Midwifery Birth Center and Women’s Health Care
Birth Care & Family Health Services • 1138 Georgetown Road • P.O. Box 152 Bart, Pa. 17503 • Phone: 717.786.4010 • Fax: 717.786.5507 • E-mail: info@birthcaremidwives.com                                                                                                                                                                                                                                                   Website Design © Bonnie U. Gruenberg   •   www.BonnieGruenberg.com
Birth Care   & Family Health Services

Frequently Asked Questions

Birth Care Midwifery and Family Health Services

 1. What are the benefits of midwifery care? High-touch, low-tech options Client and family-centered care Shared information so client can make her own choices Decreased rate of interventions like induction of labor and c-section. Increased satisfaction Full-scope care of women throughout their life spans (not just pregnancy!) Nationally, the rate of cesarean for clients of birth centers is only 6%, compared to  the U.S. cesarean section rate of 27% for low-risk women. 2. What services does Birth Care provide? Birth Care provides prenatal, birth, and postpartum care as well as gynecological care. We catch babies at the client’s home, at our freestanding birth center in Christiana, and at Wellspan-Ephrata Community Hospital if a woman transfers there for complications in labor. We offer family planning services including information about natural family planning, hormonal birth control, and intrauterine contraception (IUCs). We also offer testing and treatment for infections, and routine screenings like Pap tests. 3. What is a free-standing birth center? Birth Centers are designed and managed to create caring, warm, home-like settings where women feel supported, respected, safe and secure. Pregnancy and childbirth are normal healthy life events for most women and babies. At a Birth Center, if the delivering mother is hungry, she is encouraged to eat. If she wants to move about, she can. If she is more comfortable in a warm tub, it is there for her use. If she finds a certain position most comfortable to push in, she can move that way. The midwives and birth center staff respond to each woman’s needs, while watching her closely for signs that increased support is required. Always attentive to the needs of a new mother, a birth center midwife will consult with doctors and transfer her patient to the hospital if necessary. Birth Care midwives have privileges at Wellspan-Ephrata community hospital, and in many cases can continue to care for clients if they are transferred. Source: American Association of Birth Centers 4. Is out-of-hospital delivery safe for low risk women? Yes! Recent studies comparing normal, healthy women with one group opting for birth center care and one group opting for hospital care show that birth centers have as good or better outcomes than hospital deliveries for healthy women. The studies also show lower rates of Cesarean section, episiotomy, and forceps/vacuum-assisted delivery for women in birth center care. Read the research HERE at BirthCenters.org Likewise, the best evidence shows that home birth with good backup can be a safe option for low-risk women. http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/full http://midwifery.ubc.ca/files/2012/12/Home-Birth-Annotated-guide-to-the-literature.pdf  5. What can I expect when I come in for my first appointment? Midwives take time to listen to you. Midwives believe that childbearing is normal and that you and your family should create the birth experience that will be meaningful to you.For a prenatal client, first appointments are all about getting to know each other. We will discuss your health and family history, tell you a bit about our practice and what to expect, and answer any questions you might have. The physical exam is saved for the second appointment. For a well-woman exam, the visit will focus on your particular needs. It will definitely include time for you to ask any questions you might have, and may include a physical exam, or procedures and labs as needed. All labs and procedures are are discussed in advance and are based on the wishes of the client. 6. What is a Certified Nurse-Midwife? Certified Nurse-Midwives are the only type of midwife legally licensed to practice in the State of Pennsylvania. Certified Nurse-Midwives are often Certified Registered Nurse Practitioners who have attended nursing school, and then went on to receive their Master’s degree in Nursing with a specialization in Nurse-Midwifery. After graduate school, board certification is undertaken to become a Certified Nurse-Midwife. Thereafter, they must attend continuing education to maintain their certificates. Most certified nurse-midwives can write prescriptions for medications. 7. What are the different types of midwives? All Birth Care midwives are Certified Nurse-Midwives,the only type of midwife legally licensed to practice in Pennsylvania. We are all advanced practice registered nurses and we are able to write prescriptions. We are also certified in newborn resuscitation. There are several different types of midwives. This link from Our Moment of Truth has a great description of the different types of midwives in the United States. http://www.ourmomentoftruth.com/ 8. What is a doula?  Are doulas welcome at the center? A doula is a non-medical support person that provides informational and physical support for women. There are several types of doulas, and they can specialize in childbirth, breastfeeding, or post partum care. Studies show that  doula care increases a woman’s satisfaction with her birth, decreases her  need for pain medicine, and can even decrease the length of labor! Doulas are a welcome addition to the labor team and are also welcome to come to prenatal appointments. 9. How long will I stay at the center after baby is born? Our clients usually stay at the center about four hours after baby is born. If you experience minor complications you might stay a little longer. 10. What can I expect for post partum care? If you within a specified radius  from the center, we can come to you for a  home visit  for you and your baby on your second day postpartum.  If you live out of the area, we  offer a  second day office visit at the center.  At two weeks postpartum, we will see both you and your baby in the office.  At six weeks there is a  postpartum follow-up visit for you. Babies will  usually see their family care providers  around that time. 11. What happens if I have to transfer? Certain complications, such as excessive postpartum bleeding, can usually be successfully managed at the birth center without the need to transfer. If there is a need to go to the hospital, it will depend on the situation at the time. If it is a non-emergent transfer, the client may go by car to Wellspan-Ephrata Community Hospital. If the transfer should happen to be emergent, the client will go by ambulance to the closest appropriate facility. Our midwives have privileges at Ephrata and will often continue to care for a client after transfer. When complications occur, we contact our team of collaborating physicians for recommendations. If complications are significant, we may co-manage with the physicians or transfer care to them. 12.  Under what conditions would I be transferred to the hospital? Possible reasons for transfer include labor that is not progressing normally, elevated blood pressure, fever, fetal heart rate abnormalities, excessive bleeding, malpresentation (like breech), or poor infant transition after birth.  The National Birth Center Study II  showed that on average, about 4.5% of birth center clients will be referred to a hospital before being admitted to the birth center, 11.9% will transfer to the hospital during labor, 2.0% will transfer after giving birth, and 2.2% will have their babies transferred after birth. About 82% of the women who transfer during labor are first time moms. Fewer than 1% of transfers are for emergency situations. 13. Does insurance cover midwives / birth center birth/ home birth? Often, insurance will cover midwife attendance for birth in both the birth center and hospital. Most insurance companies do not cover home birth. Please call your insurance company if you have any questions about coverage

