Tag Archives: birth

The Art of Picking a Great Birth Care Provider

Any woman who is pregnant, should ask herself, “Was I truly empowered with my first birth? With my first/second provider”? If not, then this piece should be a game changer — the prospect of changing birth care providers. This piece will make the process empowering and exciting, and introduce women to the midwifery model of care. Once they find the right provider, they will never look back! Each birth is opportunity for growth – and when women have felt ‘something was off’ with my birth – it is a sign that it is time to find someone to guide them into new motherhood.

Pregnant women are like sponges, absorbing everything and anything they can get their hands on that’s pregnancy related – which is why picking the right birth care provider is so crucial. Providers have far reaching influence and power by transmitting messages about birth while impacting outcomes. Trust between a pregnant woman and her provider is essential to ensure optimal outcomes. Here’s some great tips to help you pick a Great Birth Care Provider!

1. Decide which qualities you would like to see in your provider. Qualities topping the list: Skilled, knowledgeable, compassionate, reassuring. Speaks your language of birth. You feel heard and supported, not challenged when expressing your heartfelt ideas. Finds windows of opportunity to teach you something new and inspiring. Prompts ongoing discussions about nutrition, healthy lifestyle choices, modification of work and activities, and pregnancy safety protocols. Makes appropriate wellness referrals for a team approach (i.e., chiropractic, PT, therapist). Doesn’t rush the prenatal visit.

2. What kind of practice do you prefer? Solo or group? Do you prefer to give birth in a hospital, a birthing center in a hospital, a free standing birthing center, or have a home birth? The smaller the practice, the closer the relationship you build. The larger the group, the less apt you are to get to know each provider as they rotate you through the practice. The goal is to be philosophically like-minded with each provider. Find a birth location where you feel safe. Each person has a different perspective and there is no right or wrong place to give birth.

3. This is my first baby. Should I work with a doctor or a midwife? What’s the difference? Midwives work with healthy women and obstetricians care for both low and high risk women with medical conditions such as diabetes, heart or liver disease, and auto immune disorders. Midwives are independent health care providers with expertise in pregnancy, childbirth, the postpartum period, care of the newborn, common primary care issues, family planning, and annual gynecologic well-woman care. Midwives screen their clients carefully and make medically indicated referrals to their collaborating and consulting obstetrician, perinatologist, (maternal fetal medicine), genetic counselor, or doctors in other specialties. Midwives consult, collaborate and co-manage with these practitioners. Some midwives co-manage VBAC (vaginal birth after cesarean section,) or twin pregnancies with obstetricians. Midwives do not perform cesarean sections, although some are certified to first assist. While obstetricians are trained in medicine, disease, and abnormality – midwives are trained to recognize variations in normal pregnancies and refer accordingly. Obstetricians are trained surgeons and take care of women with disease states that require initiation and adjustment of medications, and perform surgical procedures including c-sections. Perinatologists are experts in their specialty field when a woman or fetus encounters a high risk medical problem requiring fetal surveillance, procedures, and medications. While OB’s graduate from medical school programs and practice in accordance with the American College of Obstetricians and Gynecologists, (ACOG), midwives graduate from accredited midwifery schools and receive their master’s degree, and some go on for their PhDs. A certified nurse-midwife is educated in two disciplines  – nursing and midwifery. Midwives practice in accordance with the Standards for the Practice of Midwifery as defined by the American College of Nurse-Midwives (ACNM). They are licensed by their individual states, and have prescription privileges. You can give birth with a midwife either at home, in a birthing center, or on labor and delivery floor hospital setting. Midwifery care is reimbursed by most health insurance companies, as is obstetrical care with a doctor. Whether you work with a midwife in a solo practice such as mine, or a group practice, the midwifery model of care has a more holistic view of childbirth than the traditional obstetrical medical model of care. Midwives do not see birth as an illness. If your own heath history or your baby’s medical situation requires only the skills of an obstetrician, find a compassionate good listener.

