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What is a certified nurse-midwife?
A certified nurse-midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery. Nurse-midwives independently manage the care of women during pregnancy, childbirth, and the postpartum period. The nurse-midwives at Kaiser Permanente Redwood City practice collaboratively with our on-site obstetrician to provide safe, sensitive, individualized care.
The Midwife Birth Experience at Kaiser Permanente Redwood City
The Certified Nurse-Midwives of Kaiser Permanente Redwood City are honored to be present with you on this wonderful and miraculous journey. "Midwife" traditionally means "with woman". We will work with you and, if you desire, your personalized birth plan to keep your birth experience as close to what you want as possible. What follows is a review of the Kaiser Permanente Redwood City Midwives' Birth Experience, our "birth plan" for you, to ensure a safe delivery and wonderful memory.
Our Goals, Your Rights
- Our goal is the same as yours: healthy mom, healthy baby.
- We seek to earn your trust and want to work with you toward this goal.
- We believe every birth is unique and every woman and her family have the right to make informed choices regarding their care. All will be treated with respect for their individuality and personal preferences.
- We will provide our best care and advice based on our training, knowledge and experience.
- We understand that it is disappointing if special circumstances arise that cannot be predicted and plans or intentions must be modified. We will work with you through all medical decisions, providing sensitive explanations and support.
Our Labor and Delivery Suite
Our private labor/delivery rooms are comfortably appointed for the mother and her support people with the following:
- State-of-the-art birthing bed (complete with squatting bar)
- Pull-out "daddy" bed
- Rocking chair
- Private bathroom with shower
- TV with cable stations and DVD player
- Lights that dim
Our birthing rooms are designed so that even women with an IV and those who require continuous fetal monitoring are able to change positions and move around the labor room.
There is a kitchen with refrigerator and microwave oven near the nurses' station.
Frequently Asked Questions Regarding Midwifery Care
1. Is a midwife available at all times to deliver my baby? Certified Nurse-Midwives are in attendance most days and nights. We account for approximately 50% of all births at Kaiser Permanente Redwood City.
2. Can I bring people with me to support me in labor? Yes. Family members, friends and doulas are all welcome. The number of support people is limited to 3 at one time, to comply with safety and privacy issues in the labor and delivery suite.
3. Can I have a natural (aka unmedicated) birth in the hospital? Though the midwives are generally unable to give one-on-one labor coaching, we fully support the intention of women who would like an unmedicated birth. We will work with you and your support people to help you achieve that goal.
4. Can I have an epidural to be as pain free as possible if a midwife is working with me? Absolutely! We can provide medication to decrease the pain of labor and work closely with our anesthesia department to order epidural anesthesia at the best time.
5. Why should I take childbirth classes if I know I want an epidural? We strongly recommend childbirth preparation classes (breastfeeding and childcare classes, too!) to help women and their birth partners understand the natural process of labor and giving birth. Knowing what to expect lessens both anxiety and pain. Classes also explain coping skills for early labor, when it is too early in the process for most to receive an epidural. In addition, they introduce some of the medical interventions that may be necessary to insure a healthy outcome.
6. Do I have to have an IV in labor? Not every woman needs an IV, but it may be recommended on a case by case basis for medication, hydration, preparation for an epidural or as a safety precaution.
7. Must I stay on the baby monitor through the whole labor? We can monitor the baby intermittently if the baby is handling labor well, based on a review of the initial fetal heart rate, and if the woman is unmedicated and there are no other complicating factors.
8. Will I be allowed to eat in labor? Most women can eat lightly according to preference and drink frequently during labor, though there are some circumstances where this may be restricted. We can provide refreshments or you may bring your own.
9. Can I walk around and try different positions to make labor go faster and help the baby move down? Once the baby's initial status is assessed, women with an uncomplicated pregnancy can walk, utilize a variety of labor positions, or try a warm shower to help labor move along. We encourage you to bring your own "birthing ball", if you like, and your own music, to set the right atmosphere for you. Women who have an epidural are restricted to bedrest.
10. Will I have to have an episiotomy? We do not do routine enemas, shaves or episiotomies. We work with you during the pushing phase and crowning to prevent perineal tearing.
11. Who will deliver my baby? YOU deliver the baby, WE "catch"! - that's the way midwives like to think about it! A midwife is available most hours and days to attend your birth. In addition, an OB is available 24 hours everyday. There are some circumstances where an OB is the best choice for your delivery. We work as a team, making every effort to accommodate your preference. Our priority is doing what is best for you and your baby.
12. Can my partner cut the umbilical cord? Unless otherwise indicated, the mother's significant other will cut the umbilical cord.
13. Can the baby be placed on my chest immediately after the birth? We understand the special benefits of skin-to-skin contact between baby and mother. Unless there is a need to do otherwise, we place baby directly on the mother's chest when he/she is born.
14. What happens if I have to have a cesarean section? Kaiser Permanente Redwood City has a very low cesarean section rate and we are proud of that! If there is a need for a c-section, there is an obstetrician onsite 24 hrs, 7 days a week to perform that surgery. We rarely have emergencies where the mother cannot be awake with regional anesthesia or the birth partner cannot accompany the mother in the operating room. Most often, the midwife accompanies you into the OR, too, to assist the doctor. We understand that delivery in the OR can be disappointing if it wasn't a planned event, but the doctor, midwife, nurses and anesthesia team make every effort to make the birth as joyous as any other, with the foremost concern for the safety of mother and baby.
Postpartum Care
- Breastfeeding is encouraged to begin right after birth. Immediate skin-to-skin contact and breastfeeding within the first hour of delivery is promoted.
- Unless there is a special circumstance, babies are weighed in the birthing room and given their first bath with the family present.
- The new family will stay together in the birthing room for approximately two to three hours after delivery. This is true for most cesarean births, as well.
- Babies and mothers are roomed together on the postpartum floor to promote bonding and successful lactation. Lactation educators and consultants are available most days to answer questions and provide one-on-one support.
- We make every effort to accommodate private rooms and significant others are encouraged to stay when private rooms can be arranged.
- Families stay 24-48 hours after a normal delivery and up to 4 days after a cesarean birth.
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