Evidence Based • Midwife Care

THE SECRET OF QUALITY IS LOVE

Experienced, Empathetic & Accommodating Midwife Practice

Our philosophy is the mother is having the baby. Village Maternity midwives’ job is to help her. We are a source of information and support, but the mother is the leader. Of course, if you are floundering, we are there with comfort and suggestions. If there is the potential for harm, we are responsible for the safety of your birth. Yet, mothers instinctively know how to do this. Village Maternity has all the high-tech benefits of modern obstetrics.

We offer advanced genetic testing, sonograms, consultations with Maternal-Fetal Medicine specialists, and epidurals on demand. But not all or even desirable in every case. The choices are yours.

Prenatal visits are in our private office – 101West 12th Street in Greenwich Village, NYC — with a midwife on our prenatal team. When you are ready to give birth, a midwife on the laborist team will meet you at Metropolitan Hospital on the Upper East Side.

Please contact us by phone or email for further discussion and to schedule a tour. We look forward to speaking with you!

Frequently Asked Questions

Midwives are health care providers who offer services to women of all ages and stages of life. With their advanced education and focus on research and partnering with women, they are among the most modern, forward-thinking health providers in the US today.

Most midwives in the US have a master’s degree and must pass a national certification exam. There are different types of midwives, each holding certifications based on their education and experience. Certified nurse-midwives (CNM) and certified midwives (CM) attend approximately 93% of all midwife-attended births in the United States. Since 2010, both CMs and CNMs need a master’s degree to practice midwifery. Midwives provide a whole-woman approach to care. Many offer care from puberty through and beyond menopause. Midwives work with women to prepare for pregnancy, provide care through labor and birth, support you as you move into parenthood, and some can provide care for the newborn baby during the first 28 days of life.

For the majority of women, pregnancy is a normal, healthy, low-risk life event. Midwives view pregnancy and birth as a normal life event during which you need special attention, support, guidance, and care to prevent problems. For most women, pregnancy is a time of wellness. It is a time of change when mother and baby should be supported so both can be as healthy as possible.
 
The midwifery approach to health care has never been more important. Today’s woman expects the best care. She expects her provider to understand and value her individual needs. She wants a provider who will partner with her to make health decisions.
 
Midwives focus on what is most important to each woman’s unique situation and values.

Midwives have expert knowledge and skill in caring for women throughout their pregnancy, birth, and the postpartum period. But they also do much more. CNMs and CMs provide health care services to women in all stages of life, from the teenage years through menopause. Their care includes general health check-ups, screening and vaccinations, pregnancy and birth, postpartum care, and well-woman gynecology care.

Midwives have a license to prescribe a full range of substances, medications, and treatments including pain control medication and birth control. They can also order needed medical tests within their scope of practice and consistent with state laws and practice guidelines.

A midwife is a health provider while a doula is a childbirth coach. Their roles in the childbirth process are quite different.
 
You might choose to have a midwife instead of an OB for prenatal care and delivery. Midwives can deliver babies in the hospital, birthing centers, or in your home.
 
A doula doesn’t replace your healthcare provider but rather can add extra services such as helping you with techniques to manage pain during labor and provide support during a baby’s early days.

Evidence-based practice and professional standards ground Midwifery. Midwives have a deep understanding of the normal, natural events in a woman’s life span. They approach women’s health care based on researched evidence and clinical expertise, while also considering a woman’s values. The American College of Nurse-Midwives (ACNM) has joined with other national health care organizations to develop and endorse principles for client safety in childbirth. These principles promote care based on scientific knowledge, respectful coordination of care between different members of the health care team, active involvement of clients and their families in care practices, and a commitment to improving the quality of care. Together, these principles help promote the highest standards for quality and safety in maternity care in the US.

Giving birth is a family event and your midwife will work to create a birth plan that meets your desires and needs as a family. You and your partner/family will decide on the level of involvement that is best for you. Your midwife will encourage you to have people who are important to you with and around during labor and birth. Your midwife may ask your partner/family to comfort you, provide emotional support, give a massage, provide drinks and food, adjust the lighting, or support you while laboring. Or ask your doula to work together in the support you need.
 
Midwives approach pregnancy, labor, and birth based on normal, bodily processes. The midwifery model of care does not support the routine use of medical procedures if there is no clear reason or their use is not supported by research. For example, scheduling a labor induction or a cesarean section without a clear reason is not supported by research and can lead to unwanted problems. Yet, when a medical procedure is necessary, midwives work to have all the information needed to make an informed decision about care. They make sure you are aware of any options or alternatives available.

