FAQ

Frequently Asked Questions

Can I meet you before I decide if I want a midwife or if my partner or family has questions?

We offer a complimentary 15 minute meet and greet visit with one of our midwives.  Please call our office at 303.738.1100 to arrange this meeting.

Can I have an epidural?

While many women who desire natural birth seek midwifery care, many of our patients use epidural anesthesia during their labor. We are supportive of all ways women chose to have a baby, and have many options available at the hospital.

What is your episiotomy rate?

Our episiotomy rate is about 1%.  It is safer to tear then it is to have an episiotomy, so we never routinely do episiotomies.  We do many techniques to help avoiding a tear during birth.

What is your Cesarean Section rate?

Around 10-15%. National average is 33% and we are very proud of our low rate.  When we recommend a cesarean section, it is always for a legitimate medical reason.

What positions can I be in during labor and birth?

We encourage you to move into positions you are comfortable in, both in and out of the bed during labor and birth.  Our women try a variety of positions, including on a birthing ball, in water, walking, squatting, or in bed.  If you have an epidural, then you are restricted to the bed, but we will work with finding comfortable potions in the bed which will aid in labor progression and pushing.

What if I become high risk during my pregnancy or labor?

We collaborate with fabulous physicians at South Denver OB/GYN, who are available 24/7 if need be.  Some scenarios require a one time consultation, some require co-management between the doctor and midwife, and in certain situations, a transfer during your pregnancy to the care of physician.  Because we work together, you do not need to transfer clinics if a complication arises. Certain situations include, but are not limited to: Diabetes requiring insulin, Pre-Eclampsia, Vaginal birth after a cesarean, Twin pregnancy, and the need for a cesarean section.

Can I wear my own clothing during labor?

Yes, absolutely.  We want you to be comfortable.

What is the difference between a CNM and a doctor during labor and birth?

Generally speaking, CNMs not only attend the birth, but provide support through out the labor and spend more time with you during the whole process.

What is a Colposcopy?

A Colposcopy is a diagnostic tool to determine the cause of abnormalities found in Pap smears. A colposcopy is a visual examination of the cervix, a relatively simple and painless procedure, usually performed in our office. The actual procedure lasts approximately ten to fifteen minutes.

If I have a midwife, does that mean I deliver at home?

We do not attend home births.  All of our families have their baby at Castle Rock or Littleton Adventist Hospitals.  Our Certified Nurse-Midwives graduated from a Masters or Doctorate program accredited by the American College of Nurse-Midwives (ACNM), are board certified, and have hospital privileges.

Why do we have our families deliver at Littleton Adventist Hospital or Castle Rock Adventist Hospital?

Our families rave about their experience at both Littleton and Castle Rock Hospitals.  Not only do the nurses have an average of 15 years of experience, the birthing center is well-equipped with Jacuzzi tubs, portable and waterproof fetal monitoring (if needed), complimentary therapy options (including aromatherapy) and a massage therapist postpartum (Littleton).   Both birth center staffs enough lactation nurses to provide support to all women postpartum.

To help you feel confident about your upcoming delivery,  the hospitals offer a program called Birthday Wishes (Littleton) or Birth Concierge (Castle Rock) which allows families an opportunity to meet with a nurse at the hospital during their pregnancy, discuss and fill out their birth preferences for their file and receive a tour.

Most importantly, these hospitals provide top notch care with excellent outcomes.  The hospitals have an on-call obstetrician in-house every night, a neonatal nurse practitioner (NNP) and 24 hour anesthesia coverage.   With Level II (Castle Rock) and Level III (Littleton) Neonatal Intensive Care Units (NICU) you can have peace of mind that if a complication would arise with your baby, the likelihood of your baby needing to transfer to another hospital with a higher level of care is very rare.   And, finally, we like that both hospitals have a reputation for avoiding overmedicalized birth and avoiding unnecessary cesarean sections.

Can I have an induction OR When do you require an induction?

Inductions have contributed to our countries skyrocketing 33% cesarean section rate.  Due dates are guesses as to when your baby will be born, give or take 2 weeks.  While inductions can be a safe option, they do come with risks, and can double the chance of a cesarean section for a first time mom.  While we discourage inductions for non medical reasons, we believe our families are capable of making informed decisions based on the known risks and benefits.  In most cases we offer induction between 41-42 weeks for healthy pregnancies.  We also have a variety of natural ways to go into labor.

Can I do delayed cord clamping?

There are many newborn benefits to not immediately cutting the cord after birth (typically waiting 3-10min). We routinely practice delayed cord clamping for healthy babies.

Do I have to be on the fetal monitor continuously when I am in labor?

If you are low risk and not using medication, you qualify for intermittent fetal monitoring of the heart rate and contraction patterns.  We follow recommended guidelines by ACOG and ACNM for how often your baby needs to be monitored.  If any condition required continuous monitoring, both the Littleton and Castle Rock Hospitals have portable monitors available giving you the freedom to labor outside of the bed or in water.  Everyone will have a 20-40 minute monitor strip on admission.  As long as the baby looks healthy on the monitor, we generally listen to the heartbeat for a few minutes every 30 minutes.  Research shows that outcomes for babies did not improve after the invention of continuous electronic fetal monitoring for low risk women (not on medication, including induction medication or epidurals).

What is a doula?

A doula is a professional birth coach. They are not trained in offering medical advice, but are certified to give support and education during pregnancy and labor.  Women who use doulas have higher rates of natural labor and lower rates of cesarean section.  We are welcoming of doulas, and work closely with Jacie Gonzalez of South Denver Doulas. Doulas are independently hired by our families, and can be hired during labor and/or the postpartum period after discharge from the hospital.

Should I make a birth plan?

Birth plans are not required, but a great way to communicate your wishes, preferences, and fears.  Most of our families will at least to a birth wishes tour at the hospital, and fill out a preference sheet for their file.

Should I take classes before giving birth?

Most women have less fear and feel more prepared if they take labor, newborn, and breastfeeding preparation classes.  Our clinic offers hypnobirthing, labor and breastfeeding classes on location (please inquire or visit www.southdenverdoulas.com for more info).  We have a complimentary healthy pregnancy class that we encourage every pregnant woman to attend as soon as they can in their pregnancy.  We also have a variety of recommendations for classes at various locations including Littleton Hospital, Sweet Beginnings (downtown Littleton) and Natal to Nest.

Do I need to reschedule my pap smear if I have my period?

We use the ThinPrep liquid-based pap. You can have a pap smear if you have your period as long as the flow is not very heavy.

When do I need to start getting mammograms?

Women age 40 and older should have mammograms every 1 to 2 years. Women an increased risk of breast cancer should talk with their doctor about whether to have mammograms before age 40.

How do I know if I have a yeast infection?

It is normal to have vaginal discharge and it is normal for it vary throughout the month. Your discharge may be abnormal if it heavier than normal and is associated with persistent itching, burning or a foul odor. If you have these symptoms, please call for an appointment.

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