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FAQ – Inspiration Family Birth Center

FAQ About Our Midwifery Care

How Do You Monitor the Baby and Mother in Labor?

We use a handheld Doppler to listen to the baby’s heartbeat during labor on a regular schedule according to where you are in labor. The monitoring intervals become increasingly more often as you move through your labor.  This is called intermittent monitoring.  Research shows that listening intermittently is equally as effective as continuous electronic fetal monitoring (EFM) in identifying problems during labor and delivery.  In fact, studies show that intermittent auscultation results in lower rates of c-sections with the same neonatal outcomes.

Mother’s are monitored regularly throughout labor. Vital Signs such as Blood Pressure, Pulse and Temperature are checked often. This monitoring is done for mother and Baby at Inspiration Family Birth Center is as unobtrusively as possible. If you are out for a walk, we simply meet you on the porch to check you and your baby. Enjoying the water birth tub? No problem! All our equipment is water resistant and we will monitor you while you relax in the warm water. No need to lie in the bed on your back just to monitor mom or baby, these can be done while you are active and mobile, or relaxing in the water birth tub.

Is Birth Center or Home Birth Safe??

Yes. A resounding YES. Below are links to several resources to help you explore this important question. Safety of you and your baby is our TOP priority and we would never put you or your baby at unnecessary risk. If you and your baby are both low risk, and fall within well established protocols, out of hospital birth is among the safest way to have a baby. All options are discussed at length and communication with you is important to us. We want you to make every decision completely informed all benefits and risks along  the way.

In 2011, the American College of Obstetricians and Gynecologists Committee Opinion on Planned Home Birth references that hospitals and birthing centers are the safest setting for birth. This was followed up in 2015 with the consensus document on Levels of Maternal Care by ACOG and the Society for Maternal-Fetal Medicine that acknowledges and addresses care provided at birth centers, including the role of caregivers. (Cite)

A landmark study published in the Journal of Midwifery and Women’s Health,[2] shows that birth centers provide first-rate care to healthy pregnant women in the U.S. The purpose of this article is to fill you in on what the The National Birth Center Study II found and what it means for moms and families. (Cite)

What about an Emergency?

Complications are rare in low risk women, at term with a low risk baby. However they do occur. Birth Center midwives are equipped and trained to handle all emergencies situations that may arise. We would start treatment from IV’s to Oxygen to medicines that need to be started, while transferring to the hospital if it is deemed necessary. Not all emergency situations will require transport to the hospital. If the emergency is resolved by the midwives and is not expected to return, we may continue at the birth center with out transferring. If you require transport a midwife or member of our senior staff or senior students would accompany you to the hospital for continuity of care. We will stay with you as long as possible to ensure your care is uninterrupted. For time sensitive transports – meaning we need to be at the hospital very quickly, we use Florida Hospital South/Princeton. This hospital is 5 minutes away. Our staff would call ahead and alert the hospital to expect us. We would skip the waiting and go straight to a room. There would be no gap in your care from birth center to hospital, as care would be rendered en route. 

Our most common transfer is a non emergency transfer for failure to progress in labor. When all our midwife tricks are not working and it is clear that the mom and baby would benefit from hospital care, we would arrange to transfer you. Our Transfer Rate is <10%. Our C/S rate from those transfers is 2%. Most of our families go on to have a normal, vaginal delivery at the hospital, even after transferring from birth center care. 

Do You Offer VBAC (Vaginal Birth After Cesarean) ?

Birth Center law does not allow for VBAC in a birth center facility. Currently we can only offer home birth for those that would like a VBAC.  Birth Center rules and laws are different from Home Birth laws and Rules.

If this is your first attempt at a VBAC and your previous child was born via c-section, we can not accept you into care. If you have already had a vaginal birth after your c-section, then you are eligible for our care, for home birth. There are quite a few home birth practices that are offering primary VBAC services. Please call our office for recommendations on midwives in the area providing this service.

