yet, but I'm a doula and I have some thoughts. What you want to ask really depends on what your priorities are, who is doing the tour, and how big the labor ward is. Let me explain why each of those matters before I go further. "What your priorities are" is a 2-parter. First, do you know what is most important to you and what you're willing to compromise on? And second, if all of the hospitals in my area answer this wrong what will I do? It's rather common for the good natural birth hospital in the area not to be the good breastfeeding hospital. The hospital that does the most planned C-sections might not be the hospital with decent PP rooms. How far are you willing to go if you get the wrong answer? Will you switch doctors or midwives to change hospitals? Would you seek out a birth center or home birth if you're not okay with what you hear? To put it super basically: what do you intend to do with the answers you get? "Who is doing the tour" is simpler. Ideally, the person doing the tour is a labor nurse who works in that hospital and also happens to run the tour. That person is going to have a great idea of what actually goes on, not just the official line. Some hospitals have dedicated educators who just teach classes and don't take patients. I've even heard of a non-nurse unit secretary running the tour. If it's not a nurse who actually works on the ward you have to take the answers with a heavier grain of salt, and you may even be better off calling the unit on occasion to ask a few questions of an actual labor nurse. And third, "How big the labor ward is" is very straightforward: The bigger the unit the more nurses they'll have on hand at any given time and the more likely it will be that you can request a nurse that does a lot of your preferred type of birth and/or get a new nurse if you don't gel with the first one. I'm not saying a bigger ward is better, but the more options you have for nurses the more likely you are to find one who will bend the rules for you. I always recommend being super nice to the nurses, even if you don't like them, because being nice will get you places and win friends when you need them. Some people even bring a basket of goodies for the nurse's station with a sign saying something like "Thank You from Katy, Jordan, and Baby Smith in room #1234" to get in everyones good graces before you even meet them. Keep each of those previous things in mind when deciding what to ask and who to ask. Also, keep in mind you'll likely get the most detailed answers to the most questions if you take the hospital's "birth class", which is really more of a "how we expect your birth to go in our hospital" class.

1. If you're planning on hiring a doula I would do that before any hospital tour or class (early to mid-second trimester) and ask your doula about what their experiences are with the hospital and provider and what they think you should ask given your specific ideals. If you plan to take a childbirth class outside the hospital (which I highly recommend, but I am an independent CBE myself so I'm biased) you can also ask your educator for their input. This is my first suggestion because it's local to your hospitals and personal to you. 2. Ask about training and staff. Training and staff make the biggest difference in your experience. If we know enough, we care enough, and we have enough people available we can make just about anything happen. Are the nurses trained in spinning babies or use of the peanut ball? Do they do that on their own time or is it provided by the hospital? Are the labor nurses trained in feeding, and specifically your chosen method of feeding at birth? Don't assume a lactation consultant will be available because babies are born during nights and weekends sometimes and the LCs might not work those hours. Do the LCs work those hours and do they see people in the labor room for the first feeding if necessary? If an epidural is an option for you (even if you don't plan to use one) can the nurses adjust the dose or bolus it for you, or do they need to call the anesthesiologist back in to do that? Can you press a button to bolus it yourself? 3. Policies. Some policies are in place for safety and some are archaic or inconvenient. Do they have a policy on decision-to-incision time for emergency (not just unplanned) C-sections? Is it 30 minutes or less? Do they offer "gentle" or "family-centered" cesareans with a clear drape, the option to have a support person cut the cord (a section of it, typically the doctor will cut it long so Dad or someone else can still cut it), baby on your chest in the OR, nursing in the OR if you want, etc? Do they have a rapid-response plan for pre-eclampsia, amniotic fluid embolism, hemorrhage, shoulder dystocia, etc? How many or how few people (staff and your support people) can be in the room while you're pushing? How many people can go with you to triage? Is your doula counted in the normal support person "limit" or are they considered a part of your care team? 4. Equipment. Equipment is great, but like I said before most things can be accomplished if you have enough people who care and know what they're doing. The opposite can be true as well, though. Sometimes if the equipment isn't there or isn't available there's no amount of DIYing that can accomplish the same effect. Do they have peanut balls of various sizes and are they available to all of the rooms, some of the rooms, or from a limited central supply? (If they're not in every room ask your doula if they have one, or consider bringing your own if your doula or the hospital nurses know how to use them. Mark it with your name and phone number so they don't mistake it for their own) Do they offer active birth equipment like a hanging rope, floor mats, beanbags, low stools or birthing stools (like the CUB or Kaya), yoga balls, and/or squat bars? Do they have wireless monitors? Are they waterproof or waterproofable? Do they have dopplers? Do they have a portable ultrasound that can go to your triage or labor room? Do they have clear drapes for the OR? Do they have tubs or pools to labor or birth in? How many? Are they stationary in the room or are they inflatable and can go to any room? Do you need to provide a liner? Do they offer nitrous oxide?

