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If you are unfamiliar with midwifery you probably have a few questions you'd like answered. The following are some of the most common questions we encounter about Puget Sound Birth Center specifically and midwifery in general. Regardless of the question, we encourage you to come in for a free consultation where we can best answer any and all questions you might have. Please contact our Office Manager to schedule your consultation.

Q: What is a freestanding birth center and why would I choose a birthing center over a hospital?

A: A "freestanding" birth center is a birth center that is not affiliated with any hospital. It is a home like setting where safe maternity care is provided to low-risk women. In hospitals, birth is treated as a medical event like most other "dis-ease". There is a predominant emphasis on what could go wrong and what must be done in hospital with medical interventions leading to more medical interventions. In the birth center, some interventions are never employed, such as:
  • induction and augmentation of labor with oxytocin
  • continuous electronic fetal monitoring
  • epidural anesthesia
  • narcotics
  • operative delivery

In our birth center, our philosophy of care supports the birthing families' choices and desires in how they labor and give birth. Because labor and birth are considered normal events, the usual rigid protocols are not imposed on a normally laboring woman. We focus on what most often goes right with labor and avoid unnecessary intervention. As long as the mother and baby remain normal, strict timeframes for the progress of labor are not required.

According to Henci Goer in Obstetrical Myths Versus Research Realities (A Guide to the Medical Literature), "...the routine interventions practiced in hospitals introduce risks....Birth center studies also uniformly report much lower rates of these interventions."

Birth center studies uniformly report outcomes equivalent or superior to those of comparable women giving birth in the hospital.

Q: What is a licensed midwife?

A: Literally speaking, midwife means, "with woman." A midwife is a person who views pregnancy and birth as healthy, normal processes, albeit ones that call for supervision and care. In the midwifery model, the childbearing woman has the central role. Midwifery care addresses the psychological and emotion health as well as the physical health of the mother. The midwife seeks to empower the woman by helping her master the challenges of pregnancy and birth.

Midwifery Education in Washington State: In Washington state, most Licensed Midwives (LM) obtain their education at the nationally accredited Seattle Midwifery School (SMS), founded in 1979. SMS requires 1 to 2 years of science/pre-med type courses for entry into the school. The SMS student then begins their didactic and clinical education that lasts for 27 months (3 college years). Additionally, the SMS student is required to attend a minimum of 100 births to graduate.

In practice we assess new clients much like a physician does. We complete thorough histories and exams. We also offer all the usual laboratory testing as well as provide complete information on all prenatal screening to be sure that our clients are able to make informed decisions regarding their care. Pregnancies are constantly monitored for problems, and we consult or refer to a physician when a significant deviation from normal occurs. While in labor, women are also monitored very closely and early consultation is made with a physician when a deviation from normal occurs.

Q: Is this a safe way to have my baby?

A: Professional midwifery care has been steadily growing in the Puget Sound area since the early 70's. Birth center studies (with care being given by midwives) in the medical literature uniformly report outcomes equivalent or superior to those of comparable women giving birth in the hospital. Fullerton and Severino report in a 1992 Journal of Nurse Midwifery the following... "[Low risk] women in hospital were more likely to receive an interventive style of labor and birth management [than similar women in birth centers.] Neonatal outcomes were...similar, although the incidence of sustained fetal distress, prolapsed cord, and difficulty in establishing respirations were significantly greater in the hospital sample. Hospital care did not offer any advantage..., and it was associated with increased intervention. The results of this study provide support for the National Birth Center Study's conclusion that birth centers offer a safe and acceptable alternative fore selected pregnant women."

Since 1996, the midwives of PSMBC have been consulting with obstetricians, perinatologists, neonatologists, family practice physicians, and pediatricians in Seattle. A licensed obstetrician or perinatologist is available for consultation and referral at all times. As licensed midwives, we have very definitive practice guidelines that keeps our practice limited to low risk women. We consult with a physician when anything abnormal comes up during the prenatal, birth, and postpartum periods. If it becomes necessary to make a transport during labor, we call the physician to update them on the client's condition and then meet them at the hospital. We transport to various local hospitals, including Evergreen, University of Washington, and Group Health Central. We have found the doctors and staff at these hospitals to be highly competent, respectful, and accommodating to out of hospital transfers.