Frequently Asked

Questions

Birth Care

Midwifery and

Family Health

Services

 1. What are the benefits of midwifery care? High-touch, low-tech options Client and family-centered care Shared information so client can make her own choices Decreased rate of interventions like induction of labor and c-section. Increased satisfaction Full-scope care of women throughout their life spans (not just pregnancy!) Nationally, the rate of cesarean for clients of birth centers is only 6%, compared to  the U.S. cesarean section rate of 27% for low-risk women. 2. What services does Birth Care provide? Birth Care provides prenatal, birth, and postpartum care as well as gynecological care. We catch babies at the client’s home, at our freestanding birth center in Christiana, and at Wellspan-Ephrata Community Hospital if a woman transfers there for complications in labor. We offer family planning services including information about natural family planning, hormonal birth control, and intrauterine contraception (IUCs). We also offer testing and treatment for infections, and routine screenings like Pap tests. 3. What is a free-standing birth center? Birth Centers are designed and managed to create caring, warm, home-like settings where women feel supported, respected, safe and secure. Pregnancy and childbirth are normal healthy life events for most women and babies. At a Birth Center, if the delivering mother is hungry, she is encouraged to eat. If she wants to move about, she can. If she is more comfortable in a warm tub, it is there for her use. If she finds a certain position most comfortable to push in, she can move that way. The midwives and birth center staff respond to each woman’s needs, while watching her closely for signs that increased support is required. Always attentive to the needs of a new mother, a birth center midwife will consult with doctors and transfer her patient to the hospital if necessary. Birth Care midwives have privileges at Wellspan-Ephrata community hospital, and in many cases can continue to care for clients if they are transferred. Source: American Association of Birth Centers 4. Is out-of-hospital delivery safe for low risk women? Yes! Recent studies comparing normal, healthy women with one group opting for birth center care and one group opting for hospital care show that birth centers have as good or better outcomes than hospital deliveries for healthy women. The studies also show lower rates of Cesarean section, episiotomy, and forceps/vacuum-assisted delivery for women in birth center care. Read the research HERE at BirthCenters.org Likewise, the best evidence shows that home birth with good backup can be a safe option for low-risk women. http://onlinelibrary.wiley.com/doi/10.1111/jmwh.121 72/full http://midwifery.ubc.ca/files/2012/12/Home-Birth- Annotated-guide-to-the-literature.pdf  5. What can I expect when I come in for my first appointment? Midwives take time to listen to you. Midwives believe that childbearing is normal and that you and your family should create the birth experience that will be meaningful to you.For a prenatal client, first appointments are all about getting to know each other. We will discuss your health and family history, tell you a bit about our practice and what to expect, and answer any questions you might have. The physical exam is saved for the second appointment. For a well-woman exam, the visit will focus on your particular needs. It will definitely include time for you to ask any questions you might have, and may include a physical exam, or procedures and labs as needed. All labs and procedures are are discussed in advance and are based on the wishes of the client. 6. What is a Certified Nurse-Midwife? Certified Nurse-Midwives are the only type of midwife legally licensed to practice in the State of Pennsylvania. Certified Nurse-Midwives are often Certified Registered Nurse Practitioners who have attended nursing school, and then went on to receive their Master’s degree in Nursing with a specialization in Nurse-Midwifery. After graduate school, board certification is undertaken to become a Certified Nurse-Midwife. Thereafter, they must attend continuing education to maintain their certificates. Most certified nurse-midwives can write prescriptions for medications. 