Frequently Asked Questions (FAQ)
FAQ
What is a midwife?
Midwives are, and have been, the traditional care providers for mothers and infants around the world. Midwives are trained professionals with expertise and skills in supporting women/birthing people to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women/birth people with individualized care uniquely suited to their physical, mental, emotional, spiritual, and cultural needs. Midwifery is (traditionally) a woman-centered empowering model of maternity care that is utilized in all the countries of the world with the best maternal and infant outcomes. Midwives value communication and developing a trusting, working relationship with the women/birthing people and families they serve. While developing that relationship, midwives provide personalized and thorough care during the childbearing year (pre-conception counseling, pregnancy, childbirth, and the postpartum period). Many midwives also provide care of the normal newborn through 6 weeks of age. In addition to being trained to conduct comprehensive physical exams, order laboratory screening and other diagnostic tests, midwives provide extensive health care education and counseling, as well as engage in shared decision-making with their clients and patients.
Why should I use a midwife?
A midwife may be the best provider of pregnancy care if…
• You have a low-risk pregnancy (If you don’t know the answer, a midwife can help you find the answer)
• You want to be an active decision-maker in your pregnancy and birth
• You want a natural birth with minimal interventions
• You would prefer more than 5-10 minutes per visit with a provider (a midwife visit is 45 minutes to 1 hour each)
• You believe that pregnancy and birth are normal body functions and not an illness routinely requiring hospitalization and doctors (1/3 of the babies born in San Antonio hospitals are born by c-section)
• You want options of movement, eating, drinking, and where you birth YOUR baby
• Hiring a midwife will not guarantee a vaginal or out-of-hospital birth, but it will greatly increase your odds of having the birth experience you seek.
Are you licensed in the state of Texas? What are your credentials?
Yes. Licensure is a legal requirement for all midwives in the state of Texas. Lay midwives and unlicensed midwives are illegal in Texas. Robin is a licensed midwife and certified professional midwife (and any other midwife employed by this facility should have the same credentials). LM means the midwife is licensed in the state of Texas. A CPM is an independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care.
How is a birth center different from a hospital?
A birth center is a haven offering a caring, warm, home-like setting where you are supported and respected, as well as safe and secure. You will have a private suite to birth your baby. You should feel comfortable wearing your own clothing, have nourishment when you feel hungry, soak in a tub for comfort, and have the freedom to move around in labor. A birth center welcomes your chosen support team (family members, doula), who will be with you as you labor and give birth. It is a place providing up-to-date information on newborn care, breastfeeding, parenting, and family planning.
Do you provide care for LGBTQ and/or multicultural families?
Absolutely! It is vital that ALL people have access to knowledgeable and skilled midwifery care, advice, and support when contemplating pregnancy and during the prenatal period, labor and birth, and the postpartum period. This practice provides ALL people access to evidence-based, culturally sensitive, individualized, and client/family-centered care and support.
Can I use my health insurance to pay for services?
Westover Hills Birth Center is an “out-of-network” facility, and we are not contracted with any health insurance provider or company. Texas Medicaid, Tricare, and Blue Cross Blue Shield (or any of their subsidiaries such as Anthem Blue Cross, or from any state) will NOT pay for out-of-hospital midwifery care. Many major insurance companies, such as United Healthcare, Aetna, and Cigna, might pay for out-of-hospital maternity care and birth, but the extent of reimbursement coverage and benefits is typically very minimal, and therefore, we cannot accept insurance billing for our services. Westover Hills Birth Center will also not provide itemized superbills, insurance CPT or ICD-10 codes, or file claims with any private health insurance, Tricare, or health share organization plans for clients paying our early-pay global fee for services. Our global fee cannot be itemized for insurance superbills. You will/may, however, be able to use your insurance or Medicaid to pay for “outside” or ancillary services such as lab work, ultrasound exams, or chiropractic care. Also, “FSA” and “HSA” accounts through your employer can usually be used to pay for services provided by Westover Hills Birth Center.
What should I expect at a prenatal visit?
Each visit lasts about 45-60 minutes. During that time, your questions will be answered. We discuss concerns, fears, and changes in your body and daily life since your previous visit. Your vital signs will be monitored – blood pressure, pulse, and temperature. Your baby’s position will be palpated in your belly. We measure the growth of the baby and listen to the baby’s heart tones. Each visit, your urine will be checked for protein, glucose, and blood. Discussion and decisions about various lab tests will occur and be performed at appropriate times. Family, friends, doulas, and other invited guests are always welcome to attend your prenatal visits and ask questions if you agree. (No private health information will be shared unless the client approves.)
What is your view on labor and birth?
