New Birth Center in Nashville

On our last post, we shared about a new midwifery option offered by WOMEN OB. With an increasing demand for a more hands-off approach to birth, we are excited to share about a new birth center option coming by the end of October to St. Thomas Midtown.

What is the overall vision for this birth center?
The vision is to give low-risk patients access to a home-like environment for a natural, holistic birth within the walls of a highly specialized hospital. This allows women to have the atmosphere conducive for a natural labor, all while having the benefit of a very short transfer (down the hall) to labor and delivery or the OR, should the need arise. The goal is to have a patient-driven, family-centered birth center that will become a community standard. This is the first birth center of its kind within an inpatient facility in Middle Tennessee.

Doulas, Whitney and Vicki, get a sneak peek tour of the new birth center!

Which providers are part of the birth center committee? 
WOMEN OB put together a committee of obstetricians and midwives to make this new birth center a reality. This committee includes:

Dr. Sharon Norman, Dr. Donna Crowe, Kayleigh Holthaus, CNM – WOMEN OB

Dr. Nicole Heidemann, Dr. Reagen Saig   – Tennessee Women’s Care, PC

Dr. Allison Strnad – Heritage Medical Associates

Addie Graham, CNM/FNP – Vine Hill Midwives

Can any provider deliver babies at the birth center? 
Any care provider with practicing rights at St. Thomas Midtown will have rights to deliver at the birth center.

When is the birth center opening?
It is currently scheduled to open by the end of this October.

Where is the birth center located?
The birth center will be located inside of St. Thomas Midtown. Patients will use the same triage entrance as the rest of the L&D floor. However, once admitted into the birth center, double doors will “close off” the birth center from the rest of the hospital, giving patients more privacy.

How many rooms will there be?
The birth center will consist of three rooms in its own hallway, separated by double doors. The rooms have the best view of the downtown Nashville skyline in the whole hospital. 

How will the rooms be different than other hospital rooms?
So much attention to detail went into designing these rooms to make them as home-like as possible within a hospital setting.
Each room will be equipped with:
-Regular, double size beds – no hospital beds
-Walk-in showers
-Labor tubs for hydrotherapy
-Birth ladders
-Birth stools
-Birthing balls and peanut balls
(Don’t know how to use these tools in labor, a doula can help 😉 )

Who is the perfect candidate for the birth center?
The birth center is intended for low-risk mothers. Providers will be given a criteria that the patient must meet in order to qualify for delivery in the birth center. Babies must also be at term (37 weeks+) and healthy in order to deliver at the birth center. 

Because epidurals will not be administered in these rooms, the birth center is for women choosing a natural delivery. Admittance into the birth center rooms will be at active labor (around 5-6cm).

Will VBAC candidates be approved for the Birth Center?
Unfortunately, VBAC (Vaginal birth after Cesarean) will not be permitted in the birth center. 

Will IV Fluids be required?
Saline locks will be recommended but no routine IV fluids will be given. 

What about fetal monitoring? 
The birth center will utilize intermittent monitoring. Portable monitors will be available, as well as scarves to cover up monitors. Another feature of the birth center includes a 1:1 nurse to patient ratio.

Will there be pain medication options?
Nitrous oxide and a short list of IV pain medications will be available.

What if I decide I want an epidural?
Epidurals will not be administered in the birth center rooms. These rooms are intended for women desiring a natural birth. However, if a mother requests an epidural, she will transfer to a standard L&D room, if a room is available. No need to be re-admitted in triage.

What if I end up needing a C-section? 
Similar to an epidural, the birth center is for women planning a natural, vaginal birth. If a C-section becomes necessary, the mother will go down the hall to the OR.

Can I eat or drink during labor?
Yes, a small fridge will be provided for outside food. Although, since women are not being admitted until active labor, most are not going to be wanting to eat very much at that point. But food and drink will be allowed. 

What happens after delivery?
The birth center will provide 4 hours of uninterrupted mother-baby bonding time. After the four hours, the mother will be moved to a standard postpartum room for 8-12 hours. Discharge time will vary depending on the mother’s delivery, desire to leave, and written approval from the pediatrician (made in advance).

