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Why should I choose to use a Midwife over hospital/physician care?

Less Chance of Intervention: If you are interested in natural childbirth without medical intervention or drugs, there are many benefits in using a midwife. We believe that birth is something that a woman’s body is made to do. In most low-risk cases, her body can complete a successful delivery without medical interventions that could actually cause problems for mother and baby. Midwifery care helps equip Mom with nutritional info, beneficial exercise regimens, and natural pain management techniques- all designed to support mom’s natural ability to carry and deliver her baby without the need for intervention.

Less Pressure to Induce: Medical induction increases the chances of cesarean surgeries and many OB practitioners are eager to perform this type of delivery. Today’s cesarean section rate in the US is 33% although the World Health Organization has stated that a healthy rate should not be over 15%. Midwives routinely deliver healthy mothers and babies with cesarean rates less than 10%.

Support for Mother’s Wishes: A midwife assisting at birth works with the mother to make informed decisions about her care and strives to meet the mother’s requests. Our Midwives work to guide her gently to a successful, no-intervention delivery.

More Support During Labor: Smart Pregnancy and Birth offers comprehensive labor care. We attend the mother throughout the entire labor, whereas most physicians stop in only for brief checks, and when the baby is about to deliver.

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How is birth different with a midwife?

Under the care of a midwife, laboring mothers are encouraged to follow the body’s leading from the first contraction to pushing time. Moms are encouraged to use different positions so Baby can be born as easily as possible. We will not perform an episiotomy, which is a cut to the vaginal area that has been proven unnecessary to birth a baby (even a larger baby). Mom is encouraged to drink fluids, remain as mobile as she wishes, have Father and/or support persons present, take pictures, and do anything else that would make the birth meaningful. Baby is given to Mom immediately after birth and they are not separated as we perform the necessary checks to see that they are both healthy. Mom can deliver in bed, in the water or anywhere else she chooses.


Is Midwifery a safe option?

If you’re wondering whether it is safe to use a midwife rather than a hospital system, the answer is yes! For information on the safety of home birth and / or midwifery care visit, review the summary of this Midwifery Study by the British Medical Journal. This study on births attended by certified professional midwives shows that out-of-hospital birth is just as safe as hospital birth for low risk mothers when looking at infant mortality statistics.

This study also shows that mothers had safer outcomes with less cesareans, less forcep delivery, less vacuum extractor deliveries, and fewer episiotomies. With current cesarean rates at an all time high at nearly a third of all births, midwifery care (shown to have less than 10% in cesarean births) is a safer alternative for the mother.


What are prenatal visits like?

You are seen by the midwife who will be at your birth and are not rotated among a large number of other care providers that you may never see again.

During prenatal visits, we provide useful information on nutrition, exercise, stress management, as well as pregnancy/birth education. Our prenatal visits are designed to prevent problems before they even start. Physical exams are performed at each visit, when we check all of the things that are checked at a normal OB visit. These checks include blood pressure, protein/glucose levels in urine, edema, and abdominal palpation to determine size and position of Baby. We monitor maternal weight, and ask in-depth health questions to screen for any signs of potential problems. Vaginal exams are kept to a minimum, unless preterm labor is a concern, or Mom is past her due date. Labs (blood work) and ultrasounds are the only services that must be outsourced.

A full hour is allotted for each visit, giving us plenty of time to evaluate Mom’s health and discuss any questions or concerns she may have.


What are the benefits of having a water birth?

Water has been called the midwife’s epidural. It’s very effective in helping the mother to relax, making her birth easier and faster. Water can provide warmth and support to the vaginal tissues helping them stretch during the birth. Studies have shown that water birth is safe for mother and baby. Most women really like the use of water and choose it again for subsequent births. If a mother doesn’t like the water or if the lack of gravity in the water slows labor, she can simply get out and try a new position.


Can I have a water birth at home?

Yes! If Mom wants the option of a water birth at home, she may labor in her own tub, or we can bring a portable tub and fresh liner to the home a few weeks before the due date. We provide instructions for filling the tub and list a few extra supplies that would be beneficial to have on hand, such as extra towels and a space heater.


What if I decide to go to the hospital in labor?

Mothers make the choice to deliver out of hospital because they want to experience birth and to give themselves and their child the best start possible in mother / baby life. As a result, we see extremely few women who prefer to transfer to the hospital for pain relief.

You have the right to change your mind at any time and transfer in to hospital care. However, the toughest part of labor, transition, is actually the shortest part at the end of first stage when the midwife excels at helping the mother to carry on to the point at which she can start pushing her baby into the world. Transferring to hospital care at this point would most likely not give enough time for an epidural to be placed or would cause the birth to occur en route in EMS — not what the mother had desired. We routinely see mothers working hard with transition but very thankful at the end that they persevered and had delivered their babies as they had planned, naturally.


What if there is an emergency during the labor?

Midwifery care is focused on preventative care through healthy nutrition, education and informed decision making, reduction of stress, exercises for health and promotion of labor progress, and lengthy prenatal visits to discern problems beforehand and to make recommendations for correction or make referral for hospital care if it is determined that the pregnancy is no longer low risk and would be more safely delivered there. Medications are requested from the physician before birth to have on hand to manage postpartum hemorrhage.

The midwife monitors mother and baby at regular intervals throughout labor to assess their health and to make corrections for minor variations and / or to refer for more advanced care.

The midwife has learned out-of-hospital management skills for the rare variations of birth that may occur such as breech and multiple gestations although her priority is to recognize these prenatally and refer to hospital care.

The midwife is trained in CPR and Neonatal Heart Resuscitation skills. Oxygen and bag and mask are available for resuscitation needs. Intubation is not done out of hospital nor are IVs administered although these can be quickly provided in EMS if necessary in a transfer situation.


What happens in a transfer?

If a transfer is advised in labor, the midwife alerts the predetermined hospital Labor & Delivery that a transfer is being made and provides them with relevant information regarding the mother and baby’s health. Paper copies of labs, prenatal care, and birth events are given (home birth) or records are faxed (birth center) to the receiving hospital. EMS may be called to assist with the transfer, but only if necessary.

The midwife will maintain labor support at the hospital and provide on-going emotional support and labor assistance. Medical care will be transferred to the obstetrician on-call at the receiving hospital. The midwife (or assistant / doula, if the parents desire) will remain with the mother until after the birth. The midwife will continue with postpartum care and lactation support after the birth in the home setting.


Who files the Social Security and Birth Certificate paperwork?

We do the necessary paperwork at your postpartum visit to file the birth certificate information and give you instructions on how to get a copy after it has been processed by vital records. There is also the choice of receiving your child’s social security number at the same time.


How do I begin?

Contact Susan and set a time to meet to discuss your birth desires. If you are interested in delivering at the birth center, your meeting may take place there so you can tour the facility. Once you’ve discussed your birth, a meeting will be scheduled to review your medical history and to start your prenatal care. Information will also be given regarding other care providers and resources in the community to help you have the safest, most informed pregnancy possible.

If you have already begun care with another care provider, it is simple to have records forwarded from the previous care provider to Susan and we will begin care from that point. Visits are scheduled monthly up to 32 weeks, bi-weekly up to 36 weeks, and then once a week until birth.


We will tell the next generation the praiseworthy deeds of the Lord, his power, and the wonders he has done. Psalm 78:4
Copyright 2016, Smart Pregnancy & Birth
950 Jolley Road, Chesnee, SC 29323
(864) 909-0042