*Updated*
We went for our tour and I was SUPER impressed. I'm really excited about this place and I think it's going to work out for us. I still have some time to collect more information before we make a final decision as I'm not yet pregnant, so if you think of anything else I should ask, let me know.
Q: Is the center licensed by the state?
A: Yes.
Q: Is the center accredited by the NACC?
A: Yes.
Q: Once I become pregnant, when should I schedule my first appointment?
A: Somewhere between the 6th and 10th week.
Q: With Tricare Prime, do I need a referral from my PCM to make my first appointment?
A: Not yet answered.
Q: Is the entire pregnancy covered by my insurance? If not, what additional charges might I incur?
A: Not yet answered.
Q: Will I get to meet all of the midwives who may attend my birth?
A: Yes, you are scheduled with each of the 4 midwives at least once for prenatal visits.
Q: How long are prenatal visits?
A: The initial visit is 1 hour, all others are 30 minutes.
Q: Do you perform ultrasounds? If so, how many?
A: Not routinely, but we will perform them as needed or by request.
Q: What is your C-Section rate?
A: 4% to 7%
Q: During pregnancy, what conditions would require me to transfer to the care of another provider?
A: High risk pregnancies. i.e. pregnancy past 42 weeks, twins or other multiples, diabetes, placenta previa, preeclampsia, high-blood pressure, previous c-section, other pre-existing conditions. We have about an 11% transfer rate.
Q: During labor, what situations would require me to be transferred to a hospital?
A: Breech delivery, baby in severe distress, mother in severe distress.
Q: If transfer becomes necessary, what is the backup hospital and who are the backup providers? Can I arrange to tour the hospital and meet those providers?
A: The backup hospital is Christiana Hospital in Newark, DE. It's a 20 minute drive from The Birth Center. We also do transfers to St. Frances Hospital in extreme emergency situations which is 1 block away.
Q: What percentage of women who transfer have C-Sections?
A: Not yet answered.
Q: Would my midwife be able to remain active in my care if I need to be transferred to the hospital?
A: Possibly, but possibly not. Because the midwife would not longer be your primary care, it would be up to the hospital whether or not the midwife would be allowed to stay with you.
Q: Under what circumstances would my baby need to be transferred to a hospital?
A: Not yet answered.
Q: Do you have any policies that limit the number of people I can have with me during labor and birth?
A: No, you can have as few or as many people as you would like in the room with you during labor and birth.
Q: Do the midwives here routinely provide continuous support during labor? If not, do you have experience with trained labor support (doulas) during labor and birth? Do you encourage the use of a doula?
A: Yes. The midwife will remain with you for the duration of labor and delivery. We do support the use of doulas, but they are not always necessary.
Q: Do you offer intermittent fetal monitoring (with a doppler)?
A: Yes. We routinely use a doppler for intermittent fetal monitoring, but we do have a continuous monitoring system available if we need it.
Q: What are your usual policies and practices about: IVs, freedom to be active and move about during labor, eating and drinking, positions during birth?
A: An I.V. is not standard during labor and delivery, if we need to give you antibiotics we will give you a heparin lock. You are free to move about during labor, eat and drink whatever you like, and you can choose any position for birth that feels right.
Q: What is the usual care if labor is progressing slowly?
A: Natural methods of induction, castor oil, stripping of membranes, possibly breaking your water.
Q: Under what circumstances would you induce labor with Pitocin or other drugs?
A: None, if that were to need to happen, you would be transferred to the hospital.
Q: Is there a time limit on labor?
A: Only once your water has broken. Once your water breaks, you have to be in active labor within 24 hours.
Q: Do you ever perform assisted deliveries with forceps or vacuum extractor?
A: Not yet answered.
Q: What is your episiotomy rate?
A: Less than 1%.
Q: Under what conditions would you perform an episiotomy?
A: To avoid the need to transfer you to a hospital in the event that the baby is in distress. Only if absolutely medically necessary.
Q: What drug measures for pain relief are available?
A: We do offer I.V. pain medications.
Q: Do you use epidurals?
A: No, we do not perform epidurals as there is no anesthesiologist on staff.
Q: How long is the average stay after birth?
A: The minimum is 4 hours, you usually go home the same day.
Q: What follow up care and support would you provide after I go home?
A: The midwives will call for your and your baby's vitals the next day, the 3rd day will be a home visit, there is a one week check-up for the baby and a six week check up for the mom.
Q: Can I still have a home visit even though we live over an hour away?
A: Yes, the midwives will still come to your home.
Q: Do you provide information and support over the phone after I go home?
A: Yes.
