Frequently Asked Questions

Frequently Asked Questions

As you explore the option of giving birth outside of the hospital – either at home or in a freestanding birth center, some questions may arise. Here are some frequently asked questions and answers to help you investigate where you want to give birth.

What services do you offer?

The Birth Sweet is a home that provides a beautiful setting for birth outside the hospital It is located within a few blocks of the hospital. Elizabeth Smith, CPM and Cyndi Johnson, CNM hold office hours at this site with prenatal, birth at the client’s home or at The Birth Sweet and postpartum care. In addition, well-woman care, including Pap smears, and annual exams, family planning services, pre-marital consults and pre-conceptual consults are offered. Childbirth education, massage, CPR classes, infant massage classes are also offered.

Is out-of-hospital birth safe?

Numerous studies have shown that planned out-of -hospital births attended by skilled attendants, such as certified nurse-midwives and certified professional midwives – whether at home or in a birth center – are as safe as or safer than hospital birth for healthy women experiencing normal pregnancies.

Can my partner and I have active control and participation in the birth process?

Good health is promoted by encouraging women to take responsibility for their health and encouraging women to be true participants in their care. You share your goals with your midwife and together plans are made to help you achieve them.

Are the support and participation of family, including children and friends encouraged?

Family members and friends are more than welcome to come to prenatal visits and participate in your birth -as you need and desire.

Who are the main care providers in this setting?

Cyndi Johnson, CNM, is a certified nurse-midwife with a master’s degree in midwifery and is licensed in the state of Utah to provide care for the healthy woman throughout their childbearing experience and beyond. Cyndi is nationally certified through the American College of Nurse Midwives. Although most CNMs work in hospital settings, Cyndi’s experience has been exclusively in out-of-hospital settings. She has attended well over 1,000 births.

Elizabeth Smith, CPM is a certified professional midwife who is nationally certified with the North American Registry of Midwives. She is licensed with the state of Utah as a Licensed Direct Entry Midwife. She began her apprenticeship in 1985. She has attended well over 1,000 births. She loves her calling as a midwife. She often works with an apprenticing midwife and has trained many local midwives.

Each family may have an experienced birth assistant at the birth. A birth assistant is someone who has the skills of a doula; but additionally has the skills to assist the midwife in cases of emergency. A physician will be available for care in the hospital should the need arise.

What is the philosophy of birth at The Birth Sweet?

The midwives have a profound belief in the ability of women to birth and a deep respect of the process. When the woman is the central focus of care and she feels supported by those in attendance, the childbearing woman can be empowered to birth normally, without the need for medical intervention. The process is aided by promoting the mother’s health; respecting the mother as a unique individual; and feeling safe in a familiar environment.

How are the mother and baby unit treated after birth?

The goal is to keep mother and baby together. The midwife never takes the baby from the mother or family. All care is given to the baby on the mother’s bed. As soon as the baby is born, he or she is in the mother’s arms and stays there as long as desired. Immediate breastfeeding is encouraged.

What is the procedure after the baby is born; and what is the follow-up support available?

For several hours after the birth, the midwife and birth assistant (or apprentice) carefully observe and monitor the mother and baby.

The midwife and her assistant do home visits in the first days following the birth to monitor your physical and emotional postpartum adjustment, assess the baby’s condition, and assist with breastfeeding. The parents’ chosen pediatrician should also see the baby within 24-48 hours of the birth.

Are the midwifery services or The Birth Sweet covered by insurance?

Many insurance companies will cover midwifery services. Check with your insurance company to see what the coverage may be. Be certain to ask about reimbursement for a certified nurse-midwife or certified professional midwife (as opposed to midwife) as licensed midwives’ services are often reimbursed and at a higher rate than a midwife without those credentials. Home birth is generally not covered, but prenatal, postpartum and newborn care often are covered. A global bill with the appropriate codes will be presented after the birth for you to submit to your insurance company for reimbursement of your payment to your midwife.

 Is electronic fetal monitoring routinely used?

Electronic fetal monitoring is not used. The fetal heart rate is carefully listened to in labor by periodically using either a fetoscope or a hand held Doppler device. Studies have shown that this is as effective as continuous electronic monitoring at detecting a fetus at risk.

Are episiotomies forceps, vacuum deliveries, or cesarean sections performed?

The midwives are trained to do episiotomies when necessary to avoid severe perineal tearing or hasten delivery of a baby who appears to be in distress and whose birth is imminent. However, Liz and Cyndi’s episiotomy rates are very low because they seldom perform them. The midwives can repair tears or episiotomies using local anesthesia.

When complications arise, the mother will be transferred to the hospital and will receive the care of the back-up physician. If the labor requires medical intervention like augmentation, forceps/vacuum delivery or cesarean section, the back-up physician will perform the procedure(s).

How are major complications handled?

As mentioned above, when complications arise in labor, the mother will be transferred to the hospital. The most common reason for transfer is ‘failure to progress’ in labor. This is often accompanied by maternal exhaustion and, occasionally prolonged rupture of membranes. These account for almost 75% of transfers and are not emergencies. The midwife accompanies the family when transfer is necessary and acts as a support person and an advocate for the family in the hospital, staying with them until the baby is born.

The midwives are trained in neonatal resuscitation, CPR and have oxygen, resuscitation equipment, emergency medications, and IV fluids available to use if needed. In an emergency, the midwife will stabilize mother or baby until the rescue squad arrives for transport to the hospital. Less than 1% of mothers require transfer after the birth, and less than 1.5% of babies require transfer.