FAQs Here are some commonly asked questions to help you get acquainted with the Midwifery Group. What services can a Certified Nurse Midwife offer? What if I have a health concern that requires further attention? What is the difference between a doula and a midwife? If I have a midwife as my provider where will I give birth? Does my insurance cover my care with a midwife? How long are my visits with a midwife? Who will deliver my baby? If I have a baby with a midwife does it mean that I can't have pain medications? Can I birth my baby in the water? Can I have a vaginal birth after cesarean? What if I need a cesarean birth? Will I see a doctor during my prenatal care or birth? Can I have family members and/or children present at the birth of my child? Will I get help breastfeeding my baby? What services can a Certified Nurse Midwife offer? Along with care during pregnancy and birth we also provide well women gynecological care across the life span including: Contraception (including diaphragms, pills, patches, rings, depo, IUDs and Implanon) Preconception planning Annual exams Gynecological problems (including vaginal infections, urinary tract infections, pelvic pain, abnormal bleeding, breast complaints) Laboratory testing and radiology referrals (mammograms, pelvic ultrasounds, etc.) What if I have a health concern that requires further attention? We can easily refer you to one of our consulting physicians or other area providers for further evaluation and treatment or surgical consultation. We are also able to refer you to other health care providers like chiropractors, physical therapists, counselors, etc., as necessary. What is the difference between a doula and a midwife? Doulas are individuals chosen by an expectant mother to work with her and her family during labor to provide uninterrupted physical and emotional support. They are frequently an integral part of the labor team, surrounding the patient and her partner with encouragement and suggestions for coping with labor. Your midwife’s goal is to do the same but in addition, we are responsible for monitoring your health and your baby’s health during labor, providing you with information about your progress, giving you options or advice related to your labor, discussing medical decisions as needed and “catching” or delivering your baby. There is very good evidence that having a doula present at your labor can decrease the use of pain medication and improve outcomes for you and your baby. If I have a midwife as my provider where will I give birth? As part of the University of Rochester faculty, the midwives at URMC Midwifery Group attend births at Highland Hospital. We strive to provide you with the birth experience that you and your family desire and need, ranging from natural, low intervention childbirth to the use of epidurals or higher level evaluation and monitoring. The midwives work to promote normal, healthy birth but in a setting where medical resources are available if needed. We avoid unecessary intervention. When an unexpected intervention is necessary, our families are informed and involved in the decision-making process. We have found Highland Hospital to be very supportive of the URMC Midwifery Group and our patients. The midwives attend approximately 500 births a year and since 2000, the midwives have attended 5,277 births. Does insurance cover my care with a midwife? All forms of insurance in the state of New York cover midwifery care. In some cases you may need a referral. If your insurance is from outside the Rochester area, we ask that you contact your member’s services department to ensure they participate with our practice or whether a referral is necessary. How long are my visits with a midwife? Following a detailed initial visit with a nurse and then a midwife, your prenatal visits are typically 15-20 minutes long. Visits are monthly at first, then more frequent as your pregnancy progresses. A visit will include checking your weight and blood pressure, measuring the growth of your baby, listening to the baby’s heartbeat and exploring any problems or questions that you may have. Our goal is to get to know you and your partner and/or family members and understand what your thoughts and goals are for your pregnancy and birth and participate in shared decision making together. Who will deliver my baby? One of the midwives from URMC Midwifery Group will “catch” or deliver your baby when the special day arrives! Although it is not mandatory, you are encouraged to get acquainted with as many of the midwives as possible during your pregnancy as it is difficult to predict which midwife will be on call during the time of your birth. If there is a midwife that you feel more comfortable with or would like to see more often, that is for you to decide and that can requested at our front desk. Some women do not feel that they need to meet the midwife who will be with them at their birth before the day arrives; they would rather see the same one or two midwives through their pregnancy. That is also fine. We leave it up to you as this is your journey and your experience. If I have my baby with a midwife does it mean that I can’t have pain medications? The midwives at URMC Midwifery Group strongly believe that this is YOUR birth. This means that we are supportive and respectful of women’s choices regarding their prenatal care, the people present at the birth, the plan you have for labor and giving birth, and the decisions surrounding your pregnancy and birth, including the option of using pain medications. We have many patients who choose any or all of the following for pain management in labor: hydrotherapy (using a Jacuzzi tub), sterile water papules, narcotics, and/or epidurals. Your birth experience is a journey and one that is often unpredictable so we encourage patients to remain open to all options. Our goal is to provide you with education and choices while you remain in control of your birth experience —one of the most profound moments of your life. Can I birth my baby in the water (waterbirth)? There are currently no hospitals in the Rochester area that offer waterbirth. At Highland Hospital we offer the use of Jacuzzi tubs in labor to promote pain relief. Many of our patients will use the tubs at some point during their labor. When it comes time for your baby to be born, if you are in the tub, we will help you to get out of the water. Can I have a vaginal birth after cesarean? The midwives will spend time with you during your prenatal care to discuss the option of a vaginal birth after cesarean (VBAC) with you. For most individuals it is a very safe option to pursue a VBAC. If you decide to attempt a VBAC, you will have strong support from URMC Midwifery Group, and a very good chance at success (often about 80-90%)! The decision to have a VBAC is a personal one and often difficult. The midwives will support and respect the decision you make, whether it is to attempt a VBAC or to have a repeat surgical birth (cesarean section). What if I need a cesarean birth? If you need a cesarean birth, the doctors who work with us will do your surgery. Usually this is in labor but occasionally it is needed before labor begins. Regardless of the time of day there is a doctor available. Your midwife will remain with you throughout your surgery and will be present during your recovery. A midwife and doctor will continue to see you for your postpartum stay in the hospital which is normally 3 days (2 days for a vaginal birth). Will I see a doctor during my prenatal care or birth? Most women who choose URMC Midwifery Group will not see a doctor during their pregnancy or birth. Approximately 75-80% of babies worldwide are born into the hands of midwives. We work closely with our consulting physicians so that if a complication arises at any point during your pregnancy or labor they will join the team to help care for you and your baby. Can I have family members and/or children present at the birth of my child? Yes! We encourage you to have support from family and friends throughout your birth experience. Your older children are also welcome. It is ideal to have prepared them before the birth so that they know what to expect, what they will see and how they might feel. Highland Hospital limits the number of guests in the labor room to 5 at any given time. Will I get help breastfeeding my baby? We strongly encourage you to breastfeed your baby as it is the healthiest thing for both you and your newborn! Breastfeeding is very natural but not always easy, so we are lucky at Highland Hospital to have full time lactation consultants at the hospital 7 days a week whose only job is to help you and your baby establish a healthy and painless breastfeeding partnership. The midwives, the labor nurses, the postpartum nurses and the lactation consultants will work with you, your baby and your family to help make breastfeeding a successful experience for you.