How are nurse-midwives trained?
Nurse-midwives first complete training as registered nurses and then continue on to receive a Master’s degree in Nursing with a concentration in nurse-midwifery. We specialize in caring for women with low-risk pregnancies, but are trained and have experience in identifying complications as well as providing care in emergency situations.
Will the nurse-midwife I see for my prenatal visits be there at my delivery?
The nurse-midwives at Swedish share in the prenatal care of our patients. We encourage patients to establish a relationship with one midwife for the first three visits in early pregnancy, and then to either continue to see that midwife or rotate through to meet the other midwives in the second half of their pregnancy. We communicate often with each other about our patients and what is happening in their pregnancies and their lives. We work 24-hour call rotations at the hospital, and your birth will be attended by the nurse-midwife who is on call on the day (or night!) of your delivery. The on-call midwife does not routinely see patients for visits in the office in order that she can be available when needed at the hospital. Likewise, the midwife that you are scheduled to see in the office is assigned only for office visits so that you can get through your scheduled visit in a timely manner.
Will I be required to see a doctor during my pregnancy?
No. We have physicians available for regular consult meeting with the midwives and also available for emergencies that may arise in the office or childbirth center.
What happens if I need a cesarean?
Should you require a cesarean, your on-call nurse-midwife assists the obstetrician with the surgery. Our consulting physicians are available 24 hours a day in case of emergency, questions or surgery.
Do you see patients who are attempting a vaginal birth after cesarean (VBAC)?
Although we support the option of VBAC, Swedish/Ballard is a Level 1 community hospital and the midwives are not able to offer VBACs at this time. For patients who are choosing a repeat cesarean, we can provide prenatal care and offer a scheduled cesarean with one of our consulting physicians where one of our nurse-midwives is present and assisting with the surgery.
Do you offer waterbirth at Swedish/Ballard?
We do not currently offer underwater birth at our facility. Each birthing room is equipped with a shower and there is a private jacuzzi tub for laboring on our unit.
What is the difference between a nurse-midwife and an obstetrician?
The two professions are complementary; however, our fundamental approach to pregnancy and birth are different. OB/GYN physicians are surgeons and gynecologists, in addition to practicing obstetrics. Their time, interest and expertise are in treating women with more complex and high-risk issues. Generally, nurse-midwives’ interest focuses on the care of healthy women in pregnancy and birth, and we provide a holistic approach to achieving a healthy pregnancy and satisfying birth experience.
What is the difference between a nurse-midwife and a doula?
The skills of doulas and nurse-midwives are different but complementary. Nurse-midwives are independent health-care providers who specialize in low-risk pregnancy, childbirth and postpartum care. Our primary concern is to ensure the health of mother and baby, and throughout pregnancy and childbirth we make observations and recommendations to protect their safety and well-being. In addition to providing a supportive environment for families, we perform clinical tasks such as gathering thorough medical histories, maternal and fetal monitoring, and managing complications. The nurse-midwife might also be responsible for caring for more than one patient at a time, making her unable to provide constant labor support. A doula is trained to provide continuous physical, emotional and informational support to the mother before, during and just after birth.
Will I be required to be attached to fetal monitors or have an IV?
We do not routinely require that a patient have continuous fetal monitoring or IV access. Some situations might arise when we might recommend one or the other. In situations where continuous fetal monitoring is recommended (for example, when complications arise such as high blood pressure, low amniotic fluid or when a woman has Pitocin or an epidural), we often have the option to use wireless monitoring so that a woman is free to move around to help labor progress. IV access is sometimes needed if a woman tests positive for group beta streptococcus and requires antibiotics. In that case, we can keep an IV access port and unhook tubing if it’s not needed.
Do you attend home births?
The nurse-midwives are supportive of healthy women choosing home birth, but we only attend births at Swedish/Ballard.
What is Centering Pregnancy?
Women starting their care at Swedish Midwifery & Women’s Health have the option of choosing traditional care with individual prenatal check-ups with the midwives, or choosing group prenatal care. Centering Pregnancy brings expectant parents together for group sessions covering aspects of prenatal care. During each group (initially monthly, then bi-weekly), expectant moms (and their partner or support person) spend five minutes semi-privately with the midwife to assess their baby’s growth and heartbeat and voice any personal concerns. All prenatal education is then done in a group setting allowing soon-to-be moms to find companionship and support from other pregnant women in their group as they discuss common pregnancy concerns and plan for their new babies. Partners or support persons are encouraged, but not required, to attend.
I’ve been told that I might be “high-risk.” Can I still see a midwife for my pregnancy?
Some health conditions may preclude you from seeing a nurse-midwife for your pregnancy care. We strive to provide high-quality care and acknowledge that some women might be better served under the care of a physician. Though advanced maternal age does increase some risks in pregnancy, we are happy to accept patients over age 35 in our practice. Please ask us if you are unsure if you are appropriate for midwifery care.
Where will my baby be delivered?
We attend birth at the Family Childbirth Center at Swedish/Ballard Medical Center. Swedish/Ballard is a Level 1 community hospital and does not offer specialized long-term neonatal care for infants who are born pre-term or with complications that would require admission to a neonatal intensive care unit (NICU). In these cases, we recommend transfer to Swedish’s First Hill campus.
If a nurse-midwife is delivering my baby, can I still choose to have an epidural?
Epidural anesthesia is available 24 hours/day at Swedish/Ballard. Some of our patients know that they have a preference for epidural anesthesia during labor and others may choose an epidural if their labor is long or difficult. We will be supportive of your choices for pain management in labor, and we encourage patients to fill out our birth plan form so that the midwives and nurses are aware of any preferences.