4. A doula is a godsend. Research confirms the many proven benefits to hiring a doula. Women seem to pick their doula quite carefully, and from speaking to many doulas, I get the feeling that pregnant women are asking many more questions of a prospective doula than they do of their prospective providers. The reality is that doulas are not medically trained and should not be depended upon in this capacity. Regardless of how much loving care, massage, and emotional support a doula provides, they can’t make medical decisions. If a woman doesn’t like her provider,  suspicion, doubt, and blame can arise when interventions are needed, even in the wake of true fetal distress. The stakes are high for mother, baby, bonding, and breastfeeding – when trust is missing. Then positive birth memories become at an all-time low. Many doulas are mothers, (I was) committed to creating a harmonious energy in the birthing room. If you are not in sync philosophically with your provider from the onset, doulas will often find themselves in an adversarial role. Liza Maltz, Certified Lactation Counselor and Birth Doula at birthyourownway.com, is on a mission, “Women should not be afraid to speak to their doctors about their concerns and question their answers. I give my clients the courage to ask questions, I address their issues, so they feel comfortable enough to seek another provider late in pregnancy if necessary.” Maltz observes, “When a woman feels uncomfortable with her provider, I can see her labor slow down when they walk into the room. It’s a set up to fail.”

5. Meet your backup doctor or midwife. When I showed up nine centimeters dilated on September 29, 1989, my back up doctor was waiting. He looked at his watch often, barely making eye contact with me. I felt an emotional distance. While ‘distance’ may be acceptable while waiting on a check out line at a supermarket, (however some cashiers are quite friendly,) birth is up front, close and personal. Busy and distracted providers are like having strangers at your birth. They illicit shyness, modesty and closed legs from their patients making it difficult to open. With basically a stranger between her legs, a laboring women will be kept on guard and labor naturally slows down to ‘protect’ the baby. That is what happened to me until I focused on motherhood and delivered.

6. Explore your motivation. Is the provider you chose your mother’s OB/GYN from 20 years ago who delivered you? If a friend recommended your provider, how was their own birth experience? Worth emulating? Women often pick providers who unconsciously remind them of a significant role model such as a parent or grandparent who was either nurturing or absentee. Selection should not be based on fear or convenience. I believe the c-section rate would drop dramatically in our country if women were mindful of the reasons they choose their providers to begin with. Pick your provider and birth location from your heart, as this woman did, who picked me!

“I need a provider who will work with me (not on me), who will take the time to establish mutual trust and respect (rather than demanding them based on his/her credentials), who understands the holistic nature of pregnancy and childbirth (instead of compartmentalizing mother and child and creating an unnatural disconnect between the two), who is incredibly skilled, and respects and believes in the natural process, understanding that it is truly the safest way to birth (while at the same time recognizing that technology and “medical intervention” may become necessary for the continued health of mother and/or child). After a long day and an even longer 5 months of searching, I finally collapsed. Tears of relief uncontrollably streaming down my face, I knew that I had finally found someone who will help me, teach me, push me, challenge me and most of all who I can trust will take care of me during what I now know will be the most exhilarating, exasperating, and enjoyable time of my life. I must have you as my midwife. Angelique.”

If you are becoming alarmed about your waning comfort level with your provider, transfer practices. ‘Better late than never,’ is right on time when finding the best fit for yourself and your baby.

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Risa Klein CNM, OB/GYN NP, M.S., has been working with pregnant women for 25 years. She is a graduate of the midwifery program at the Columbia University School of Nursing, where she received her Master of Science degree in Nursing with a specialty in Midwifery. Risa offers a home birth approach on Labor & Delivery at Mount Sinai West in New York City. Her office is located on Manhattan’s upper east side. She was the “birth consultant” for the feature films Baby Mama and Maze. To learn more about her midwifery practice, click here.

This blog has been repurposed from Risa Klein CNM.

Meet Our Friends at Village Obstetrics™

We want to introduce you to our friends at Village Obstetrics™ and the wonderful support and care that they provide their patients. We partnered up with them for a Q&A to give our readers an opportunity to learn more about their impressive work.