Pregnancy, labor, and birth are natural life processes. With proper education, time, and referral to resources, parents can make the best decisions for their pregnancy, labor, and birth. Reassuring a laboring woman that what she is experiencing is normal and safe helps her to have the natural birth that she is seeking. The midwives feel it is very important for a laboring woman to move, eat, drink, sleep, and use the toilet as she desires throughout her labor and birth. They also believe that the hospital setting does not often facilitate these basic human functions. The midwives believe that by reminding and encouraging the laboring woman to move, eat, drink, and sleep, the woman is better able to allow her body to birth her child.
See how we do things differently.
How will I cope with labor?
Some women will tell you that they “couldn’t have done it without an epidural.” Think about this: When you strap a woman to the bed (usually on her back) with electronic monitors and IVs, leave her alone in a sterile hospital room, take away her clothes, forbid her to eat or drink, take all power and control away, and stress her out with a constant stream of strangers in the room (many performing exams and “managing” labor), what other coping mechanisms does she have? Research shows that stress hormones, such as cortisol, increase pain and slow the progress of labor. We try to make your labor as low-stress as possible. Our clients get to know Robin and Julie personally from prenatal visits. They are familiar with the birth center since they visit us for visits and classes frequently! We do not perform unnecessary interventions or keep you on a “labor curve.” We hand the power to you when you wear your own clothes, eat your own food, choose who will be present at the birth, and trust your body. During labor, you are encouraged to walk and change positions often. We have birth balls, birth stools, and “birth” (yoga) slings to help you get into the most optimal position for labor progress. We use heat, massage, and TENS units on sore backs. Hydrotherapy (our beautiful soaking tubs) has been shown to decrease the pain of labor, so we encourage women to labor in the water. You are surrounded by continuous support from the midwife and your support network. When you are allowed to follow your body, labor is very manageable. You will instinctively get into the best position for your labor and birth.
Do I still need to see my doctor?
No! Midwives are licensed providers that can independently provide care in the childbearing year. If a physician consultation and/or co-management is needed, the midwives will make a referral.
I started prenatal care with another practitioner. Is it possible to transfer care to you?
Absolutely! We would love to have you come join our family! We can accept transfer of care for most clients, providing there are no pre-existing risk factors that make out-of-hospital care too high of a risk for you and your unborn baby. You will fill out a “records request” form that allows your previous provider to send us your medical records.
I have heard that birth centers only care for “low-risk” pregnancies. What is “high risk”?
We believe that pregnancy is normal and that your body knows how to give birth. Your age and number of prior pregnancies are no concern, provided you are healthy with no significant pre-existing health conditions. Per state regulations, we can safely deliver babies between 37 weeks gestation (3 weeks before your due date) and up to 42 weeks gestation (two weeks past your due date). However, there are high-risk situations that are not appropriate for out-of-hospital births. We cannot accept clients with chronic high blood pressure, diabetes requiring medication or insulin, placenta previa (the placenta is over the cervix at term), pregnancy-induced hypertension/preeclampsia (aka “toxemia”), or a previously diagnosed medical issue with the unborn baby (heart defect, etc.) that will require immediate special care. If you have a question about your “risk status,” feel free to make an appointment to speak with Robin about your personal concerns.
What happens if there is a problem during my pregnancy or birth?
Midwives specialize in normal pregnancy, labor, and birth. They focus on encouraging healthy habits to encourage a healthy body and pregnancy. If a complication arises during pregnancy, consultation and/or co-management with a maternal-fetal-medicine specialist (MFM) will be arranged. If the condition becomes too high risk to safely continue care at the birth center, transfer of care to a hospital-based provider will be initiated. When labor and birth occur spontaneously and naturally, complications are rare. During the birth process, the midwives carefully monitor both the mother and baby. All midwives who work at the birth center are trained and experienced to recognize and manage emergencies, should they arise. If a complication presents, the midwives do not hesitate to transfer care to a more appropriate location, the hospital. The midwife’s goal is always to have a healthy mother and a healthy baby. The birth center has a working relationship with the OB hospitalists at Christus Santa Rosa Westover Hills Hospital, located less than 3 miles away. In the case of an emergency, we can have you in the hospital in a timely manner. If the birth occurs in a hospital (or a postpartum/newborn transfer to the hospital becomes necessary in the immediate postpartum care period), normal midwifery care can usually be safely resumed after hospital discharge for the remaining 6-weeks of postpartum and well-baby care.
Is water birth available?
Absolutely! Each birth suite has a large soaking tub for laboring mothers to experience the pain-relieving/relaxing magic of water and to birth their babies if they choose (and it is deemed a safe option for mother and baby).