hospital birth

Planned Hospital Births

For our clients planning hospital births, we do planned hospital births at Providence Alaska Medical Center only. Midwife means “with women” and we take that responsibility – and privilege - very seriously. We are there with you at the hospital during your entire active labor. We will check in with you as needed in early labor so that you can be admitted to L&D at the optimal time. We encourage you to write a birth plan so that the nurses who are caring for you will know your wishes and plans as well as we do. Whether your goal is a natural birth or a medicated birth with few interventions, we strive to provide that for you to whatever extent is possible given the multitude of influencing factors within the hospital setting such as the nurses assigned to you, the back-up physician involved, fetal monitoring requirements, and hospital policies and procedures. It is very clear from our outcomes that our presence there, being with our patients continuously in labor, is beneficial to their goal of vaginal childbirth. Our C-section rate over the last 20 years has been consistently close to 9% or less. The C-section rate for Providence Hospital as a whole is close to 35%, and their C-section rate for women having their first baby is close to 50%.

(View stats for all Alaska hospitals

Your Choice of Provider
What many women don’t realize is that their choice of provider is the single largest influencing factor in how they will give birth, even more important than their own medical history.

One of the reasons why provider choice is important has to do with how your provider will monitor the baby. Studies show that use of continuous electronic fetal monitoring has an extraordinarily high false positive rate (99%!) for predicting whether an infant would be born with cerebral palsy, which was the original use for the technology. When Dr. Hon developed electronic fetal monitoring in the 1970’s he thought this new technology would eliminate cerebral palsy in newborns. It was widely adopted in the late 70’s and early ‘80’s and continues to be used today for both high-risk and low-risk women in many hospitals. Unfortunately, since the adoption of this technology, the CP rate among newborns has remained unchanged, but the C-section rate has skyrocketed from a nationwide average of 5.5% in 1970 to an average of 33% for 2014. While continuous electronic fetal monitoring is not solely responsible for the rise in C-sections in the US, it plays a very big role, and is the major contributing factor to the precipitous rise in C-sections that occurred between 1975 and 1988. View graph

C-Cection Rates
While hospitals certainly have their own protocols for fetal monitoring, these do not necessarily explain the wide range in C-section rates that can be seen among hospitals, some of them even in the same city located within miles of each other. This is because the individual providers are still ultimately responsible for how they use this technology and what they do with its results: View article: What Hospitals Do Not Want You to Know About C-sections

Our Fetal Monitoring Philosophy
We at Geneva Woods Midwifery believe that low-risk women should not be subjected to continuous electronic fetal monitoring – in fact, its use on low-risk women is actually counter to clinical practice guidelines. “Intermittent auscultation” is what our midwives use to check on your baby in labor…whether you labor in the hospital or in the birth center. (Read a good discussion on these different monitoring techniques). We believe that the keys to our sub-10% C-section rate are that we use intermittent auscultation for fetal monitoring, we wait for spontaneous labor unless there’s a medical indication to induce labor, being patient with labor and not using interventions to speed it up unless it is progressing abnormally, and above all, being with and supporting our clients throughout active labor.

If you truly want a vaginal birth in the hospital, you need a provider who will be there for you the entire time, on your side, advocating for your needs and your goals. Midwives also share that first goal of “a healthy baby,” but we do not believe that that has to preclude you from having the birth experience you want. Nationwide the research shows that when you birth with midwives who support you throughout active labor, it can be win-win: healthy baby and healthy, happy mom!

Call us to discuss if this is a good fit for you.

Read more information on midwifery care.

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