In the days of our great-grandmothers, women were always delivered at home. Today practically all American children are born in hospitals. Since we have learned from experience that the safest place for the delivery of a baby is a hospital that offers good maternity care, your doctor will almost certainly want you to have your baby in a hospital. He will make the arrangements with the hospital for you. He may do this just after your first visit to him early in your pregnancy, or he may wait until later. Your hospital experience will be more comfortable and have much more in it for you, if you know beforehand what to expect.

Hospital facilities

Some hospitals are glad to show prospective parents as much as they can of their maternity units. Many do not permit such tours. In every hospital, however, there is someone you can see who will be able to tell you what you want to know about the building, admission procedures, the care of maternity patients and costs of maternity care.

Hospitals vary a good deal in the kinds of accommodations they offer, in the services they provide, in the regulations they expect patients to observe, and to some extent, in their charges. Nearly all have private rooms, as well as wards with two, four, or more beds. A room of your own is more expensive than a room you share. If yours is a busy, noisy household, privacy for these few days may be a good investment. On the other hand, you may be someone who likes company and would be lonely in a room by yourself.

Some hospitals do not make reservations ahead of time for maternity cases but all of them register patients in advance. The only room available when you enter may be one that you would not otherwise have chosen. By the next day you can usually get what you want. You will not be in the hospital long unless there are complications. The average stay for maternity cases is about 5 days.

Counseling services

Many hospitals employ one or more social workers—persons trained in counseling who know a great deal about people and their problems, about hospitals and medical practice. If there is one at the hospital where you are going to be, feel free to ask to talk with her about anything that may be concerning you. Expectant mothers who are worried about themselves, their husbands, their children or their finances often find that these hospital social workers can help them to think of ways of solving their problems that might not otherwise have occurred to them. If there is no such person in the hospital where you will be, your doctor or his nurse can put you in touch with the social agency in your community most likely to be able to give you the kind of help you need.

Hospital expenses

As soon as you can, find out what your hospital expenses are going to be. Know exactly what each item includes, how payment is to be made, and when payments are due. Some hospitals make separate charges for the delivery room, for anesthetics, and for nursing care for you and the baby. Other hospitals charge a lump sum that covers everything. Have a clear understanding about this, so that you will not be surprised, at the end, by bills you did not expect.

You may have hospital insurance, or belong to some group that provides hospitalization for its members. In that case reread your policy carefully, including the fine print, to be sure just what it covers. If you do not have such insurance—and sometimes even if you do—your hospital may require a cash deposit when you enter. This will be subtracted later from your bill. Ask about this in advance so that someone will have the money ready if and when it is needed.

Previewing arrangements

Unless you are regularly attending the hospital clinic, your first contact with the hospital may be when you come for your delivery. Phone your doctor when contractions begin. He will tell you when to start for the hospital. He will also let the hospital know when to expect you.

When you get to the building, you will go first to the admitting office, to check in. Here you will be asked to give certain information about yourself and to sign a contract with the hospital for your care. If your labor is so far advanced that delay is unwise, you will be taken directly to the maternity unit. Your husband or some other member of your family will complete your registration later. The hospital will take charge of any valuables you may have brought with you.

You may wonder why the hospital asks you some of the same questions you have answered for your doctor. This apparent duplication is for your protection. The hospital has taken responsibility for your welfare by admitting you as a patient. It must have in its own records the facts that might be needed to deal with any emergency in your case.

From the general admitting office, you will be sent to the maternity wing or unit. Here you will exchange your own clothes for a hospital gown, and receive your initial preparation for the delivery. Your blood pressure will be taken, a specimen of your urine will be examined and a general check will be made on the stage of your labor. Your blood will be typed and you will be tested for the Rh factor, if these determinations were not made earlier in your pregnancy.

When these preliminaries are over, you will be taken to the labor room to wait until it is time for your delivery. Your labor may be short or it may last for several hours. Some hospitals allow, even encourage, husbands to stay with their wives while they are in the labor room, but many do not. Here again it is important to know the hospital routine. Even if no member of your family is with you, you are not alone. Doctors and nurses will be keeping close track of your progress, and you will probably not be the only patient in the labor room.

From here you will go to a room especially prepared for deliveries. This is where your baby will actually be born. When you first see the equipment in this room you may be reminded of the contraptions in a cartoon. The delivery table has attachments for raising and lowering it, and for changing its angle. It has special devices for holding you in the best positions for delivery, and for giving you support where you need it.

There will be other unusual looking pieces of apparatus for the administration of anesthetics and the protection of the baby. Everything in this room has been designed to make each delivery as safe and comfortable as it can possibly be. You will be the only patient here while your child is being born.

After the baby is born

After the birth, the baby will be taken to the nursery and you will be moved to a recovery room, or to your own room. The hospital will make sure that your baby is properly identified before either of you leaves the delivery room. You will be bathed, your uterus will be massaged and your blood pressure will be frequently checked. Someone will be with you until you are fully awake. Where and when your husband will be allowed to see you depends on the regulations of the hospital. He may or may not be admitted to a recovery room.

