Choosing a Delivery Hospital

Deciding on a hospital to deliver from might leave you feeling a little anxious especially if you are a first time mother and/or have never been admitted before. Most mothers don’t know that you can actually take a tour of the hospitals you have available to you. These hospitals will allow you to view their delivery facilities such as the labour ward and delivery room. They will also provide you with a member of staff who will be able to take you round and explain the rules of the hospital, the price options available and basically answer any questions you might have. The best time to schedule this visit is in the last months of your second trimester or the first month of your third trimester (months 5, 6 and/or 7) when your energy levels are high. Though if you are already well passed your 7 month you can still organize for a hospital visit, just have someone accompany you to the hospitals.

The main things which often determine where you deliver from include:

1. Cost: Does the cost of delivery at the hospital meet your budget. It is important to do this price estimate looking at the worst case scenario. For example if you will need an emergency cesarean section done will you be able to fit the bill.
2. Proximity and Quality of Service: It is important to choose a hospital closer to where you live to allow for easy and quick access to medical care. As well as, a hospital which you know at least adheres to government standards, for example is NHIF (National Health Insurance Fund) accredited and provides quality care. This can be established during your sight visit.
3. Insurance Coverage: If you are planning to pay using insurance, you will have to find out which hospitals are covered by your insurance panel and what level of coverage the insurance plan offers. For example, some health insurance policies only cover the cost of admission in the general ward and anything above this cost must be catered for out of pocket.If you simply must deliver at a hospital not covered by your insurance scheme you could always find out if they will be able to refund you the cost incurred during delivery. However it is important to note that most insurance companies who can offer you a refund often do not refund the full amount.
4. Mode of delivery: If you plan to have, for example a water birth it is important to first establish which hospitals provide this service and what level of experience and success they have on the same. The same applies for if you have any medical condition which will require specialised care.
5. Choice of Doctor: Not every medical practitioner has admitting rights in every hospital. You might want to ask your doctor which hospitals s/he is able to deliver you from and which ones s/he is not. Depending on your condition and if you will require any special care your choices here are either to:
   • Go with your preferred hospital and choose another doctor
   • Go with your preferred doctor and choose a hospital where s/he has admitting rights

As you begin the search for a delivery hospital take some time to look around and ask your doctor, friends who have delivered before and hospital staff during your visits any questions you might have. Remember that if you haven’t made any advanced payments you can always change your choice of hospital later and before you do make any payments find out the hospitals policy on refunds.

Here are a few sample questions you might want to consider asking:

1. Your Doctor during one of your antenatal visits:
   1. Which hospitals do you have admitting privileges in?
   2. Which hospitals do you recommend for delivery and why?
   3. What should I expect on the day of delivery?
   4. What should I look out for on the day of delivery? Is there anything I should be concerned about?
2. The hospital attendant during your sight visit:
   1. What is the cost of a normal delivery, caesarean section for a doctor delivery and midwife delivery? Also what is the cost of admission in a general ward, duplex and private wards?The hospital attendant during your sight visit:
   2. What insurance cards do you accept?
   3. Do I have to book in advance before I come to deliver?
   4. If I plan to pay for my bill using insurance what information will you need me to come with prior and on the day of deliver?
   5. How many people can I have with me in the labour ward and delivery room? Is this specific only to spouses or can another relative be allowed to join me as well?
   6. Will my spouse be allowed to stay with me 24/7 before and after the delivery? Will there be a time when he will be asked to step out? If so, when and why?
   7. Is there any parking fees? If so, is there any special passes for spouses who will most likely come to visit for long hours?
   8. What are the visiting hours and are there any special rules about visiting, for example can my other child come to visit me in hospital? Is there a certain number of people allowed per visit? Etc
   9. What delivery options do you provide? How long have you provided this for and how many people on estimate so far have used these services for example, how many people have had a successful water birth in the hospital?
   10. What is your nurse to patient ratio? Will I have the same nurse attending to me during my stay or will they keep changing?
   11. If I were to have any complications for example an emergency caesarean section, will the hospital be able to do this or will I have to be transferred to another hospital? If so, which hospital will I most likely be transferred to?
   12. Am I allowed to walk around during labour and can I find my own delivery position?
   13. Do you offer epidurals? [This is a pain reliever usually offered to mothers through the spine.]
   14. Do you have a paediatrician on call or do I have to contact my own paediatrician?
   15. Do you have a NICU (Neonatal Intensive Care Unit)? What level of care can be given should my baby require any emergency intervention and what steps are taken in such a situation?
   16. What level of support will I be given to care for my baby, that is, when it comes to washing, breastfeeding and changing my baby?
   17. Is there going to be any training offered on how to care for my baby?
   18. Do you offer any counselling or postnatal services?
   19. Will I be allowed to stay with my baby 24/7 or will s/he be moved to the nursery at certain times? If so, which times will my baby be in the nursery?
   20. How soon will I be allowed to go home after I deliver my baby?