What other requirements will there be to birth at the birth center?
Patients wanting to use the birth center will be required to take a mandatory class at St. Thomas by 36 weeks. This does NOT replace a regular childbirth class. Dr. Norman recommends all couples take a natural birthing class

Why do I have to get written approval from our pediatrician?
Typically after a natural, vaginal delivery with no complications, a mother is cleared for discharge within a few hours. However, discharge for babies is dependent on the pediatrician. The state requires screening on a newborn at 24 hours for conditions like congenital heart defects. If the mother would like to go home within a few hours of delivery with her baby, she needs written permission from her pediatrician. If the mother would rather stay the night in a standard postpartum room, she can choose to do so as well.

It is amazing to see the changes and increase of options for pregnant women in Nashville. We can’t wait to assist our client’s at this new birth center!

New Midwifery Option in Nashville

We are excited to share with our clients and readers a two-part blog post revealing some exciting new options for birth in Nashville!

This week we were honored to sit down with Dr. Sharon Norman and Certified Nurse Midwife, Kayleigh Holthaus of WOMEN Obstetrics and Gynecology to learn about some exciting changes within their practice that we know so many of our clients and birthing families in Nashville are going to want to hear about! (We were also able to chat with Dr. Donna Crowe for about 5 minutes before she had to dart off to labor and delivery!)

Two years ago, this group of all-female physicians added two Nurse Practitioners because they wanted their patients to have easier access and faster response time to questions or concerns they had throughout pregnancy. This patient-centered approach naturally led into the desire to give pregnant clients more access to high-touch, low-intervention birth, which so many of their patients really want. Although the physicians at WOMEN OB all love to provide this type of care, they decided to make this even more accessible to their patients. That’s when they added midwifery care to their service line.

Nurse Midwife, Kayleigh Holthaus

Sharon Norman passionately tells us, “We cannot hold patients back if what they really want is midwifery care.” She goes on to tell us that they not only are thrilled to have added Kayleigh Holthaus, CNM to their fantastic team of providers, but that as of next week they will be adding a second midwife to the team, Angie Long. Together, the two certified nurse midwives will be able to see all midwifery patients, and attend all of those births. To date, this is the only hospital-based midwifery option in Nashville that we know of that offers such a low patient to provider ratio. You are guaranteed to know and have built a relationship with the midwife who will attend your birth! To ensure this level of care, the two midwives will only take about 10 births a month, each.

The two-midwife team is also able to give prenatal care and attend VBACs (Vaginal Birth After Cesarean), so this is another fantastic option for VBAC in Nashville. Current patients of the practice can switch to midwifery care during their pregnancy if they are good candidates.

Side note: Have you seen their gorgeous office? Not only is this practice made up of wonderful care providers, the atmosphere for all the prenatals and well-women visits is so relaxing and calming.

(Photo Credit: Pencil and Paper Co)

If you are pregnant or planning to be and you are interested in midwifery care through WOMEN OB, give them a call!

Stay tuned for part two of this informational blog post where we share with you some insider info we received on the new birth center at St. Thomas Midtown opening in October of this year!

Switching Care Providers

If you read our last blog, you know all about interviewing care providers in early pregnancy. And if you read the blog before that, you know why choosing your care provider and birthing location carefully is so important!

If you choose your birthing location based on our flowchart, interview possible candidates, and find the perfect care provider for you, then you are off to a great start for a positive birth experience! But what if you aren’t early in your pregnancy and ahead of the game? That’s ok! You want to switch care providers? That’s ok, too! You CAN switch care providers. You may be thinking about ditching your OB to go with a different OB. You may even be thinking about switching from an OB to a home birth midwife.

Here in Nashville, we are so lucky to have several different options on where to birth your baby and who to birth them with. If you want to transfer your care, you have a few choices: an OB in a hospital, a midwife in a hospital, a midwife at the birth center, or a midwife at home. Each choice has different parameters, depending on your situation, about if you can transfer your care.

