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Commonly Asked Questions about the Birth Center
Is it right for me?
How is care at Mountain Midwifery Center different than hospital-based care?
Can I transfer care to MMC for my pregnancy? How does that work?
Why Certified Nurse Midwives?
What if a transfer to the hospital is necessary?
What is your ratio of staff to patients? How are staffing needs met when several women deliver at the same time?
How do you handle the after hour care needs of your clients?
What is the average length of stay for women that deliver at the Birth Center?
What about the care of the newborn? Do you provide these services as well?
What type of preventative and medical services do you routinely provide? Do you provide primary healthcare services to your clients or only services related to maternity care?
Is it right for me?
Birth centers are for healthy moms and healthy babies. A healthy mother makes the kind of wellness choices that facilitate successful birth outside the hospital. Mountain Midwifery Center’s prenatal care can help a mother-to-be achieve optimum wellness and avoid unnecessary risk. Extensive prenatal screening is in place to ensure that any potential problem is caught early.
As a “maxi-home,” high risk pregnancies must be referred to delivery facilities with more extensive resources. Based on what we learn of a mother’s health and circumstance, we can refer her to a provider that will best match her condition and wishes. This list is not exhaustive and talking to a midwife about your specific situtation may be necessary. These are conditions that cannot have a birth center birth:
• Heart disease
• History of embolus or clotting disorders with pregnancy
• Symptomatic congenital heart defects
• Renal disease
• Use of SSRI antidepressants (Wellbutrin is acceptable)
• Current drug or alcohol addiction (no THC use or cigarette smoking after 12 weeks)
• Diabetes Mellitus or Gestational Diabetes
• Hyperthyroidism
• Hypertension (BP greater than 140/90)
• Bleeding disorder
• Sickle cell anemia
• HIV
• Hepatitis
• Active genital herpes lesion at term
• Cancer within 2 years (we will need a remission letter from oncologist)
• Marfan’s Sydrome (including family history of first degree relative)
• Epilepsy
• Certain Thrombophilias
• Hematocrit less than 30%
• Previous Rh sensitization
• Declining or refusing Gestational Diabetes Screen or Rhogam (if Rh-)
• Pap smear CIN III confirmed with colposcopy
• Active tuberculosis
• Paraplegia or quadriplegia
• VBAC (vaginal birth after cesarean)
• Twins
• Breech
• Grandmultip (6 and more babies)
• Gestation of more than 20 weeks with no prenatal care
• Primip (first time mom) pre-pregnancy BMI 35 and higher
• Multip (mom with at least one child) pre-pregnancy BMI 40 and higher
• Pre-pregnancy BMI of less than 17.5 (primip or multip)
• Active anorexia or bulimia within the last year
• Gastric by-pass or lap bands
• Development of any other severe obstetrical, medical, surgical or mental problem
*We do NOT consider age, IVF/ART, or previous pregnancy/birth history to be risk factors.*
*Patients with active Medicaid or Medicare are not eligible to be seen at MMC. Please note that laws designed to protect patients from exploitation prevent MMC from accepting "self-pay" payments from clients enrolled in Medicaid or Medicare. Please see these past blogposts for more information: "Medicaid Update and Letter from Tracy" and "Colorado is out-of-compliance with Medicaid management."*
If you're currently with another provider for your prenatal care but are considering a transfer to MMC, please decide before 32 weeks. You need time to meet all of our midwives and gain their trust in our model of care. We need time to bond with you as well. Also, our facility does have a limited capacity and our schedule can fill up quickly. When scheduling your first appointment with us, please keep in mind that our earliest availability is usually 2 to 3 weeks from the day you are calling. There is a $25 no-show fee for missed appointments.
If you would like to use the Mountain Midwifery Center but are unsure whether it is the right place for you, feel free to Contact Us and please consider coming to a prospective client orientation. return to top
How is care at the Mountain Midwifery Center different than hospital-based care?
At Mountain Midwifery Center, we treat pregnancy, birth and the postpartum period as a normal, healthy part of a woman’s life—not an illness! We pride ourselves on giving families information to make informed healthcare decisions. Our prenatal visits are a minimum of 30 minutes, so that your midwives have the chance to get to know you and answer all of your questions. At Mountain Midwifery Center, you are treated as an individual, not a number.
Our midwives, nurses, and student nurse-midwives are all highly skilled at supporting women in childbirth and beyond. During labor, you will have constant care from your birth team instead of having someone arriving at the last minute to deliver your baby. This team starts with an MMC midwife and RN that you will know personally after meeting them over the course of your prenatal care. There are no "floor nurses" you've never met at MMC.
Mountain Midwifery Center has three birth rooms, each with a queen sized bed and an AquaDoula labor/birth pool. You are required to drink in labor and eating is encouraged. Positions for labor and birth are not restricted. Your baby will be placed in your arms immediately after birth and we practice delayed cord clamping as well.
