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Why Midwifery

 

A more nurturing and empowering birth experience.

At Geneva Woods Midwifery, we believe very strongly in practicing the Midwifery Model of Care. While this model of care lends itself best to birthing outside the hospital, even in the hospital we strive to preserve as much of the model as we can while adhering to hospital policies and our consulting physicians’ guidelines.

The Midwifery Model of Care

happy woman with rainbow

Reciprocal Relationship

The client and her family are empowered to play a role in the decision-making regarding their care. This is a partnership based on continuous dialog, mutual respect, and trust. The midwife spends ample time getting to know you, listening to your needs and concerns, and answering your questions. Visits in our office will range from 30 to 90 minutes, and this entire time is spent with the midwife.

pregnant woman talking to midwife

Midwife’s Body of Knowledge

A midwife’s training is based on what is normal. While she is trained to detect and treat problems where they arise, a midwife does not seek out or create abnormalities where they don’t exist. Midwives give clients and their families the information they need to make informed choices at all points in their care.

woman sipping tea at the window

Birthing Environment

Midwives believe that all women deserve to be at the center of their birth experience. The midwife will be a continuous presence during your birth, whether you choose to give birth in a hospital or in a birth center. Our midwives will create a safe space where women can trust in birth and in the power of their own bodies.

Nationwide Recognition for Birth Centers

The safety and care quality of nationally accredited birth centers is well-documented. While research has been conducted on birth center safety and outcomes since the 1970’s, many major breakthroughs in nationwide recognition of birth centers have been more recent.

In 2006, the American Association of Birth Centers asked its accredited birth center members to collect data on outcomes for the second National Birth Center Study which was published in 2013. Geneva Woods Birth Center is proud to have been part of the study, along with 78 other accredited birthing centers across the country. Just recently in 2015 the American Congress of Obstetricians and Gynecologists (ACOG) formally integrated birth centers into their Uniform Levels of Care designations.

Obstetric Intervention Rates

The 2013 study demonstrates the safety of the midwifery-led birth center model of collaborative care as well as continued low obstetric intervention rates, similar to previous studies of birth center care. In this study that encompassed approximately 15,000 births nationwide at nationally accredited birth centers shows the risk of bad outcomes for low-risk women to be the same as those for the hospital. What this basically means, in plain English, is that nationally accredited birth centers can achieve the same level of safety for low-risk women and their babies as a hospital can, without the use of as many medical interventions, and with a much higher rate of satisfaction with their experience for the women and their families.

Neopuff Infant Resuscitation in Anchorage

Geneva Woods Birth Center has a Neopuff Infant Resuscitation machine. This is the same equipment found in most hospitals, which is used to help a newborn breathe. In addition to this safety feature, everyone on our staff is trained in cardiopulmonary resuscitation and neonatal resuscitation. We hold staff drills 4 times each year to practice our skills should they ever be needed. In addition to being prepared to assist a newborn with breathing, many prospective parents want to know how we handle emergencies like excessive maternal bleeding after childbirth. We have IV fluids and three different medicines to help control bleeding. We don’t use them routinely, but if bleeding is excessive they are available in our birth center. We take safety very seriously!

Our Cesarean Rates

Geneva Woods Birth Center has an overall cesarean section rate of 4%. This means that of all the women who started labor at the birth center, only 4% have ended up with C-sections. This is data collected over the 13+ years we have been open. The national C-section average is 32%, with the overall C-section rate at Providence being 34.9%, but 50% for first-time moms.

For clients choosing hospital birth (or developing risk factors before labor and becoming ineligible for the birth center), our cesarean rate has remained under 10%. Our midwives take care of clients with intermediate risk factors such as mild hypertension, [diet-controlled] gestational diabetes, bleeding disorders and on occasion twins, so the risk of cesarean is greater when women have other risks. Our cesarean rate matches up with what is predicted and expected for safe care according to many national organizations such as the World Health Organization (WHO). View the report. According to the WHO, a cesarean rate below 10% may indicate underutilization, and a rate over 15% indicates over-utilization.

Myths Surrounding ‘High Risk’

There are many myths out there as to what constitutes a high risk pregnancy. Many women believe (and this belief is often fostered and perpetuated by physicians) that they are high risk because they are over 35 years old, or have had 1st trimester miscarriages - whether it be one or several. Many women also believe that if they had to use fertility drugs or techniques to get pregnant, they have a high-risk pregnancy. None of these are high-risk conditions. Neither is having ovarian cysts or having a personal history of cancer. None of these conditions would risk you out of the care of CNMs, OR out of having your baby at a birth center, if that is what you desire.

What “High-Risk” Really Means

The women who are truly too high risk for a birth center are:

  1. Having a breech baby (that was not successfully turned)

  2. Have a history of a previous cesarean section (the state won’t allow VBACs in birth centers)

  3. You have a clotting or bleeding disorder, or are severely anemic

  4. You develop preeclampsia or high blood pressure this pregnancy

  5. You have twins

  6. The placenta is covering your cervix or you have unexplained heavy bleeding

  7. You have too much or not enough amniotic fluid surrounding the baby.

 

These lists aren’t meant to include every high risk condition, so if you have any questions, please call us. Certified Nurse Midwives can take care of patients with some of the conditions listed above, and can attend their birth in the hospital.

What is a “Normal” Labor?

What constitutes a “normal labor curve”, or in other words, how long should a woman’s labor last? There are many factors that determine the length of labor. Some of the most important factors are:

  1. Fetal positioning-labor is usually longer when babies are face up

  2. Genetics: If your family history (mom and sisters) is for fast labors, you may have a fast labor also.

  3. Preparation: Women who are relaxed and prepared generally have shorter labors

  4. Level of fitness: women who exercise and keep their pregnancy weight gain down will typically have slightly shorter labors

  5. Condition when labor started: Being well rested and hydrated help labor move along.

  6. Epidurals and sedation may slow down labor

  7. Being induced generally results in a longer labor compared to labor starting on its own.

 

Read an excellent article on the increase in the diagnosis of “failure to progress.”

See the actual length of labor in stages.

Each Woman is Different

At Geneva Woods Birth Center, we understand that labor is different for each woman. We have been fortunate to have cared for many women who have three to four babies with us and we know that each labor can be different for individual women.

We don’t have hard and fast rules about when someone isn’t progressing enough and needs to go to the hospital. Progress is sometimes measured in cervical thinning, or the baby turning her head and dropping lower. We won’t expect you to dilate 2 cms every hour according to some medical curve developed in the 1950’s… But there are ranges of normal, and if your labor is stalling out, we more than likely will try some natural ways to encourage your uterus along. We may use herbs, a breast pump, IV hydration, a nap, sterile water papules or other techniques to get more efficient contractions.

If we have exhausted these natural techniques, the decision to transfer to the hospital is a shared decision with you and your midwife. We have hospital privileges and can take you there without interrupting your care, but we strive to preserve the birth center experience if at all possible, and don’t transfer you unnecessarily or against your will.

Certified Nurse Midwives

 

There are two kinds of midwives licensed in the State of Alaska: Certified Nurse Midwives, or CNMs, and Certified Direct-Entry Midwives, or CDMs. The latter’s name derives from the hands-on apprenticeship-style training that they do to directly enter the field instead of passing through a university. At The Nest, all of our midwives are Certified Nurse-Midwives, which means they have completed Masters-level training in nursing or midwifery, can prescribe medications as needed, can deliver VBAC births, and are certified by the American Midwifery Certification Board.

Learn more about the History of Midwifery and Birth Centers.

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