"C" is for Certified Nurse Midwife

Well, it's official--I changed my obstetric care over to a Certified Nurse Midwife (CNM).  On Monday, Kim, the CNM, completely put me at ease and provided answers to questions that I hadn't even asked yet.  She was very personable, and I felt like I could trust her with my care and Tully's delivery.  One neat thing we discussed is how Tully is positioned in my belly.  He kicks/punches/pushes in the same general areas, which I pointed out to Kim.  She confirmed his head is down and pointed out where his shoulders, back, butt, and legs are located.  There's not a lot of room to roll around, so he'll probably stay in his current position, which is similar to the picture to the right.  I could go on and on about how great Kim is and how she relieved all of my anxiety, but I'll spare you the details.

After deciding to use the CNM, we needed to choose a new hospital for Tully's delivery, either St. Francis South (SFS) or SouthCrest (SC).  Kim called both hospitals to see how busy they were.  Since SFS wasn't too busy, we toured the labor and delivery area.

For moms-to-be and future moms-to-be, here are a few questions you might want to ask when touring the labor and delivery area at your local hospital.

• Is there a nursery?
• If there is a nursery,
• how soon is the baby taken to the nursery after delivery?
• do babies room in with mom, or do they stay in the nursery until mom calls?
• How long does mom stay in the labor and delivery room before being transferred to the postpartum recovery room?
• Is there a NICU?
• If there is no NICU,
• where will baby be transferred, if needed?
• will mom be transferred with the baby?  (There are cases where baby will be admitted to a different hospital for NICU care, and mom will not be discharged from the hospital where the delivery took place.)

Other questions to ask that are related specifically to natural childbirth are:

• How do you feel about patients who request a natural childbirth?
• How do you feel about intermittent vs. continuous fetal monitoring?
• How do you feel about patients who wish to only have a hep-lock (i.e. IV hookup only) vs having the actual IV fluids connected?

SFS definitely had a different vibe than St. John (SJ), which we toured last weekend, and I felt much better when I walked out of SFS.  No tears.  No frantic phone calls.  I know the information we get and experiences we have are highly dependent on the nurse(s) we talk to, but since all of the nurses work together in a particular hospital, I would think the mentality and culture for care is somewhat the same.  SFS did not have a nursery like SJ, and SFS's policy was that the baby rooms in with mom.  (Rooming in was important to us!)  The only downside at SFS was that they do not have a Neonatal Intensive Care Unit (NICU).  In the event NICU care was needed, all of the nurses at SFS are NICU certified to care for the baby until it can be transferred to the main St. Francis Hospital, which is a few miles away.   A small percentage of babies require NICU care, and we haven't had any complications so far, so I don't have any big concerns with SFS not having a NICU.  Hopefully this weekend we can tour SC Labor and Delivery to compare it to SFS to make a final decision on the hospital where Tully will be born.

For those who are curious and may be considering a midwife instead of an obstetrician, I found the following info online.  I would also note that CNMs can also provide basic gynecological care, so I am considering Kim for this as well.

A Certified Nurse Midwife is an Advanced Practice Nurse who has specialized education and training in both Nursing and Midwifery.  CNMs function as primary healthcare providers for women and most often provide medical care for relatively healthy women, whose birth is considered uncomplicated and not "high risk," as well as their neonate.  CNMs in most states are required to possess a minimum of a graduate degree such as the Master of Science in Nursing or Post-Master's Certificate.  CNMs must also hold an active Registered Nurse license in the state in which they practice. They practice in hospitals and medical clinics and may also deliver in birthing centers or attend at-home births. They are able to prescribe some medications, treatments, medical devices, and therapeutic and diagnostic measures in all 50 states.  While their specific scope of practice will vary from state to state, in most states they provide medical care to women from puberty through menopause.

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