If you are looking to switch your care to a different OB or a midwife in a hospital, you are most likely not under any time constraint. OBs generally will take a transfer patient anytime in your pregnancy. If you are unhappy with your current OB and wish to switch, use the interview questions we discussed in our previous post to find a new one. This time you want to get it right so you are not wanting to switch again! Make sure you ask specific questions pertaining to what you were concerned about with your previous OB. You may be looking for a more “natural minded” care provider, one that is more supportive of a VBAC, or even one that you just simply wish you were more comfortable with. The most important thing is that you are happy and comfortable with your choice and that you are confident your new OB will help you achieve the birthing experience you are looking for. Check out this chart to see information on Nashville area OBs and hospital midwives.

If you are wanting to switch to birth center care, and you are in the Nashville area, you will be contacting Baby + Co! The birth center will allow you to transfer your care before 32 weeks if you are considered low risk and if they have availability in their schedule. If you are thinking about transferring to the birth center, do not hesitate to call them. They fill up fast!

If you are wishing to switch to a home birth midwife, you have many to choose from in the Nashville area. Check out their information in this one-stop Nashville Care Provider Chart. The latest time you can change to a home birth midwife in Nashville is around 34-36 weeks depending on which midwife you talk to. It is important to call several midwives and interview them to find one you feel is a good match for you and your family.

Switching care providers can seem like a daunting task, but we want you to view it as an opportunity to have the most positive birth experience possible. You have so many options so take a deep breath and dive in! We guarantee that one conversation with a new care provider that you feel confident in will make all the difference in the world!

Interviewing Care Providers

In our previous post we discussed why it’s so important to choose your care provider and birthing location carefully. If you have not checked out our Choosing Your Care Provider Flowchart, please do so before reading any further! This flowchart asks simple questions to lead you to the ideal birthing location and provider for your desires, comfort level, and values. The blog also included a chart specific to Nashville care providers. You can view that here.

Once you have made the decision that you are going to set up interviews with either midwives, OBGYNs, or both, now you may be wondering, “What questions do I ask?” We  have compiled a list of several questions for you to take into the consultation. Some questions may not apply to all care providers, so use this as inspiration for your interview and pick and choose what questions you will need.

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The first set of questions are all logistical. If you find that the care provider you are interviewing is extremely bias or passionate about certain questions, that can tell you a lot about how they will be on birthing day. If their answer impresses you and aligns with your own opinions on certain procedures, you might have found the perfect care provider for you. And on the flip side, if their answers send up a red flag in your mind, you might choose to keep interviewing other care providers. Be sure to ask these:

Logistical Questions: 

  • What routine procedures do you do?
  • What is your c-section rate?
  • How often do you induce?
  • How often do you do episiotomies?
  • How often do you do assisted delivery?
  • Will you break my water or allow it to break on its own?
  • What positions can I deliver in?
  • Can I move around during labor?
  • What is your policy on having an IV?
  • What prenatal tests do you require?
  • Will you attend the birth or do you work in a group?

The next few questions are more personal. If you feel like the care provider you are interviewing is not comfortable with a doula or their birth philosophy does not align with yours, you may choose to go with someone else.

Birth Philosophy Questions

  • What is your birth philosophy?
  • How do you feel about a doula in the labor room?
  • What is your view on pain relief during labor?

Situational questions can be the determining factor in the interview process for many expectant mothers. Below, I have given you two examples of a “situation” you may want to ask the care provider’s opinion on. I have heard women say, “I thought my OB was fine with me going past 41 weeks, but they are already discussing induction before then!” Avoid that by asking questions on how your care provider would respond in specific situations:

Situational Questions: 

  • If labor is “long” or stalled what would you do?
  • At what point past my due date will you suggest induction?

Lastly, there are case by case interview questions. If you have had a previous Cesarean, be sure to dig deep into your care providers VBAC policies and views. Or if you have a family history of twins or breech births, you may want to ask them about that as well.

Special Scenario Questions:

  • Will you attend a VBAC or VBA2C birth?
  • Will you attend a vaginal or natural twin birth?
  • Would you attend a breech birth?

