What is a certified nurse-midwife?

Certified Nurse-Midwives (CNMs) are licensed advanced practice nurses with specialized training in women’s reproductive health. CNMs are trained to help women be as healthy as they can be in pregnancy, birth, and the postpartum period, and to diagnose and manage obstetrical problems, in collaboration with physicians. They are also trained to provide primary care for women of all ages, to support breastfeeding, and to care for newborns in their first weeks of life.

Decades of research show that midwifery care, coordinated with physician care for those who need it, is associated with better health outcomes than physician care alone. That’s because midwives have the time and the training to focus on wellness, prevention, and education throughout pregnancy, and provide one-on-one care during labor and birth. Midwives also have the skills and training to manage common problems that arise in pregnancy and birth, and collaborate with physicians and other providers to provide the full spectrum of care – whether that is an epidural for pain relief or a cesarean for a complicated labor.

Throughout the world, maternity care systems are built on the premise that “all women need a midwife, and some women need a doctor, too.” We also believe that at Baby+Company, which is why we provide midwifery care to all clients and work closely with our physician colleagues to ensure that each family gets the care that is right for them.

Why choose a birth center?

More and more families are choosing to welcome their babies in birth centers, and for good reason. Research shows that childbirth is easier and safer when women have continuous supportive care throughout pregnancy and birth and when the environment is designed for comfort, privacy, and movement in labor. This is just what birth centers like Baby+Company offer.

Hospitals offer needed technology and specialized care for women with risk factors or complications. At Baby+Company, our birth centers are closely integrated with our partner hospitals, so that healthy women can benefit from continuous midwifery care in our calm and comfortable environment, with seamless access to the hospital and physician care whenever it is needed.

This kind of collaborative care, based in midwife-led birth centers with direct linkages to partner hospitals, has impressive results. A study published in 2013, which included more than 15,500 women who received care in 79 midwife-led birth centers in the United States, found that just 6 percent of women required a cesarean birth compared with nearly 24 percent of similarly low-risk women cared for in hospital settings, with excellent outcomes for both mothers and babies. Large studies in other countries have shown similar results, and in the United Kingdom, new national guidelines urge all healthy women to strongly consider midwife-led birth center care.

Why should I care about my healthcare provider’s Cesarean Section rate?

C-sections are an important tool that obstetricians use to keep women and babies in particularly high-risk situations safe and healthy. For example, if a baby is in the wrong position for birth or if the placenta is covering the cervix, a c-section can be life-saving. However, experts agree that at a national average of nearly 33%, c-sections are overused in the United States. The American College of Obstetricians and Gynecologists has made it a priority to reduce the rate because c-sections are major surgeries and carry risk for women and babies. For women, the risks include infection, injury to blood vessels and major organs, and serious bleeding. Babies born by c-section are more likely to have breathing problems, and may have increased risk of conditions like asthma and diabetes in childhood. Recovery after c-section is typically harder, and the c-section scar can cause problems in future pregnancies that can lead to babies being born too early or too small and/or to serious bleeding for women.

Is it safe to give birth outside of the hospital?

For healthy, low-risk women, giving birth in a birth center is as safe as giving birth in the hospital and actually has health benefits. A recent national study of birth center outcomes found that maternal and neonatal complication rates were extremely low and comparable to what is typical among low-risk women in a hospital setting. Out of the 15,574 women whose outcomes were analyzed, as part of the National Birth Center Study, there were no maternal deaths. The in-labor fetal death rate was 0.47/1000 and the neonatal (newborn) death rate was 0.4/1000. That means, based on the data, out of 1,000 women admitted to birth centers for labor, about 1 would be expected to lose a baby in labor or in the first weeks after birth.

What is a reason for which I would have to go to the hospital?

The main reason a woman would transfer to the hospital is for pain relief, a prolonged labor, and in rare circumstances, concerns regarding fetal health.

How is a midwife different than a doctor?