Midwives work with all members of the healthcare team, including physicians. Midwifery care fits well with the services provided by obstetrician/gynecologists (OB/GYNs), who are experts in high risk, medical complications, and surgery. By working with OB/GYNs, midwives can ensure that a specialist is available should a high-risk condition arise. Likewise, many OB/GYN practices include midwives who specialize in care for women through normal, healthy life events. In this way, all women can receive the right care for their individual health care needs.

Midwives are a part of the OB/GYN team. They work with physicians and OB/GYN resident s. If any complications arise during labor or birth, the team will come to help or take over if necessary.

Your midwife will explain the reasons for such a procedure if required. Your partner or support person will be able to go with you to the operating room. In most cases, your midwife will go too, unless she has another laboring mother.

Doulas interest most first-time mothers. Doulas provide personalized, compassionate, and agenda-free birth and postpartum care. Doulas help cope with early labor and can provide postpartum help. Some doulas also provide breastfeeding and lactation support.

A birth plan is a way to prepare yourself for the actual day. It’s a useful tool to outline your preferences during labor and delivery. Your birth plan may include things like; whether you desire pain medication, plan to use visualization or meditation, prefer to have dimmed lights, etc. It can also include who you’ve chosen for labor support, preferred positions during labor and birth, and whether you prefer delayed cord clamping. March of Dimes has a basic birth plan that you could download and customize.

METROPOLITAN HOSPITAL

Deserves special mention among NYC hospitals.

Metropolitan Hospital shares a long tradition of midwifery care and support for physiological birth. It has among the lowest cesarean delivery rates of any hospital in Manhattan with outcomes equivalent or better. Metropolitan offers showers or tubs in every labor room for hydrotherapy and inhaled nitrous oxide as an option for pain management. It offers epidurals. Metropolitan has telemetry so you can move about freely even when continuous fetal monitoring is required for safety in active labor. There is a Level 3 Neonatal Intensive Care Unit, and ACOG Board Certified attending obstetrician available any time the midwife needs assistance with a problem during the birth.

SPECIAL FEATURES

World Health Organization accredits Metropolitan Hospital as “Baby-Friendly” designation promising no separation of mother and baby except for medical indications. A full-time lactation consultant promotes and facilitates breastfeeding. All staff has special training in assisting breastfeeding. You and baby will have a private room together with a pull-out couch for the father or other support person wishing to spend the night. Lastly, there are no visiting hours or restrictions for your chosen support team.

MIDWIFE & DOCTOR COLLABORATION

The Desire for an Uncomplicated Pregnancy and Birth

Village Maternity’s NYC midwives and doctors collaborate to aid in uncomplicated pregnancy and birth. Yet, nature and history have taught us that sometimes there are complications.

Our maternal-fetal medicine specialists have unique qualifications to help you through any obstacles. They are trained to recognize problems and advise on how to avoid dangers.

EVIDENCE-BASED MATERNITY CARE

Women Deserve Minimum Intervention & Maximum Safety

Our team bases their care on evidence-based literature including the 2014 ”Obstetric Care Consensus” and the 2017 “Approaches to Limit Intervention During Labor and Birth”. These two documents discuss our core value of assessing “ the short-term and long-term tradeoffs between cesarean and vaginal delivery as well as the safe and appropriate opportunities to prevent overuse of cesarean delivery, particularly primary cesarean delivery.” Village Maternity recognizes women deserve minimum intervention with maximum safety and positive experience.

NITROUS OXIDE

Pain Relief Options Including Nitrous Oxide

“Nitrous oxide inhalation analgesia (usually a blend of 50% nitrous oxide and 50% oxygen gas) for labor pain has been commonly used for decades in Great Britain, Scandinavia, Australia, New Zealand, Canada, and other countries . . . The patient self-administers the anesthetic gas, as needed, using a hand-held face mask over her nose and mouth or a mouthpiece. A demand valve on the portable gas tank opens with inhalation and closes with exhalation.”

UpToDate, 2016

WIRELESS MONITORING

Fetal Safety through Wireless Monitoring in Labor

Most babies tolerate labor quite well, but some do not. We offer wireless electronic fetal monitoring (sometimes called telemetry), which continuously evaluates the baby’s status while allowing the mother freedom to move about as she wishes, even into the shower. However, not every labor requires this level of surveillance. Intermittent checks of the baby’s heartbeat may be adequate reassurance in uncomplicated labors, but if continuous monitoring is needed, it is available without confining the mother to bed.

“Normal human labor is characterized by regular uterine contractions and repeated episodes of transient interruption of fetal oxygenation. Most fetuses tolerate this process well, but some do not. The fetal heart rate (FHR) pattern helps to distinguish the former from the latter as it is an indirect marker of fetal cardiac and central nervous system responses to changes in blood pressure, blood gases, and acid-base status.”

UpToDate, 2016