Do you wait to cut the baby’s cord?

Yes. We believe in a physiological birth. we will leave the baby’s cord untouched during the first few minutes. After baby has shown to be breathing well on their own and the cord appears to be diminishing in size (showing baby no longer needs the cord) we will collect a small specimen of blood to gather baby’s blood type.  Once the cord has completely stopped pulsing, we will then clamp the cord and have dad or whomever would like to cut the cord to do so. 

Do you require an Ultrasound during pregnancy?

The short answer is yes.

Here is why: We require at 1 ultrasound at 20-24 weeks of pregnancy. We request an ultrasound only when we feel it is medical needed. The reason for requiring this one ultrasound is to determine all we need to know about your pregnancy and baby in one ultrasound. We understand many families want to avoid ultrasound when possible. This is a very good goal, as ultrasound is way over used without a proper understanding of risk vs benefit of this overuse. However Ultrasounds are a very safe way of determining problems in pregnancy or with the baby, when used appropriately and when needed.

In order to have a safer birth center or home birth, you AND your baby must be low risk. We have no way of determining this without at least 1 ultrasound after 20 weeks gestation. Some minor complications of pregnancy can be monitored better in a hospital environment for birth. An example of this is a cardiac defect in your newborn. We would not know if your baby has a problem with one of it’s organs, like the heart, unless we look or at birth when baby is unable to breathe well, or has trouble with oxygen. We would not want to put a baby at risk, by being born at the birth center, delaying treatment of the baby’s cardiac defect, for example. This could compromise the baby, and possible lead to the death of the infant. Another example would be a problem with the placenta, like placenta previa. If the placenta is covering the cervix, we may not know this until bleeding occurs that could compromise the baby or the mother. This life threatening condition scan be ruled out with just the 1 ultrasound.

While ultrasound is not perfect, in our years of experience we have found many things on ultrasound that would have compromised mom or baby, should they had chosen birth center or homebirth. These mothers and baby’s then had more appropriate care and very good outcomes. For this reason Inspirations policy is for 1 ultrasound. If you reach 41 weeks of pregnancy, we will request 1 more ultrasound, but a limited one, enough to assess fetal being (called a Bio Physical Profile) to determine that it is safe to wait for labor to start on it’s own.  

Do You Require the Use of a Doppler?

Yes and no. We will use a fetoscope for you in your pregnancy, if you do not want to use a fetal Doppler. We understand that doppler waves used by monitoring equipment can be controversial.

However, we require the use of Doppler monitoring in labor. It is very difficult to properly monitor a baby’s well being in labor with a fetoscope only. For instance, if you would like a water birth, you would not be able to use a fetoscope. We would have to ask you to get out of the water or alter your position enough to monitor the baby’s heartbeat. However with a Hand held Doppler, which is water proof and able to be used under water, we can monitor your baby without asking you to move to accommodate our monitoring. We can then monitor as needed, without interrupting your labor space. This applies no matter where you are, the shower, the tub, outside walking, cuddling with your partner etc… we can monitor your baby and help keep you and your baby safe!

Our laws require us to have an intermittent monitoring schedule that means your baby will not be exposed continuously through out labor, but just often enough to determine well being. This is once every 30 minutes in active labor, once every 15 minutes in transition and every 5 minutes while pushing. This is very little exposure to the Doppler over all.

When do I see the Midwife again after the birth and what tests are done?

You will have a visit with the midwife 24-48 hours after the birth of your baby. we will check on you and your baby, assess breastfeeding and any other medical needs. Your baby will be offered 2 tests for Critical Congenital Heart Disease (more on CCHD) Screening and Newborn Metabolic screening (More info on Newborn Screening). Your baby will also need a ghearing test in the first 30 days of life. we do not perform this screening, but will refer you to an audiologist that does this test. All these tests are covered by insurance. 

The midwife will see you again at 2 weeks postpartum, and 6 weeks postpartum. However we are always available to you if you need an appointment in the mean time. 