Interviewing care providers can be an exciting process for your and your partner. Imagining who will be there to help guide your baby earth side makes it that much more real that in 9 months you will be holding your little one. Remember to interview with confidence, knowing that you have options. If you don’t like the first person you interview, it’s ok! There are many out there to choose from. Watch for red flags and go with your gut. I promise you will never forget that special person that catches your baby on the most transformative day of your life!

Download here

interview-questions-printable

Choosing Your Care Provider

You are 6 weeks pregnant. The all-day nausea is a constant reminder of the change your body is going through to bring forth your new little life. You’ve moved from shock to excitement as the reality starts to set in.

If you haven’t already seen your doctor to “confirm” the pregnancy (as if those 13 positive pregnancy tests weren’t enough), you will probably see them soon. Most women make their initial appointment around 6-8 weeks.

BOP- Choosing care providers

The first of many questions you’ll have to answer during your pregnancy and one that will set the course of your entire birth experience is deciding: “Who will I choose as my care provider for my pregnancy and birth?” This is often overlooked, but it is an important decision. Here are some common phrases we hear as doulas:

“I’ll just have my OBGYN that I’ve seen since I was 16 deliver my babies! He has great bedside manner.”

“I’ll just let my doctor know my plans for my birth sometime before I have the baby.”

“I’m nervous that one of the doctors in the group practice I go to does routine episiotomies, but I don’t need to change provider because I have a birth plan!”

You have choices.

Although it is okay to choose your care provider based on the above statements, we want you to know that you have choices. This would take learning what type of birth practices are normal for your provider and being intentional about who you choose to be in the room with you when you birth your baby. If you don’t learn what is important to you until the end of your pregnancy, you risk being disappointed because your provider didn’t offer the type of birth experience you were looking for.

When a mother chooses her provider intentionally and purposefully, she can then trust that her provider will give her and her baby the best care, and will take her desires and goals for her birth seriously. It may also be very important to you to choose a provider who will make sure you are well informed should any intervention become necessary.

What if women were empowered with the knowledge to choose the right provider for the type of birth experience they desire?

What if typical “birth plans” could virtually go away, because you chose the RIGHT provider for the type of birth you want, and you were able to fully trust that provider? This could change the way we view childbirth in our culture! With new pregnant women all the time watching The Business of Being Born and deciding they need to “fight” for the type of birth they want, the problem will only persist if women continue choosing, or staying with, care providers that do not deliver the type of birth experience they desire.

Although some situations, like high risk factors or whether or not a provider takes your insurance, may limit some of your choices, many low risk women still do not know that they can choose between:

  • Home birth, birth center, or hospital birth
  • Midwife or Obstetrician
  • A midwife at home, birth center, or hospital

If you decide you want an unmedicated, uninhibited birth in a hospital, you would not choose an OBGYN who is most comfortable with all of her patients staying in bed and continually monitored for the duration of active labor. On the flip side, if the idea of no immediate access to pain medication or the ability to do emergency surgery creates great anxiety for you, then you wouldn’t choose to birth at home or at a free standing birth center. These are just a couple of examples, but there are many different factors to consider when deciding which provider and birth location is best for you.

Getting Started.

So, you’ve decided it’s important for you to really consider this choice but with so many birthing options, where do you start and how do you decide?

To help make this easy, we want to share with you a great road map to help you figure out your values and desires for your birth. Our Choosing Your Care Provider Flowchart asks simple questions that lead you to your ideal birth location and your ideal type of care provider.

*Although this flowchart can be helpful for women all over the US, the options are geared towards women birthing in Nashville.

 

Download here: Care Provider Flow Chart

Once you’ve decided on the right birthing location and type of provider for you, then you can start interviewing care providers to find the perfect fit. Stay tuned for our upcoming posts that will discuss the type of questions to ask when interviewing potential providers and what to do if you decide you need to switch care providers.

For Nashville readers, below is a list of care providers and contact information to help get you started in the right direction.

Download here: Nashville Care Providers