Faq about Labor

When during labor should I call the midwife?
You can call our 24/7 hotline anytime to consult with a midwife.  We have found that labors progress much better if you stay in your own comfortable home for the early part.  The midwife (or doctor) should attend you during active labor, which is usually once contractions are less than 5 minutes apart, a minute long, and you can't talk or walk through them for at least an hour.  If you are far away from our centers or the hospital where you plan to deliver, you will need to call earlier.

How many people will attend my birth?
From your side, you may invite anyone you want to attend your birth.  From our side, we usually have a midwife and two student midwives at the birth.  Sometimes there will be more, but when so, the others will mostly stay in the background.  There is much work to be done, and for safety reasons, it is important to have the right number of trained hands to handle any complications that could arise.  If you feel strongly about how many people are at your birth, please speak to your midwife about it.

If you are delivering in the hospital, the hospital will determine who and how many people attend the actual delivery.

What if something goes wrong?
A midwife is an expert in normal birth.  She is trained to keep things normal, and if complications do occur, to recognize and correct them.  The most common complications in birth can be safely handled by the midwife.  In the rare case that a complication arises she cannot correct, the midwife will quickly get you to a hospital where you can get medical attention.  A good midwife has working relationships with a variety of health care providers and knows when to transfer your care to one of them.

Pregnancy and birth are as safe as life gets.  What would you do if, during the course of your normal life, a need for medical care arose?  You would seek it, wouldn't you?  That is what you should do in pregnancy and birth also.  You do not live in a hospital because a need for medical care may arise at any moment. Likewise, you do not need to birth in a hospital because a need for medical care may arise at some point. Birth is a normal part of life.

Can my partner catch the baby?
If you're birthing at home or in our birth center, of course!  We will be happy to coach your partner through the process.  Just let us know that is what you’d like and we’ll make sure it happens that way.  It is unlikely your partner will be permitted to catch the baby if you are birthing in the hospital.

Can/should my children attend?
Of course your children (and anyone else you want) may attend, but whether you want them to depends on both you and your children.  Most children do very well at births, especially if they are prepared. However, very young children may be too little to understand and may be frightened, frustrated, or bored. Often children sleep right through the birth (it’s true what they say about babies being born at night), and we don’t recommend you wake small children in this case.  Often they are disoriented and can’t appreciate the experience anyway, and they may require your partner’s attention just when you want it most.

Most important is that you are able to concentrate on your own needs and your own birth, and not feel like you must attend to the needs of your children.  Most moms also want their partner to attend to their needs, so we recommend if you want to have children at the birth that you also invite an adult your children know and trust to attend to them during the birth.  Make it clear that this is their primary responsibility, so that if the children do not want to be in the room at the all-important moment, they must leave also to be with the children.  We recommend you follow the desires of the child, as well.  Ask your children if they would feel comfortable watching the birth.  Some will, some won’t.  We do NOT recommend that you pressure or force children to be present.

Can I invite other people to my birth?
Of course!  This is your birth.  You may invite anyone you wish to be there.  However, there are good reasons and bad reasons to invite people to your birth.  Only invite people who are supportive of you and your plans for your birth.  (We’ve had hostile mothers-in-law calling 911 because they are just sure something is wrong!)  Do not invite people to whom you want to “prove” you can do it or that your way of birthing is wonderful.  You need strong support and encouragement during your labor.  You do not need to meet other people’s needs, and you do not need to perform for them.

Some people like to have a lot of people there and they gather great strength from the crowd.  But you may find you feel watched and pressured.  What if it takes 36 hours?  Are you going to feel like you have to entertain or feed these people?  Certainly do not invite people just because THEY want to be there. Protect your birth experience.  It is precious and yours, and you only get it once.  Do what YOU want. This is one time it is ok to be selfish.

Will the baby be monitored?
Yes.  There are two ways to monitor a baby–continuous and intermittent.  Continuous electronic monitoring (with a machine where paddles are strapped to your abdomen) is used in hospitals so the nursing staff can monitor you right along with all the other women in labor.  Intermittent monitoring (which is what we do at home and at the birth centers) is done at regular intervals throughout labor, but does not require you be strapped to a machine or your movement restricted.