Q: A big part of Village Obstetrics™ mission is to follow a minimally invasive approach. Why is practicing this important to your mission, and what have you seen as benefits for your patients with this approach? 

A: We see newly pregnant couples who are concerned about interventions meddling in the natural process of pregnancy and birth. And it’s true that the medical profession has become concerned about the high rate of unnecessary c-sections. So, our approach is one that respects the natural process but uses modern medicine and technology to check and see how the natural process is unfolding. If everything looks good, our job is to stay out of nature’s way, but if there’s a storm brewing our job is to figure out together with our mom what the best course of action is. Minimally invasive obstetrics is doing the least necessary to get the job done and it yields low rates of c-section with well-informed satisfied moms.

Q: What are the benefits of unmedicated v medicated birth or c-section? Is there a time in the birthing process where its too late to get an epidural?

A: Birth has lots of variables – the size of the baby, the individual pain tolerance, the length of the labor, the strength of the contraction, head position and on and on. So, it’s fair to say that keeping an open mind is especially important as you approach birth. In general, for first time labor we have seen great benefits from trying to get as deep into labor as possible before getting medications for pain relief. At that stage if you want an unmedicated birth we see how much further you have to go and if its not too far, you typically will make it without medication. Alternatively, if you are at the end of what you can manage and you still have a long way to go, or if you plan on an epidural, that’s a great time to go ahead and get relief.

After you’ve already had a vaginal birth and you are in labor with the next baby, then you need to decide sooner if you want an epidural or not. Probably when your pain is still manageable but now starting to get your attention (say a 6 out of 10 on the pain scale) then it’s time to either get the epidural or commit to finishing it as an unmedicated delivery. The last part of labor could be very fast with second or third babies and there might not be enough time to get an epidural if you wait until pain is an 8 or more out of 10. With the first vaginal birth however, its almost never too late to get an epidural because the progress of labor is much slower usually. Many of our moms now also consider using Nitrous Oxide which is available at our hospital as an alternative to epidural or to maintain control until getting the epidural later.

Q: New patients have lots of questions both pre- and post-birth. How do you help new moms and dads with the transition of becoming parents?

A: One great new addition to the information for new moms and dads is Dr. Worth’s new book, “The New Rules of Pregnancy: What to eat, do, think about, and let go of while your body is making a baby”. We are so proud of her! So many of the existing guide books are so packed full of information that they can be overwhelming and even scary. We needed an expert to sift through those big books and pull out the key information and present it in a format where you can take in a little information at a time while keeping it positive and with beautiful uplifting illustrations that provoke imagination and calm. Dr Worth made that happen and we hope you give it a read. Beyond that we intentionally structured our practice for only pregnancy and birth care. We unapologetically exclusively devote all our time and talents to this important field of obtetrics. Not doing gynecology and well woman care allows us the time to really get into questions and controversies in our office visits. We also hold our own free of charge birth class for our clients that we call our “Pregnancy Chit Chat” – it’s a group Q&A with their doctors. We also reply to our clients e-mails and we try and provide continuing community education speaking, blogging and posting whenever we are invited to by groups involved in pregnancy and birth care.

To learn more about Village Obstetrics,™ click here.

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Written by Taylor Bell, Marketing & Social Media

Do You Have a Birth Plan?

As I get closer to delivery (only five more weeks), my husband and I were advised by my OB to review a series of questions and “what if” scenarios. I found a detailed check list on The Bump, which provided a great starter template. But you have to keep in mind; plans don’t always go the way you envision. So, play out a few different scenarios so you are not surprised, or caught off guard!

Here are some interesting things they brought up that I didn’t really think about:

  1. Do you want the lights bright or dimmed?
  2. Do you want interns present from the birth?
  3. How do you prefer to spend your first stage of labor (i.e., in a bath tub, walking around, with music or in silence)?
  4. During delivery, how do you want to be positioned (i.e., stand, squat, lie on side, lean on partner)?