The vast majority of transfers (over 95%) have not been emergent in nature  – they were not so time sensitive. In the small percentage of cases where time is of the essence, we would choose to transport the client to the nearest hospital. We would, of course, accompany the client, making her medical records available to the appropriate hospital personnel. We have enjoyed excellent relationships with most physicians and hospitals, and have as a result, rendered excellent, safe, and satisfying care. Additionally, PSMBC has met the rigorous regulations and requirements of the Washington State Department of Health and the Washington State Medical Assistance Administration. We are licensed by both agencies as a Licensed Birth Center.

For a few of the numerous studies that speak to the safety of midwifery care please refer to the Bastyr University Department of Midwifery.

Q: Who can deliver at Puget Sound Birth Center?

A: Birth in a birthing center caters to the healthy, low-risk mother. Some risk factors do not prohibit you from giving birth at the center, and some risk factors must be closely monitored by our staff and/or by our consulting physicians. If you are healthy and without any chronic medical conditions such as heart disease or diabetes, you probably are eligible for a birth center delivery. You will be carefully screened on your first visit and continuously evaluated throughout your pregnancy to promote a safe and satisfying birth experience.

Q: Will my insurance cover this?

A: Most likely, YES. Licensed midwives are covered by all Washington- based insurance companies. Many out of state policies also provide coverage for midwifery services. There are, however, numerous plans within each company, so it's always best to call and check.

If you are unsure of your coverage feel free to call our office. Our staff will verify the coverage with your insurance company and will work towards maximizing the benefits provided by your plan. You should call with the following information:

- Insured person's name
- Insured ID number and group number
- Pregnant client's name and birth date
- Insurance Company and customer service phone number

For clients that are not insured we are happy to set up payment plans to suit your needs. If you are not insured and would like some tips on what insurance plans cover maternity care and midwives, give us a call or contact us via email, below. (Note: You can acquire medical insurance once you are pregnant and still have the pregnancy covered). In addition, we encourage you to become familiar with the "Direct Referral Law" and the "Every Category Law" which states: "Basically, the law says insurance policies must provide coverage for treatments and services by every category of health-care provider. This means health insurance plans in Washington state must provide access to all appropriate categories of health-care providers". Mike Kreidler, Washington Insurance Commissioner.

"Direct Referral Law" : Health care carriers shall ensure that enrolled female patients have direct access to timely and appropriate covered women's health care services from the type of health care practitioner of their choice.

For more information on insurance plans that we are currently contracted with, contact our Office Manager

Q: Do you do water births?

A: We are frequently asked if we will do a birth in the water. About 80% of our birthing moms choose to give birth in the water. Some of the benefits to laboring in the water include:

- Reduces sensory stimulus, thus producing less stress-related hormones
- Increases production of pain inhibitors, i.e., endorphins
- Decreases blood pressure
- Increases ability of the mother to focus
- Reduces the sensations of pain – an analgesic effect
- Increases skin elasticity, reducing the amount of perineal tearing
- Makes it easy for mom or dad (with midwife assistance) to "catch" their own baby because of the buoyancy of water
- Gentler birth for baby

Q: Why should I choose Puget Sound Midwives & Birth Center over other birth centers?

A: Puget Sound Birth Center has been operating for nearly 15 years. We have served over 2500 families. In addition to unprecedented local and national recognition, we enjoy a very high rate of direct word-of-mouth referral from our families – the best compliment we could get.

The Eastside's largest freestanding birth center, PSMBC is located just blocks from Evergreen Hospital. We have nearly a decade's experience developing cooperative relationships with the providers in the areas hospitals.

Q: What are your office hours?

A: Our office is staffed Monday through Thursday from 10:00 AM until 6:00 PM, and on Fridays from 10:00 AM to 3:00PM. You can reach our front desk staff during our business hours.
Phone: (425) 823-1919
Fax: (425) 823-7037
Email: OfficeManager@birthcenter.com

If you call outside of business hours you will reach our Answering Service.

If you'd like to schedule a free one-hour consultation with one of our midwives or a tour of the facility, we would be happy to schedule that with you.

Birth Center Testimonial
"Thanks for making the pregnancy and birth experience such a positive and empowering one for me. You approached everything with a gentle, knowledgeable and caring touch. I wish the rest of the health care industry would catch on to your philosophy.

We appreciated your support and encouragement to trust our instincts as well as the sensible advice when we really had no clue. I can’t imagine having gone through the last 9 months under anyone else’s care. And if we do this again, we’ll be back to work with you.

With love and appreciation,"

 –  Lorraine, Bill and Angus

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