Most hospitals keep newborns in the nursery and take them to their mothers for their feedings. Mothers are usually encouraged to spend as much time with their infants as the hospital schedule permits.

In some hospitals, mothers have their new babies with them in their own or in small adjoining rooms. This is called "rooming in." If you are interested in this plan, ask your doctor about it. Some mothers like it very much, some would rather not have this much responsibility for the baby for the first few days. As far as the baby himself is concerned, he can get a good start in life either way.

What to take to the hospital

Ask if the hospital has a printed leaflet explaining its regulations. You will want to know who may visit you, what the visiting hours are, what the checkout time is, where your husband will wait, what clothing you will need to take for yourself and the baby.

A few weeks before you expect to go to the hospital, pack a suitcase with the things you will need for yourself. Put it where you can find it in a hurry. Be sure that someone in your family knows where it is. You will probably be wearing hospital gowns during the first day or two after your delivery, but after that you may prefer to wear your own, so take two or three with you. You take your own toilet articles, of course, and a bed jacket, if you have one. The following list is not long but it includes practically everything you will need:

• Bathrobe
• Bedroom slippers
• Bed jackets, 1 or 2
• Nightgowns (short) or pajama tops, 2 or 3
• Nursing brassieres, 3 or 4
• Sanitary belt
• Shower cap
• Comb, brush, hand mirror
• Toothbrush and toothpaste
• Simple cosmetics
• Box of paper handkerchiefs
• Something to read
• Fountain pen or pencil
• Writing paper and stamps

The hospital will furnish sanitary napkins and, possibly, paper handkerchiefs. You will probably be able to buy newspapers from an attendant. The less you take with you when you go in, the less you will have to bother with when it is time to come home.

The only things you will need to pack, in advance, for the baby will be his going-home clothes. Put into a box or small suitcase two or three diapers, a shirt, four large safety pins, a wrapper, a sweater, and a cap, a blanket or bunting. It is usually better not to take these things to the hospital with you. Ask someone in your family to bring them to you the day before you and the baby are to be discharged.

The amount of outer covering for the baby will depend on the weather. On a warm summer day the sweater will not be needed and the blanket could be just a light flannel square. If he leaves the hospital on a cold winter day, a newborn will need both a sweater and a heavy outer wrap—a warm wool blanket or a bunting. Some mothers think that babies are easier to handle in buntings with sleeves.

So much for a hospital delivery.

Home delivery

Even though most American babies are born in hospitals, between 30,000 and 40,000 of them are delivered in their own homes every year. If you are pregnant and living where there is no hospital or local doctor, you probably have no alternative to a home delivery. Your first concern should be to find out where you can get reliable medical assistance. If there is a public health nurse in your county, talk with her as soon as you can about this. She will be able to help you in many ways before and after the birth of your baby. If there is no public health nursing service where you live, write to the director of maternal and child health in your State health department in your capital city. Ask for information about doctors, local clinics, hospitals, and nursing services within reach of your home. Also ask for copies of any booklets or leaflets on prenatal care and child development that your State health department may have for distribution.

What you can do to get ready for your delivery at home will depend a good deal on the house you live in and the circumstances under which you live. The people who can help you most with your preparations are the doctor who will deliver you and the nurse who will assist. The doctor will give you a general idea of what he wants you to do and the nurse will work out the details with you.

Try to have everything settled and all the supplies you will need at hand at least three months before the baby is due. This will give you time to check on your setup and to send away for anything important you may have forgotten.

Help at home

Whether you have your baby at home or in the hospital, you will need someone to help you with him or with the housework during the first two weeks or so after he is born, especially if you have other children, live in a 2-story house and are not allowed to go up and down stairs for a while. It may be that your family and friends can give you all the assistance you require, if you plan with them in advance. If not, you may be able to employ someone to come in for a certain number of hours during the day.

Some cities have set up a much needed program called homemaker service. Sometimes this service is under a community agency which has recruited and trained a staff of experienced homemakers to take over in homes where mothers are absent or ill. The agency places and supervises these women who are chosen for their warm and friendly personalities, their skill in homemaking, their common sense, their understanding of emergencies and their ability to fit into other people's family life. There is a fee for their services, but these programs are often partially supported by community funds, so you pay only what you can afford. If you have a real need for such help and the service exists in your community, it may be possible for you to have a homemaker substitute for you while you are in the hospital and stay for a few days to help out after you are back in your own home. You can find out whether there is such a service in your town by calling your local community chest, or council of social agencies.

For a while, you may feel a little timid with your new baby, particularly if he is your first one. It may be that a public health nurse could stop by to make sure that you understand the instructions your doctor has given you and know how to carry them out. Or you may be able to engage a nurse from one of the private nursing organizations for an hour or two a day, for a nominal fee. Call your local health department or council of social agencies for information about these services.

There are two final suggestions we hope you will keep in mind as you plan for the coming of your baby: Don't overdo your preparations and do what you have to do as you go along. No amount of hurrying at the last minute can ever take the place of the famous "stitch in time."

Marcus Siegel

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