 

And here are some really important questions to ask yourself and consider:

  1. Would you like labor augmentation? Do you even know what that is?
  2. What kind of pain relief do you want to use? There are a lot of options.
  3. What level of fetal monitoring do you want?
  4. After delivery, what do you want to do with the umbilical cord and placenta?
  5. What if you have to have a c-section. Read about options and recovery. You have decisions here too (i.e., want your partner there, want to see the baby come out via mirror)?
  6. Print out your plan and keep it in your hospital bag. It’ll be a nice source of comfort.

 

**Fun fact: Lindsay had her baby only one week after writing this post! Good thing she had her birth plan (and this blog) all set.

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Written by our Founder & CEO, Lindsay Bell

Have a Birthing Experience Like an A-Lister

Giving birth to your newborn child is one of life’s most precious things to experience (or so I’ve heard). That doesn’t go without saying that there are some not so precious things that occur during labor. To spare everyone of all the glorious details, let’s instead talk about how giving birth can be one of the most luxurious experiences of your life!

You’ve heard it here first; labor can be an experience where you feel like a queen, and it may leave you never wanting to leave that hospital room again.

In an article published by parents.com, they introduce some of the most luxurious birthing suites in the US. That’s right ladies, think spa treatments, 24-hour concierge service, and a private chef! It’s time to leave the roommate life behind, and experience a birthing experience as Amal Clooney would.

  1. Ronald Reagan UCLA Medical Center
    Birthing suites are designed to look like the outdoors! Oh yeah, your food is delivered by a tuxedo-wearing “food ambassador.”
  2. Rose Medical Center in Denver
    Birthing rooms have private bathrooms with Jacuzzi bathtubs, rocking chairs, and flat-screen TVs. To be totally low key, VIPs can enter one of the luxury suites, and be offered the services of a private chef.
  3. Cedars-Sinai in Los Angeles
    If a three-room suite isn’t enough, mom can treat herself to an in-suite manicure, pedicure, or haircut. Celebs like Kourtney Kardashian, Rachel Zoe, and Victoria Beckham have given birth here, so start planning your totally casual celeb run-in now.
  4. The Mount Sinai Hospital in New York City
    Enjoy your luxury suite overlooking Central Park and have your newborn wrapped in muslin cotton swaddling blankets. And no mom leaves without a postpartum massage!
  5. The Women’s & Children’s Hospital at Centennial in Nashville
    How about a 24/7 concierge service to handle your requests? From making sure your car gets an oil change to delivering food from Nashville-area restaurants – can we say VIP?

 

We provided the top five luxurious birthing suites. For the remaining five you can read the full article, here.

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Written by our Marketing & Social Media Coordinator, Taylor Bell

Village Maternity Making a Difference

There are a lot of options for an expecting mother on how she would like her pregnancy to go. A lot can go as planned, but of course some people have to roll with the punches and figure it out along the way.

Birth transforms your life and body completely. Whom you select as your pregnancy caregiver makes all the difference in determining the satisfaction and safety of your pregnancy journey and birth experience.

Village Maternity believes the best birth for mom and baby comes from blending the unique strengths of midwives and doctors with the safety of a wonderful hospital partner.

‎The Village Maternity team firmly believe that true collaboration of midwives and doctors provides you with the safest and most satisfying birth experience. They approach your pregnancy with energy and enthusiasm and strive to help make your care with Village Maternity an amazing journey.

Village Maternity proudly collaborates with Metropolitan Hospital - a hidden gem for NYC families. Among Manhattan birth sites, Metropolitan has a long history of true midwifery care, including support for unmedicated birth with one of the lowest epidural rates. Metropolitan has one of the lowest cesarean section rates and the least overcrowding.  Metropolitan physicians provide support for one of the highest rates of vaginal birth after cesarean section.

Village Maternity offers both Maternity Care (prenatal and postpartum) as well as Preconception Care. Not to mention 24/7 phone access. How reassuring to have your doctor a call away. They even have weekend and evening office hours. Village Maternity offices are conveniently based in midtown east.

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Note: Village Maternity did not pay for this post. I met the doctors at Village Maternity and truly believe in their mission. For more information please visit their website.

Written by our Founder & CEO, Lindsay Bell