Here are some frequently asked questions, answered by Kate Hartwell. Please note that we don’t expect these questions to take the place of a face to face meeting and we encourage you to call the center and book a personal tour.
Am I able to have a waterbirth either at my home or at the Birth Center?
Yes. We encourage our clients to use our waterbirth tubs for laboring, and, if desired, birthing. Being immersed in warm water is an exceptional way to help soothe the intensity of labor contractions. Waterbirth is a safe option that promotes a calm birth setting. When you have your baby at the Birth Center, we offer free use of the waterbirth tub, which includes a clean plastic liner for each client. We rent our tubs out to our homebirth clients, and the fee of $200 covers set up, breakdown, and a clean plastic liner. The tubs that we use are the brand “Birth Pool in a Box”. If you’d like more information about waterbirth, check out www.waterbirth.org.
Can I use my insurance to pay for my birth?
Yes. We are contracted with Anthem, Cigna, Harvard Pilgrim and Medicaid. We also accept most other insurance companies out of network. We are able to have our insurance biller do an “insurance verification” to determine that you are, indeed, covered; we also are able to let you know what you can expect to owe depending on your individual insurance plan, including any deductible you may have.
We also offer generous payment plans for both out of pocket clients and for large insurance deductibles.
What if something “goes wrong” during my labor or birth of my baby?
One of the most crucial elements of the training to become a Certified Professional Midwife is how to recognize and handle emergency situations. During your labor, your midwife will consistently check on how both you and your baby are faring. We strive to help keep labor within the range of normal by making sure that you're eating, are well hydrated, and are alternating between moving your body and resting.
There are two typical situations that involve intervention on behalf of the midwife. The first is recognizing when a labor is not within the range of normal, and initiating transfer of care to the local hospital. Some of the reasons for transferring before a birth can include unreassuring fetal heart tones, maternal exhaustion, or an unusually long first or second stage of labor. We have worked hard to coordinate with the staff of our local hospital--Concord Hospital--and continue to have quality improvement meetings, to make transfers of care as smooth as possible. When transfer happens, our clients are accompanied by the midwife. We are able to communicate with the receiving provider the reason for transfer, give them a copy of the chart, and once care is placed in the hands of that provider, we are able to be a support person for our clients. This includes helping with coping in labor and helping to initiate breastfeeding.
The second scenario involves complications that can happen during the birth which are unpredictable. We are trained to act and manage these situations, which include performing neonatal resuscitation, managing shoulder dystocia, controlling postpartum hemorrhage, and managing a wrapped cord - among many other skills. As midwives licensed by the state of New Hampshire, we have access to lifesaving medications, oxygen, IV supplies, and resuscitation equipment. We encourage you to read our scope of practice, available at www.gencourt.state.nh.us/rules/state_agencies/mid.html. Scroll down until you see “MID 500” and click on that link. This document will tell prospective clients exactly what to expect from any NH Certified Midwife.
We at the Concord Birth Center feel that it’s important for our clients to understand that while we don’t expect to have to transfer, we acknowledge that it does happen, and it’s always in the best interest of the mother and baby. We put safety first. “Prepare for the worst, expect the best.”
I have had a cesarean section. Can I birth with the midwives at Concord Birth Center?
Absolutely. We have a scope of practice that we need to follow for VBAC (vaginal birth after cesarean section) which is available for review at the link to our scope of practice above. We encourage VBAC candidates that meet our scope’s standard of safety to consult with us on your next birth. We have had many successful VBAC births at Concord Birth Center and in our client’s homes.
Who will attend my birth?
You will be attended by at least one midwife, either Kate Hartwell or Cindy Owen, and one qualified midwife assistant. Sometimes Kate and Cindy assist each other. Other times, we bring along a student or other local midwife to assist. We strongly believe that a safe out of hospital birth requires two skilled sets of hands. Anyone who assists Kate or Cindy will be certified in both Neonatal Resuscitation and CPR. They will also be familiar with emergency procedures, such as placing an IV or administering an intramuscular injection.
What happens if two women go into labor at the same time?
Because we have two midwives in our practice, we are able to split up if needed, and bring in assistants as needed as well. In the rare occasion that Kate or Cindy take a vacation, we have back up midwives on call. Our goal is for our clients to have either Kate or Cindy, and for them to know their assistant. While this isn’t always the case, usually you will have plenty of opportunities to get to know everyone present at your birth. If two people who plan to birth at the Birth Center go into labor at the same time, we are able to turn the “family room” into a second birth room. (We are a licensed two-bed facility). We are able to make a bed up, bring a tub in, remove the toys, and it transforms into a beautiful birthing room!