Each mother receives careful guidance in the first few hours after birth so that when she is discharged between four and six hours after birth (an evidence-based practice), she feels confident in her ability to breastfeed and care for her herself and baby. Our rigorous prenatal education ensures that families are well educated about the early postpartum period and know how to assess the well being of mother and baby after birth center discharge. The nurse-midwives and nursing staff closely follow the family at office visits for the first few weeks of the new baby’s life. return to top
Can I transfer care to MMC for my pregnancy? How does that work?
Yes, MMC does accept transfers of care. We have a few rules though:
- There needs to be slots available in your birth month. We do reach our maximum capacity for most months at least 2 months prior to delivery.
- We prefer transfers that occur within or prior to your 28th week of gestation. We have taken later transfers, but these require review by our Clinic Director and there are requirements for the patient as well.
- Moms-to-be need to fulfill these requirements:
- Attend an Orientation.
- First-time parents are required to take a natural childbirth education class, breastfeeding class, and newborn care class. First time for out-of-hospital birth requires at least the "Birth at MMC" class (see our Classes page). Please speak to our staff to best determine what we’ll require for your situation.
- Upfront payment, by 32 weeks gestation, of your estimated client responsibility for professional and facility fees / claims.
- $145.00 is required at minimum at your first visit.
Why do we have these requirements? In short – for safety and increased success. We need to ensure you are a good candidate for out-of-hospital birth and that you and your family/partner/support are well prepared. We also want you to spend time with our whole team so you have confidence in the midwife at your birth. return to top
Why Certified Nurse Midwives?
Certified Nurse-Midwives are experts in the care of uncomplicated pregnancy and birth. We are highly-skilled at caring for women in the birth center environment, where healthy women experiencing normal pregnancies can safely deliver with far less technology and intervention than is needed in the hospital for women with risk factors complicating their pregnancies. Our Certified Nurse-Midwives provide continuous support during labor and birth. Studies have shown that continuous labor support decreases the need for epidural anesthesia, medical interventions and cesarean sections. Certified Nurse-Midwives typically spend three times longer with their clients than do physicians. This allows ample time for developing the relationship most women desire with their health care-provider. The partnership that unfolds with our midwives will help you to stay healthy throughout pregnancy. return to top
What if a transfer to the hospital is necessary?
Every birth center client is required to pre-register at Swedish Medical Center. This ensures a smooth transition from birth center to hospital in the event of a transfer. National statistics have been maintained on birth center outcomes for over 20 years, and it has been demonstrated that virtually all clients who transfer to the hospital do so on a non-emergency basis (typically for labor stimulating hormones or epidural analgesia). However, if an emergency transfer to the hospital during labor is necessary, this trip takes only 3 minutes by ambulance, putting us well within a 30 minute “decision to incision” standard for Cesarean section that most hospitals strive to achieve. This emergency responsiveness is better than that provided by many rural hospitals.
Our style of care facilitates a smooth transition to the hospital and we stay involved through your baby’s birth. In the event of a transfer, our involvement with your care does not stop - it becomes collaborative in nature. For multiple reasons, our midwives cannot work at MMC and have hospital priveleges. Without priveleges the midwives have no decision-making authority in the hospital setting, but they are involved with the care plan formed by the hospital team and remain available to the delivering family for questions (especially during the transition to the hospital). If the midwife cannot be physically present, after the hospital transition and care plan are long over, we remain available via the on-call midwife and of course as a complete practice during office hours.
We feel confident our transfer model works well. Our statistics support us. Hospitals in the area, and especially Swedish, don't treat our transferred patients as emergencies. As only about half of our intrapartum (during labor) transfers result in a Cesarean surgical delivery, we can see that our involvement in the care plan for the mother (sharing records and consulting with the physicians, midwives and nurses) leads to wider range of response than just an "emergency C-Section." Also, the majority of our transferred mamas choose to have their postpartum care done at MMC, which speaks to the trust placed in MMC by the hospital physicans and the real continuity of care patients see MMC achieving with the hospital care teams. return to top
What is your ratio of staff to patients? How are staffing needs met when several women deliver at the same time?
2-3 clinical staff members are present at every birth at the Mountain Midwifery Center, including one or more CNMs. Additional staff are called in for multiple moms in labor. return to top
How do you handle the after hour care needs of your clients?
A CNM is on call at all times. return to top
What is the average length of stay for women that deliver at the Birth Center?
9-12 hours total, with 4-6 of those hours in the postpartum period. return to top
What about the care of the newborn? Do you provide these services as well?
Yes, Certified Nurse-Midwifes are licensed to provide newborn care. We work closely with area pediatricians and family physicians to provide continuity of care. Mountain Midwifery Center offers all standard testing and treatments commonly offered to newborns in the first two weeks of your infant’s life. return to top
What type of preventative and medical services do you routinely provide? Do you provide primary healthcare services to your clients or only services related to maternity care?
Mountain Midwifery Center can provide the full range of primary care to women, including preventative care. We provide diet and exercise education, as well as routine screenings such as pap smears, cholesterol, glucose, thyroid testing, and a full range of family planning services. return to top
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