The American College of Obstetricians and Gynecologists, in Fetal Heart Rate Patterns: Monitoring, interpretation, and Management, Technical Bulletin Number 207–July 1995, stated: “Well-controlled studies have shown that intermittent auscultation of the FHR is equivalent to continuous electronic monitoring in assessing fetal condition...”  Your midwife will follow guidelines for monitoring your baby intermittently so you will be free to move about or assume any position you like, and with a minimum disturbance to you.

Do I have to have an IV?
No.  Although IVs are available at home and in our birth centers for things like emergencies and treatment of group B strep, we do not routinely use an IV in labor.  If you are birthing in the hospital, you will most likely be required to have a routine IV.

Will I have an episiotomy (a cut to enlarge the vaginal opening)?
No.  There is now extensive data to show that a natural tear will be less extensive, hurt less, and heal better than a cut.  Besides, we will do our utmost to prevent any tear to your perineum, and that is certainly less that the definite damage of an episiotomy.  In our opinion, an episiotomy should only be done as an emergency measure, when you must deliberately sacrifice the mother to get the baby out very quickly.  This situation is extremely rare in our practice.

How early is too early to have the baby?
We will not deliver a baby before 37 weeks gestation (3 weeks before your due date) because there is a significant risk that the lungs will not be mature enough for the baby to breathe without help, and other organ systems may also be underdeveloped.

What if I go overdue?
Many times babies are overdue, especially first babies.  Contrary to popular opinion, the risks of post-maturity do not begin to increase significantly until at least 2 weeks after the due date.  We are content to let babies come when they will. Induction by any method entails risk.  However, there are times when a health problem or other issue makes it worth it to take those risks.  If you find yourself in this situation, speak with your midwife team about your options.

Do you have a birth ball?
Yes.  Our birth centers have birth balls.  If you are birthing at home, the midwife will bring a birth ball with her to your delivery.  The birth ball is very helpful to lean over while in hands-and-knees position, to sit on, or to push against.  A birth ball may or may not be available in the hospital.

Do you have a birth stool?
Yes.  Our birth centers have birth stools.  If you are birthing at home, the midwife will bring a birth stool with her to your delivery.  The birth stool is very helpful because it simulates a squat (which creates the largest diameter birth canal and allows gravity to assist) without requiring you to support yourself.  Birth stools are not available in hospitals.

Do you do water birth?  What is the tub like?
Yes! We love water birth.  The birth centers have wonderful jetted tubs, and we have great inflatable tubs for our home birthing clients.  Please see our water birth page for all the details.  Water birth is not generally available in the hospital.

Is pain relief available?
Yes!  We offer extremely effective natural (non-drug) pain relieving techniques at home and at our birth centers.  For example, water labor and water birth are often called the “natural birth epidural” because they feel so good.  There are many other techniques we use to make the discomfort of labor manageable for you.  Childbirth education classes can be extremely effective at making a natural birth comfortable.  If you need more relief than these natural methods can offer, you may be glad to know we are one of the few birthing facilities in the country to offer nitrous oxide (mixed 50% with oxygen) in labor.  Nitrous oxide is used extensively in other countries and can be extremely effective.  Nitrous oxide is not available in hospitals in our area.  We do not offer epidurals, as these would not be safe in an out-of-hospital setting.  If you know you want an epidural, we recommend you choose hospital birth with our partner ob/gyn.

What is a doula, and do I need one?

A doula is a professional labor support person.  We love doulas!  If you would like one, we will provide a doula to you at no extra charge whether you are delivering at home, in our birth center, or in the hospital with our partner ob/gyn, so it is not necessary to hire a separate doula.  However, if you have a special person you want to be your doula at your birth, we welcome her as part of the team.

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"We felt so supported by you guys through all of the decisions that we had to make.  As first time parents, we didn’t really know what we were doing but we just had to go with our gut.  Even if you didn’t agree with us, we only felt that you guys were willing to help us in whatever we decided to do."

- KM 2015

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