7. What are the different types of midwives? All Birth Care midwives are Certified Nurse- Midwives,the only type of midwife legally licensed to practice in Pennsylvania. We are all advanced practice registered nurses and we are able to write prescriptions. We are also certified in newborn resuscitation. There are several different types of midwives. This link from Our Moment of Truth has a great description of the different types of midwives in the United States. http://www.ourmomentoftruth.com/ 8. What is a doula?  Are doulas welcome at the center? A doula is a non-medical support person that provides informational and physical support for women. There are several types of doulas, and they can specialize in childbirth, breastfeeding, or post partum care. Studies show that  doula care increases a woman’s satisfaction with her birth, decreases her  need for pain medicine, and can even decrease the length of labor! Doulas are a welcome addition to the labor team and are also welcome to come to prenatal appointments. 9. How long will I stay at the center after baby is born? Our clients usually stay at the center about four hours after baby is born. If you experience minor complications you might stay a little longer. 10. What can I expect for post partum care? If you live in a 30-minute radius from the center, we can come to you for a  home visit  for you and your baby on your second day postpartum.  If you live out of the area, we  offer a  second day office visit at the center.  At two weeks postpartum, we will see both you and your baby in the office.  At six weeks there is a  postpartum follow-up visit for you. Babies will  usually see their family care providers  around that time. 11. What happens if I have to transfer? Certain complications, such as excessive postpartum bleeding, can usually be successfully managed at the birth center without the need to transfer. If there is a need to go to the hospital, it will depend on the situation at the time. If it is a non-emergent transfer, the client may go by car to Wellspan- Ephrata Community Hospital. If the transfer should happen to be emergent, the client will go by ambulance to the closest appropriate facility. Our midwives have privileges at Ephrata and will often continue to care for a client after transfer. When complications occur, we contact our team of collaborating physicians for recommendations. If complications are significant, we may co-manage with the physicians or transfer care to them. 12.  Under what conditions would I be transferred to the hospital? Possible reasons for transfer include labor that is not progressing normally, elevated blood pressure, fever, fetal heart rate abnormalities, excessive bleeding, malpresentation (like breech), or poor infant transition after birth.  The National Birth Center Study II showed that on average, about 4.5% of birth center clients will be referred to a hospital before being admitted to the birth center, 11.9% will transfer to the hospital during labor, 2.0% will transfer after giving birth, and 2.2% will have their babies transferred after birth. About 82% of the women who transfer during labor are first time moms. Fewer than 1% of transfers are for emergency situations. 13. Does insurance cover midwives / birth center birth/ home birth? Often, insurance will cover midwife attendance for birth in both the birth center and hospital. Most insurance companies do not cover home birth. Please call your insurance company if you have any questions about coverage
Midwifery Birth Center and Women’s Health Care
Birth Care and Family Health Services 1138 Georgetown Road P.O. Box 152 Bart, Pa. 17503  Phone: 717.786.4010 • Fax: 717.786.5507  E-mail: info@birthcaremidwives.com Website Design © Bonnie U. Gruenberg      www.BonnieGruenberg.com
Birth Care   & Family Health Services