Transcription:
How a Midwife Can Help You

Melanie Cole (Host):   Midwives are probably best known for helping women with childbirth but they do provide a wide range of other care for women. My guest today is Kate Becker. She’s a certified nurse midwife who specializes in all aspects of women’s health needs including pregnancy and childbirth at UVA Health System. Welcome to the show, Kate. Explain briefly just a little bit about what a midwife is.

Kate Becker, CNM, MSN, RN (Guest):   I am a certified Nurse Midwife. That means I’m a Master’s Degree prepared nurse. As you said, midwives tend to focus on pregnancy and childbirth but we also do other types of women healthcare including gynecology and some primary care as well.

Melanie:  So, you really run the gamut. How do you work with women? Do they go through a physician first or do they come directly to you? How does that work?

Kate:  They can come directly to us. Some women are referred though their physician. For example, we have some wonderful physicians here at UVA who may meet with a woman, prenatally, for example, and in talking with her think she might be a good candidate for the midwife. I would say that a lot of our patients are sort of self-selected in that they’ve heard of midwives; they’re aware and familiar with midwifery and the kind of care we provide and decide that they want that for themselves and they can just make an appointment directly with use.

Melanie:  So, how is delivering your baby with a midwife different? People here midwife and they think “alternative type medicine”, “water births”, “only home births” but that’s not really necessarily the case, is it?

Kate:  No, it’s not. Here at UVA, we do attend births in the hospital so we do have all the support here in the hospital we need as necessary but our goal really is to talk to the woman prenatally to get to know her; to figure out what’s important to her and, for a lot of our women, that is having a natural childbirth without medication and we have a lot of things we can do to help her achieve that. With that being said we do have women who opt for pain medication, for an epidural and we are very supportive of that as well. So, we really want the experience to be what the woman is looking for and we’re there to support her in her choices and educate her about what her choices are.

Melanie:  When you say “what her choices are”, what are some those choices of home birth and how they can do that and do women tend to be scared that if something goes wrong and they’re not in the hospital setting?

Kate:  Well, home birth is certainly an option for women. The midwives at UVA, we only do births in the hospital. So, we don’t offer home birth services. There are other midwives in the community that do that. So, the women who come to us are ones that have decided to have their babies in the hospital and I would say that over 99% of babies in this country are born in a hospital. So, that’s definitely, by far, the most common choice. What we are trying to do is make the hospital to be more of a home-like environment so that people feel comfortable and feel supported and maybe have it be a quieter atmosphere, dimly lit. As I said, those labor support pieces that midwives are so skilled at providing.

Melanie:  So, tell us about some of those labor support pieces because it sounds lovely the way you describe it with the lower lighting and maybe some soft music and how is that different from standard care that people are used to seeing or hearing about?

Kate:  Well, as I said, I think it’s really about what the woman wants. You mentioned water births, for example, here at UVA, we don’t actually have mom give birth in the tub but we do have a tub available on labor and delivery for the labor part of it. Another thing that we love to use is putting the woman in the shower while she’s in labor which can be extremely helpful. We can use massage techniques to help with, for example back pain in labor. We have different things like massage or position changes or things like that to sort of help out with that. A lot of it, I think, is also sort of working with the woman to find her own strength and to sort of help her let the natural process unfold while closely monitoring it to make sure that everything is still normal.

Melanie:  If a woman has a midwife present, does that mean that she’s not planning on having an epidural? Does that change sometimes?

Kate:  Definitely, we do have women who do opt for an epidural. Some women start out wanting to see the midwives because of the personalized prenatal care that we provide. Here at UVA, we’re a small group of midwives so it’s just a little bit more of a personalized setting. I feel that we are lucky in that we get to know our patients a little bit better than if they were seeing a larger group of providers and we can give them a little bit more individual attention. We don’t have a policy saying they can’t have an epidural or anything like that. We, as midwives, want to support the women and what they want and we’re not there to dictate to them what they can and cannot do.

Melanie:  And, are midwives involved in some after pregnancy care for women?

Kate:  We are. We do a lot of providing contraception and helping educate women on their choices for birth control. We do annual gyn exams so, PAP smears, follow up of abnormal PAP smears, menstrual  problems; again, the birth control piece. We do some preconception counseling which we always like if a woman is thinking about getting pregnant. We love for her to come see us and talk to us about if she has any medication conditions or any lifestyle things she might want to change before pregnancy and then, also, gynecologic problems—yeast infections and things like that are also things that we can take care of.

Melanie:  How does someone go about getting an appointment with a midwife?

Kate:  They would call the main phone number for the ob/gyn clinic and ask to see one of the midwives. If they’re pregnant, they would call the clinic at the Battle building which is 434-924-2500. If someone is not pregnant and wants to see one of the midwives for their annual exam or for a problem visit or some kind of preconception visit, they will call 434-924-1955 which is the ob/gyn clinic at the primary care center.

Melanie:  In just the last few minutes, Kate—what great information. I applaud all the great work that you’re doing for women. Give your best information and advice about midwifery and what it really is so that women can understand that this is a person you can choose that’s a little bit more personalized.

Kate:  As I said, I think that the thing about midwives is that we are really specialists in normal pregnancy, normal labor and delivery. We can handle some complications but if things get very complicated in a pregnancy, we do tend to consult our physician colleagues. Occasionally, we will transfer a woman to physician care but most women in this country have a normal, healthy pregnancy and we, as midwives, love pregnancy and birth and we love helping women through it and being involved and being a partner with the woman and her family so that she can understand her choices and decide what works well for her.

Melanie:  Why should women have their children and receive their healthcare at UVA Health System?

Kate:  Well, I think we have the best of so many worlds here. We have the midwives. We also have wonderful physicians in maternal/fetal medicine and general obstetrics. We have a NICU where if there are issues with the baby, the baby can be taken care of by the best NICU in the region. So, I think we really have everything that we can to provide that home-like environment while still having the technology that most of our patients don’t need but occasionally they will. Then, it’s right there for them.

Melanie:  Thank you so much for being with us today, Kate. You’re listening to UVA Health Systems Radio. For more information, you can go to UVAHealth.com. That’s UVAHealth.com. This is Melanie Cole. Thanks so much for listening.