Does the Baby see a pediatrician?

No, not at the birth center. The midwives are trained in normal newborn care and exams. The midwives will perform the first newborn exam and write a report for your pediatrician. You will see your own pediatrician with 24-48 hours after the birth. We have a list of preferred pediatricians’ based on feedback from our parents, looking for a more natural approach. 

What happens if I need pain medicine and don’t want natural anymore when I am in labor?

The vast majority of clients who start labor and are admitted to the birth center, finish their labor and birth at the center. Very few moms transfer for pain management only. This makes up less than 1% of our transfers. It does happen though. If you are in labor at the center and the labor intensity is overwhelming, we will help you. We are very good at helping you regain control of your labor. If we can not help you with our natural management / midwifery techniques will transfer you to the hospital for an epidural or other pain management at your request. Our midwives will never give up supporting you, even if you say your are done and want an epidural, our midwives will work with you to manage your contractions. However, we will not force you to stay at the center if you really do need pain management and it is not just because you are almost finished. Many women will say they can’t do it anymore, right before the birth of the baby! We know you can do this!

Does Inspiration Family Birth Center Provide Pain Medicine or Epidurals?

No. Our goal with Inspiration is a non medicated, natural birth with as little medical intervention as possible. We provide High Touch, Low Tech care. We support you physically and emotional to help you through your labor and birth naturally and without the need of medication or epidurals.   In our experience less than 1% of mother’s planning a natural birth at a birth center or home ask to be transferred to the hospital for pain relief. When you are able to eat, drink and move as you body tels you, there is not as much discomfort. Proper support and preparation prior to labor will also help significantly. We offer natural alternatives, such as a large jacuzzi tub that provides warm water and jets in just the right places to relax muscles and reduce pain. This can be a significant reduction in how uncomfortable you are, making your labor very manageable.

What About Twins or Breech Babies?

In order to qualify to birth your baby with a birthing center in Florida, you must have only 1 baby. This one baby must be head down when you go into labor. We can not do twins or breech births at our center. We watch your pregnancy closely. If we suspect twins we will have an ultrasound down to rule out multiples. We check your babies head position every visit after 30 weeks. If you baby is breech we will work with you to try and get baby to turn head down. If your baby is still breech at 37 weeks, we will discuss options for hospital delivery for you. If you come in to the center in labor and it id discovered your baby has turned head up, you would be transferred to the hospital for delivery.

Does the Inspiration Family Birth Center Provide Ultrasound?

Yes. We do not provide this service in house, but will give you a script for one of our preferred radiology centers.   Midwives are not anti-technology; we believe in the appropriate use of technology and informed choice/consent.  Your pregnancy and birth are yours—we are here to educate you and make it as positive an experience as possible.  Inspiration Family Birth Center requires our clients to have 1 ultrasound during the pregnancy between 20 and 24 weeks, known as an anatomy scan. This ensures your baby is low risk and the placenta is not in the way of the birth. This prevents unnecessary complications for you or your baby at the birth.  All other ultrasounds recommended would be for medical need only and discussed with you, so you can make an informed decision.

 

FAQ About Our Center

How Many Midwives Do You Have?

We have 1 full time Midwife, Mary Surprenant LM, CPM. We have 1 part time midwife, Laura Nathan, LM, CPM. We have a 3rd back up midwife, Robyn Mattox LM, CPM. We also have arrangements for a 4th and 5th back up midwives if needed! We always make sure we have resources to be sure you are well taken care of in your pregnancy and birth. We also have a Nurse Practitioner, Donna Fechtmuller on staff. 

Do you help with Breastfeeding?

Yes, we help you with lactation. Our midwives are well versed in first day/birth day initial breastfeeding, and have a lactation counselor on staff for problems. We welcome you to come in any time we are open for business hours, to just sit and relax and work with any breastfeeding issues. for urgent issues, your midwives will be on call for you 24/7 to answer questions or refer you to a lactation consultant, should be become a breastfeeding problem we can not help with. 