A midwife’s primary training is in normal pregnancy and birth. Midwives view pregnancy and birth as normal events in a woman’s life, not as a disease process. Midwives are specifically trained to provide physiologic care, which means supporting the normal biological processes in pregnancy and birth and to prevent complications by focusing on health and wellness. Although doctors also learn about normal pregnancy and physiologic birth, the focus of their training is the use of medical and surgical techniques to diagnose and treat problems. Midwives collaborate with our physician colleagues in cases where a woman’s pregnancy becomes complicated by a condition such as hypertension or gestational diabetes or when the birth process necessitates intervention such as a cesarean section. Midwives, particularly in the birth center setting, stay with women during labor as much as possible to facilitate an encouraging, empowering experience for the woman and her family.

Are childbirth classes offered at the birth center?

An integral part of delivering at the birth center is the education and preparation during pregnancy. Childbirth classes are available at all of our locations and will be encouraged during your prenatal care.

Can I eat and drink during labor?

Eating and drinking in labor is both allowed and encouraged. Plan to bring your own food/snacks and drinks, there is kitchen available for your use.

What are my options for pain control? Do you have epidurals?

We do not do have epidurals or narcotic pain medications at the birth center but instead promote movement, frequent changes in positioning, and laboring in water as alternative means in reducing pain. Our birth suites offer pilates bars, birthing bars, nitrous oxide, sterile water papules, and TENS units. In addition, the constant support and encouragement of your midwives and nurses is of great value in helping you cope with labor.

Do you offer water birth?

Yes, there are large soaking tubs in each labor room in which you may labor and/or deliver, if desired.

How long is my stay after delivery (postpartum)?

Following birth your stay in the birth center will be an average of 6-12 hours but not more than 24 hours.

Is it safe to go home early?

Early discharge to home is safe as long at the family is well prepared, the home environment is safe, the mother and baby are healthy after birth, and there is close follow-up after discharge to monitor for any problems. Our midwives and nurses monitor mothers and babies closely during the first hours after birth to watch for signs of a healthy transition and help get breastfeeding off to a good start. After early discharge home, we have close follow up with mom and baby – a video call to check-in around 24 hours, and a visit with a nurse or midwife around 48 hours, generally in the family’s home. At the home visit, a full assessment is completed on mom and baby, and newborn screening tests are performed, the same as they would be in the hospital. These include checks for jaundice, heart defects, metabolic diseases, and weight. Of course, there is always someone on call should the family need anything between these check-ins.

What is a doula?

A birth doula is a non-medical support person for a pregnant woman and whomever she chooses to have with her in her birthing time. A doula provides continuous educational and physical support through labor and birth. A doula assists a woman to define her wishes during her labor and birth, creates an environment conducive to informed decision-making, facilitates communication between the laboring woman and her partner, and provides hands-on support such as massage and counterpressure. A doula may support the woman emotionally during the postpartum period, as well as assisting with breastfeeding. Research demonstrates that support from a birth doula results in shorter labors with fewer complications, and a smoother start for breastfeeding. Doulas are a welcome addition to a woman’s birth team at Baby+Company as we desire continuous labor support for all of our mothers. Additionally, if a mother has to transfer to the hospital, a doula is able to continue to provide her with continuity in that setting as well. Doulas trained specifically in postpartum support assist a family to navigate the early days of parenthood through education and practical support such as making meals. There are several different certifying bodies for doulas including DONA International and CAPPA.

What if I’m not pregnant? Can I still come to the birth center?

In addition to pregnancy and birth services we also offer full gynecologic annual exams, including pap smears, pre-conceptual care, and contraceptive management.

Which insurance plans do you accept?

We accept all major insurance plans. This means that whether we are in-network or out of network with your insurance carrier, we will process claims on your behalf. There should be no more work on your part than there would be if we were in-network with your carrier.

Will my out of pocket costs be lower with Baby+Company than they would be at a hospital-based practice that is in-network with my insurance carrier?

It is likely that your out of pocket costs will be lower at Baby+Company than they would be at a hospital based practice that is in-network with your insurance carrier. In some cases, the out of pocket costs are slightly higher. We can work with our insurance carrier to understand your benefits and estimate your out of pocket costs at Baby+Company compared to a hospital based practice.

Baby and Company