F. A. Q.

Frequently Asked Questions

What is a midwife?

Midwives are the traditional care providers for mothers and infants around the world. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual, and cultural needs. Midwifery is a woman-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes. Midwives value communication and developing a trusting, working relationship with the women and families they serve. In the course of developing that relationship, midwives provide personalized and thorough care during the childbearing year (pre-conception counseling, pregnancy, childbirth, and the postpartum period). Many midwives also provide care of the normal newborn through 6 weeks of age. In addition to being trained to conduct comprehensive physical exams, order laboratory screening and other diagnostic tests, midwives provide extensive health care education and counseling, as well as engage in shared decision-making with their clients and patients.

Why should I use a midwife?

A midwife may be the best provider of pregnancy care if…

  • you have a low risk pregnancy (If you don’t know the answer, a midwife can help you find the answer.)
  • you want to be an active decision maker in your pregnancy and birth
  • you want a natural birth with minimal interventions
  • you would prefer more than 5-10 minutes per visit with a provider (A midwife visit is 45 minutes to 1 hour each)
  • you believe that pregnancy and birth is a normal body function and not an illness routinely requiring hospitalization and doctors (1/3 of the babies born in San Antonio hospitals are born by c-section)
  • you want options of movement, eating, drinking, and where you birth YOUR baby

Hiring a midwife will not guarantee a vaginal or out-of-hospital birth, but it will greatly increase your odds of having the birth experience you seek.

Are you licensed in the state of Texas? What are your credentials?

Yes. Licensure is a legal requirement for all midwives in the state of Texas. Lay midwives and unlicensed midwives are illegal in Texas. Julie and Robin are Licensed Midwives and Certified Professional Midwives. LM means that they are state licensed in Texas. A CPM is an independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. 

How is a birth center different from a hospital?

A birth center is a place that gives you a caring, warm and homelike setting where you are supported and respected as well as safe and secure. You will have a private room for giving birth where you can make yourself comfortable, wear your own clothing, have nourishment when you feel hungry, soak in a tub, and even have a water birth.   A birth center welcomes your children, your parents, and friends so you can decide who will be with you or near you as you give birth.  It is a place that gives you continuing support and information on infant care, breastfeeding, parenting, and family planning.

What should I expect at a prenatal visit?

Each visit lasts about an hour. During that time we discuss your questions, concerns, fears, and changes in your body and daily life since your previous visit. Your vital signs will be monitored – blood pressure, pulse and temperature. Your baby’s position will be palpated in your belly, measure growth of baby, and listen to heart tones. Each visit, your urine will be checked for protein, glucose, and blood. Discussion and decisions about various lab tests will occur and be performed at appropriate times. Family, friends, children, doulas, and other invited guests are always welcome to attend your prenatal appointments and ask questions, if you agree. (No private health information will be shared unless the client approves.)

What is your view on labor and birth?

Pregnancy, labor, and birth are natural life processes. With proper education, time, and referral to resources, parents are able to make the best decisions for their pregnancy, labor, child(ren), and birth. Reassuring a laboring woman that what she is experiencing is normal and safe helps her to have the natural birth that she is seeking. The midwives feel it is very important for a woman to move, eat, drink, sleep, and use the toilet as she desires throughout her labor and birth. They also believe that the hospital setting does not often facilitate these basic human functions. The midwives believe that by reminding and encouraging the laboring woman to move, eat, drink, and sleep the woman is better able to allow her body to birth her child. The midwives also feel that water is an excellent resource for managing discomforts of pregnancy and labor. See how we do things differently.

How will I cope with labor?

Some women will tell you that they “couldn’t have done it without an epidural”.  Think about this:  When you strap a woman to the bed (usually on her back) with electronic monitors and IVs, leave her alone in a sterile hospital room, take away her clothes, forbid her to eat or drink, take all power and control away, and stress her out with a constant stream of strangers in the room (many performing exams and “managing” labor), what other coping mechanisms does she have? Research shows that stress hormones increase pain and slow the progress of labor.  We try to make your labor as low-stress as possible.  Our clients get to know Robin and Julie personally from prenatal appointments. They are familiar the birth center since they visit us for appointments and classes frequently!  We do not perform unnecessary interventions or keep you on a “labor curve”.  We hand the power to you when you wear your own clothes, eat your own food, choose who will be present at the birth and trust your body.  During labor, you are encouraged to walk and change positions often.  We have rocking chairs, birth balls, and birth stools to help you get into the most comfortable position.  We use heat and massage on sore backs.  Hydrotherapy (our beautiful tubs) have been shown to decrease the pain of labor, so we encourage women to labor in the water.  You are surrounded by continuous support from the midwife and your support network.  When you are allowed to follow your body, labor is very manageable. Women instinctively get into the best position for their labor and birth (usually side-lying, standing, or hands and knees).

Do I still need to see my doctor?

No! Midwives are licensed providers that are able to independently provide care for women. If a physician visit or consultation is needed, the midwives will make a referral.

I started prenatal care with another practitioner. Is it possible to transfer care to you?

Absolutely!  We would love to have you come join our family!  We can accept transfer of care for most clients.  You will fill out a “records request” form that allows your previous provider to send us your medical records.

I have heard that birth centers only care for “low risk” pregnancies. What is “high risk”?

We believe that pregnancy is normal and that your body knows how to give birth.  Your age and number of prior pregnancies do not matter to us, as long as you are healthy.  We can deliver babies at 37 weeks gestation (3 weeks before your due date) and up to 42 weeks gestation (two weeks past your due date).  However, there are high-risk situations that are not appropriate for out-of-hospital birth.  We cannot accept clients with chronic high blood pressure, diabetes requiring medication or insulin, placenta previa (the placenta is over the cervix), pregnancy induced hypertension/ preeclampsia (aka “toxemia”), or a previously diagnosed medical issue with the baby (heart defect, etc) that will require special care.  If you have a question about your “risk status” feel free to make an appointment to speak with Robin or Julie about your personal concerns.

What happens if there is a problem during my pregnancy or birth?

Midwives specialize in normal pregnancy, labor, and birth. They focus on encouraging healthy habits to aid the woman to create a healthy body and pregnancy. When labor and birth are uninterfered with, it is rare to have complications. During birth the midwives carefully monitor both the mother and baby.  All midwives that work at the birth center are trained to recognize and manage emergencies, should they arise. If  a complication starts to arise, the midwives do not hesitate to transfer care to a more appropriate location, the hospital.  The midwife’s goal is always a healthy mom and a healthy baby.  The birth center has consulting physicians at Christus Santa Rosa Westover Hills Hospital, located less than 3 miles away. In the case of an emergency, we can have you in the hospital in minutes.

Is water birth available?

Absolutely! Each birth suite has a large soaking tub for mothers to experience the pain-relieving/relaxing magic of water and to birth their babies, if they choose.