I already started care with an OB/Other Provider, Can I transfer to Inspiration?

Absolutely!  We would love to have you come to Inspiration Family BIrth Center.  We accept transfer of care for eligible clients.  If you have had regular prenatal care, are low risk and wish to transfer to Inspiration Family Birth Center you can. By transferring to Inspiration Family Birth you terminate care with your OB/other provider and become a patient at Inspiration.

How is Inspiration Family Birth Center Different From a Hospital?

A birth center is a place that gives you a caring, warm and homelike setting where you are supported and respected as well as safe and secure. You are in a safe place, supervised by experienced midwife who you know from yoru prenatal care.

You will have a private room for giving birth where you can make yourself comfortable, wear your own clothing,eat when you feel hungry and have a water birth.   A Birth Center welcomes your children, your parents, and friends so you can decide who will be with you or near you as you give birth.  It is a place that gives you continuing support and information on infant care, breastfeeding, parenting, and family planning after the birth. Hospitals treat pregnancy and birth as an illness.  Inspiration Family Birth Center treats you as the healthy, well individual you are. You are an active participant in your care. You can be as active and mobile as you want. At the hospital you will be required to have routine procedures, such as IV’s, continuous fetal monitoring (tethered to the the monitor). Our birth center requires no such automatic treatment. Those things are available should you medically need them, but are not required.

How many hours do I stay after the baby is born?

This varies by what you need. Our facility is a short stay facility. Our law says that Birth center patients should be discharged before 24 hours. The normal stay for most mothers is around 8 hours. This varies by medical need, mom and fathers comfort level, time of day or night and other factors. YOu and your baby must meet certain criteria prior to discharge and vitals must be in normal range for over 2 hours to be considered stable. We do not discharge brand new families at 2 am on a Friday night for example. we would simply tuck you into bed and discharge you in the morning. 

What about Childbirth Education Classes?

We offer an in house Childbirth education class, taught by one of our midwives. We encourage each of our couple to take a class. There are many community resources for Classes as well. Our Childbirth Class includes breastfeeding and newborn care.

 

FAQ About Billing / Finances

Do you offer Self Pay Packages?

Yes. we work with our self pay families as much as we can. We give a very large discount for paying in advance ( by 36 weeks). You may make payments throughout your visits. We do have payment arrangements that extend beyond the birth of the baby. We believe everyone should have access to care and do our best to find a way for you to manage the expense of having a baby with our birth center. Our self pay packages include all care, labs and newborn care and labs. While our cost depends on how many weeks you are in what testing you will need, our average cost of complete care, including all labs work needed (excluding ultrasound) from start to finish is approx. $6,200.00 This varies considerably though based on your individual need and may be less expensive or involve more. We strive to make our care as affordable as possible, and will work with you. We even have some programs including bartering. So please call us and see what we can do for you to have your dream birth experience!

Do You Take Insurance?

Yes. We are in network with Aetna, Florida Blue, and Florida Hospital care Advantage Insurance. We also Accept pregnancy Medicaid (straight medicaid), Staywell/WellCare and Prestige Health Choice.

We do accept all other insurances and can often get our services covered at in network rates – with some prep work and pre-approval. We do this for Humana, United Health Care, Assurant and Cigna. The best way to find out if your insurance covers our services is to call our office and Speak with our office manager. She can run your eligibility and give you an exact expected cost or help you get approval through your insurance to cover our services.

How Do the Finances work?

Our policy is to be very upfront with all of your costs. We will not surprise you with any fees not previously discussed and in your financial agreement. This agreement is completed by your second visit. All monies due will be collected by 36 weeks or 4 weeks before your baby is due. This includes self pay amounts, such as water birth fees and insurance amounts, such as deductibles and co pays. Before your first visit will will give you a quote, so you will know exactly what your out of pocket expenses will be prior to your first appointment with the midwives.