There are a million things you can ask. My "run for the hills" questions and answers are as follows: 1. 'If I NEED someone else to care for my baby for a while and I have no one I know with me, will someone take my baby and care for them for a few hours?' This is the one I would ask if I could only ask one question, even if I was sure I'd always have help. If the answer is a straight "No" I would run. This answer doesn't mean the nurses don't care, but it does mean they aren't staffed well enough to handle 1 high-needs family and if things go wrong they're likely to fail you. Poor staffing either means the hospital is low-quality all around, or they don't treat their nurses well enough to keep them on staff and that means the nurse you get is likely burnt out or burning out. 2. 'I will not be consenting to XYZ unless there is a real, immediate need. I've talked about this with my care provider. How should I expect that to go over?' If they're overtly judgemental or try to tell you that not consenting to or not receiving XYZ "isn't allowed" I would run. If you're more the go-with-the-flow type and you don't have strong opinions about anything you can skip this, but I always think it's good to know how much they actually support your right to autonomy. 3. 'If I needed an emergency C-section how long would it take from the time we made that decision until anesthesia can't start giving me an epidural or spinal? If my doctor isn't in the hospital when the decision is made how long will it take before a doctor is ready to start the surgery?' This speaks to their in-house staff and what they're capable of in a knock-down-drag-out emergency. If I was choosing to give birth in a hospital I would want this process to be very quick, otherwise I might as well just have them at home, IMO. In a serious emergency, but not one where you or baby have lost your heartbeat, the time from the decision, until you're getting anesthesia, should be (IMO, I'm not a doctor) about 15 minutes because that's about how long it takes to force a liter of fluid into your body (to support your blood pressure) and get you set up for anesthesia to start doing their thing. IMO, again, not a doctor, I think the surgeon should be ready to go as soon as your epidural/spinal is working and you're prepped for surgery. If they told me it would be 45-60 minutes in a true emergency that would signal to me that that isn't the best hospital to deal with a true and serious emergency. You could also phrase this as "Minimum time from decision-to-incision in the OR with regional anesthesia". I, personally, would want to hear 30 minutes or less based on the conversations I've personally had with OBs and L&D nurses. Of course, those questions are based on my priorities, not yours. Again, I highly recommend you engage a birth doula and a childbirth educator to help you identify your priorities and what you may encounter. I wish you all the best in your journey! Apologies for any typos or mistakes. I tapped this out really quickly while waiting to hear news at 3am and trying to work my brain and stay awake.

maybe she thought she was prepping you for a c-section? otherwise can`t imagine what shaving would be good for

Knowledge is not only power, EMPOWERMENT!!! Learn all that you can and more. If it means you have to tell them how to do their job, than so be it. You don't have to make it sound mean just because you know you're right. And if it needs to be mean (or blunt) then so be that too. It's your body! Stand up for your wants and wishes. Never be afraid to have someone removed from your case either. Hope this gives you the courage you need😊

Have an extremely specific birth plan-obviously a realistic one, but be very specific about what your preferences are for eeeeeeverything and go over it in advance with your OB. You can find free templates online to fill out! If you’re not able to advocate for yourself during the birth, inform your birth partner and have them keep a copy of the birth plan with them as well so that they can help communicate when you may be unable to.

You should be able to call the medical records department and request a copy. Most places charge though, so ask them how they go about that

You got it! 🙏

@@Nurse_zabe thank you so much!!!

Not sure what things are like in your country, but talk to your OB or call the hospital and speak with a postpartum nurse. Ask if it's possible to either keep your baby if they do not have a high bilirubin count, or if they can bring your baby to you that third night for feedings. If you are wanting to, mention that you want to exclusively have your baby breastfed and don't want them to have formula. If for whatever reason they won't allow it, pumping overnight would be best to protect your supply.

No, there is not. But the risks are bigger with every C-section you have. There are countries (developing countries) where to this day with your 3rd or even 2nd C-sections will tell you that you they “have to” tie your tubes. Generally with the first two C-sections any provider is comfortable, starting with the 3rd let’s say the surgeons will sweat a bit more.

After 1 year of trying, or after 6 months if you are 35 or older or if you have any specific health known issues

Why wait?! Better to know up front, rather than try for a year or two only to find out you could have been pregnant by other methods years ago

If you're young, track your ovulation, and have regular periods (basically everything being perfect), 1-3 months. If you're the average person, 3-6 months. If you're subfertile due to age, male factor, or irregular ovulation but otherwise have a good hosting environment for baby, 6-12 months. Beyond 12 months you're medically considered infertile, though being infertile doesn't mean you can't conceive naturally. Medically, the recommendation is to seek help after a year if you're under 35 or 6 months if you're 35 or older. It doesn't hurt to have blood work and semen analysis done at the get-go though. These are minimally invasive tests that can be easily covered by insurance. And keep in mind that the 6 month recommendation for older women is mainly because they have less time left and every month counts. Strictly speaking, not conceiving in 6 months is MORE indicative of an issue in younger women than in older women because younger women are the ones you expect to conceive more easily, so I personally recommend getting things checked after 6 months. As far as statistics go, according to the American Pregnancy Association, 30% of women conceive the first month trying, 60% total by the end of 3 months, 80% total by the end of six months, 85% total after a year, 92% total after four years. Other sources give other stats, the most commonly cited is 30% first month, 80% within six months, 90% within a year, and 95% within two years. Obviously the most fertile people are going to conceive earlier, meaning the most fertile are the most likely to conceive the first month, the next fertile are likely to conceive within 3 months, etc. which means the longer you have to try, the less likely you are to conceive any given month, hence the decrease in success with every subsequent month.

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