Whether by choice or necessity, the majority of pregnant people in Canada—including Montreal, where I work—give birth in a hospital.
What you might not realize is that hospital protocols for managing labour, birth, and the immediate postpartum period can vary widely, even within the same city. Same with pain-management options, amenities, and even accommodations offered. Some hospitals are equipped for mostly high-risk patients. Others see more low-risk birth and are used to seeing nonmedicated labours.
You have the right to choose your hospital!
Exercise this right, and do your research. Don’t just go with the hospital closest to home. (Unless, of course, you happen to live in a really rural part of the province.)
(Note: The other option in Quebec is birthing at home or at a birthing centre [maison de naissance], with midwives. If you think you might be interested in working with midwives, even if at this point you’re a little unsure, stop reading this post for a few minutes, call all the birthing centres in your vicinity, and get your name on their waiting lists NOW. Demand for midwifery care here far exceeds supply.)
Don’t yet have a doctor? Perfect! Choose a hospital first. THEN choose a doctor with privileges at that hospital. In general, if you’re hoping for less intervention and more flexibility, opt for a family doctor instead of an obstetrician (OB). If your pregnancy ends up being higher-risk, you’ll be referred to an OB. If you want a family doctor, make sure that the hospital you like has family doctors with delivery privileges there. Some hospitals have OBs only.
If you already have a doctor you like, find out which hospital he or she works at, and make sure it’s really where you want to give birth.
Here are some questions to consider. Ask these questions of yourself, of hospital staff, and on online parenting forums in your city. And by all means, reach out to experts in your community who work with birthing people, and ask for their opinions and experiences: birth doulas, prenatal yoga teachers, childbirth educators, and so forth.
Do I want a nonmedicated birth with as few interventions as possible?
If so, then look for a hospital that sees lots of low-risk birth and that has a reputation for being hands-off as long as you and the baby are healthy.
What’s the C-section rate?
The rate throughout Canada is around 30 percent, but some hospitals have slightly higher or lower rates. Hospitals that specialize in high-risk birth may have higher rates.
What pain-relief options are available?
All hospitals offer the epidural. Some hospitals offer nitrous oxide (laughing gas). Some will give you a shot of morphine, if you want. All have showers, and some have in-room bathtubs.
What facilities, tools, and specialized support might I want?
Some hospitals have “props” like peanut balls and birth balls available. A few hospitals have in-room bathtubs. Some have a room on the ward with a tub that you can use if no one else is using it. All have showers. Postpartum rooms may be private, or you may need to pay a supplement if you don’t want to share a room. Some do labour, birth, and postpartum in the same room—no transferring necessary. Certain hospitals are known for being especially diligent about getting breastfeeding off to a solid start, if that’s something that’s important to you.
Is the hospital I’m looking at a major teaching hospital?
If so, you may have several students popping in and out of your room to observe your birth. (Though you can always ask that they leave the room, if you’re overwhelmed with too many people.)
What language am I most comfortable in?
Assuming you’re in Quebec, if you have trouble understanding and communicating in French, you might consider a hospital that serves a more anglophone and allophone clientele.
What type of doctors catch babies at the hospital I’m considering?
Only OBs (who specialize in high-risk pregnancy and birth)? Or both OBs and family doctors? In general, if you’re hoping for less intervention and more flexibility, choose a hospital where family doctors have privileges.
See Planning an empowering hospital birth for more tips.