FAQ for the CNMs
Please find below frequently asked questions women have when they are considering coming to our practice. If there is something that is not covered here, please do not hesitate to email or call. We also offer no-charge meet and greet appointments where you can sit down with a midwife and get your questions answered and your concerns addressed.
What is a certified nurse-midwife (CNM)?
A CNM is a type of advanced practice nurse. This means that CNMs are registered nurses (RNs) who have also completed graduate education and training specializing in midwifery. CNMs are certified by the state to provide a lifetime of care for women, including routine gynecologic care, birth control options, as well as pregnancy, delivery and postpartum care. In Ohio, CNMs work with physicians in a collaborative agreement. The website www.mymidwife.org has a lot of great information on midwives and the way we practice.
Why do people use CNMs?
Women who choose a midwife are generally looking for a provider who will offer them choice in their healthcare options, and a partner in helping them make important decisions regarding their health. Midwives have been providing this care to women for hundreds of years. As midwives, we consider ourselves experts in normal pregnancy and birth. The quote below from the site mymidwife.org provides a good explanation of the benefits of using a midwife.
"When you decide to visit a midwife, you can expect a special kind of care. Some midwives spend up to an hour with first-time patients, and all midwives stay with women through the entire birth process. Midwives strive to become partners in care rather than simply providers of health care.”
“Midwives approach birth, puberty, and menopause as normal life events rather than potential medical emergencies. These are times when women need special education or support, but nobody needs to cure or fix them. Midwives believe that if women are given the correct information, they can make safe and satisfying choices.
“Midwives are trained to recognize complications early and refer you for appropriate care. In a midwife you’ll find the best of health care and human support in one savvy professional."
Do you attend deliveries at home?
No. While we support a woman's right to give birth where and with whom she chooses, we are not permitted by our malpractice companies to attend homebirths.
Are you anti-pain medication/anti-epidural?
No. We believe in informed choice. If a woman believes, given accurate information, that an epidural or pain medication is the correct choice for her, we will support her in that decision.
Where do you attend deliveries?
We attend deliveries exclusively at the Wexner Medical Center at The Ohio State University.
Will my insurance cover a midwife?
We accept most insurance policies including Medicaid, Caresource and Molina. Tricare is the only insurance plan that OSU does not have a contract with, but we hope to change that in the near future.
Can I just see the CNMs? When would I see the obstetrician?
If you are experiencing an uncomplicated pregnancy, then most likely you will only have visits with the midwives. If complications arise during your pregnancy, you may have a visit with one of the physicians in our practice—Dr. Waddell or Dr. Schaffir. During labor, if an emergency arises, one of the staff physicians on labor and delivery will be immediately available.
Do you have experience with the Bradley Method? Hypno-birthing? Hypno-babies?
Yes, we are familiar with each option and have worked successfully with women who are using each in their childbirth. This is another decision we will support you in when you decide what is best for you.
Can I have a doula?
We welcome doulas at your birth.
Can I labor/give birth in any position?
Absolutely. Not only are we fine with changing position, but we strongly encourage it. We find that keeping mothers moving throughout labor is helpful not only for pain relief, but also for correctly positioning baby. We are familiar with the majority of birthing positions and will help you when the time is right to find the one that feels best for you at that moment.
Do I have to be hooked up to monitors the whole time?
Generally women are not on the monitor the entire time if their pregnancy is normal and full term. Upon arrival to labor and delivery, women are placed on the monitor for 20 minutes to evaluate baby and ensure baby is handling labor just fine. If all is well with that monitoring and the woman fits the criteria, we will then follow the intermittent monitoring guidelines established by Ohio State’s Wexner Medical Center. That entails listening to baby every 30 minutes before, during and after a contraction during active labor and every 15 minutes during the pushing stage. We would be happy to discuss this policy with you further, so you will feel comfortable and know what to expect.
Do I have to have an IV?
No. We prefer our patients to have an IV port placed in case of emergency. This would not be attached to anything and you would still have the freedom to move around.
Can I labor in the tub or the shower?
Yes. We know that hydrotherapy is very beneficial to women in labor for pain relief. In the early stages of active labor we encourage using the shower. Once we know that labor is firmly established, we are then fine with women entering into the labor tub. We want to ensure that the relaxing effects of the warm water do not slow labor down.
Do you offer waterbirths?
We are proud to say that we are the only practice in Columbus that offers the option of waterbirth. Not every woman is an appropriate candidate for waterbirth, and we would be happy to discuss the current restrictions.
What if I'm Group Beta Strep (GBS) positive?
The recommendation for women who are GBS positive is to be treated with IV antibiotics while in labor. This generally does not restrict your freedom to move around or labor and/or birth in the water if you choose.
Do you do routine episiotomies?
We do not cut episiotomies routinely. If a baby is in distress and needs to be born immediately, the decision to cut an episiotomy might be made, though this rarely happens. Our current rate of episiotomy is approximately 5 percent.
Do you practice delayed cord clamping?
Waiting for the cord to stop pulsating before clamping and cutting is a practice we are very familiar with and engage in routinely.
Can my husband/boyfriend/partner cut the cord?
Absolutely. If all is well with your birth and the baby, we are happy to allow your partner to cut the cord. We understand that the birth of a baby is the birth of an entire family and partner involvement is very important.
I want to breastfeed right away. Is that OK?
What if I want to decline the Vitamin K injection or erythromycin eye ointment for my baby?
In deciding to decline medication or treatment for your child we ask, as in everything else, that you are educated in your decision. We would even recommend discussing this option with your pediatrician. If you still decided that declining one or the other is the best option for your family, the nursing staff will have you sign a waiver on admission.
How soon after delivery can I leave?
Mothers generally do great after childbirth. An early discharge at 24 hours is something we support as long as the mother is stable. More of a concern is how a baby is doing in the first 24 hours. We recommend speaking with your pediatrician and finding out what their policy is on early discharge.
Do you attend VBACs (Vaginal Birth after Cesarean)?
Yes, we are happy to be able to offer this option to women who are delivering their babies at the Wexner Medical Center at the Ohio State University.
What is your cesarean section rate?
We understand that cesarean section is a major surgery and because of that we work very hard to ensure that when one needs to be done it is absolutely medically necessary. Our current rate of cesarean section is 13 percent.
Will medical students or residents be involved in my birth?
Although Ohio State is a major medical center and teaching hospital, resident and medical student involvement in your birth process should be minimal if at all. If you are sent in to be evaluated for possible labor or a problem, you may receive care from a resident at that time. However know that they will just be evaluating you and notifying the midwife on call of their findings. The midwife or if needed, collaborating physician, will be in charge of your care at all times. On a side note, if you are willing to have a resident or medical student observe your birth, this is always a great experience for them to witness natural childbirth and hopefully learn from it. But this is always your choice!
Which midwife will deliver my baby?
We work as a team here at Ohio State, and because of that we would like each woman to have several prenatal appointments with each midwife. We split call evenly because we want you to feel comfortable with whichever midwife happens to be on call when you go into labor.