Frequently Asked Questions
What is a midwife?
Midwife means “with women”
Midwives are specially trained to support women from menarche (the first period) through menopause. They are experts in pregnancy, childbirth and the immediate postpartum period for low risk families.
The midwifery model varies from the traditional medical model of care in that midwives provide:
- A focus on health promotion and disease prevention that views pregnancy as a normal life event.
- A partnership with women to promote self-care and the health of mothers, infants, and families.
- A practice where respect for women as persons with full human rights and self determination is the hallmark of the relationship between client and midwife.
- Advocacy for women so that their voices are heard in their own care, and in the community.
Types of licensed midwives:
Certified Nurse-Midwives (CNM)
A nurse-midwife is an advanced practice nurse who has specialized in the practice of obstetrical and gynecological care of relatively healthy women. CNMs are able to practice in hospitals and medical clinics, birthing centers, or within the home. Our CNMs have hospital privileges at Providence Alaska Medical Center and prescriptive authority.
Certified Professional Midwives (CPM)
A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM, narm.org) and is qualified to provide the Midwives Model of Care. CPMs provide continuous care for women throughout their childbearing cycle in home settings or in birth center based practices.
Midwives work in collaboration with other providers
Midwifery and Women’s Health Care believes in a collaborative model of care. Generally, we provide the complete care for a low risk client. If a woman’s risk status increases, our midwives work in close collaboration with physicians to provide the safest care. We have great working relationships with local OB/GYN and MFM physicians and make referrals to body workers and specialists when needed.
What to Expect
Maternity Visits
What happens at my first visit?
Your first visit will focus upon welcoming you and your family into our clinic. We ask for you to complete registration forms ahead of time or please arrive 10 minutes early to your visit. During this 90-minute session, a midwife will review your health history, perform a physical exam, provide guidance regarding early pregnancy milestones, discuss genetic screening and ultrasound options, and of course answer any questions you or your family members may have regarding your care. Lab options will be discussed and obtained on-site as needed. If you are transferring care into our clinic from another provider, please request your records be sent to our office through your other provider or our practice.
How do I prepare for my first visit?
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A few days prior to your appointment we will send you a link to fill out paperwork. This will enable you to supply all required information including your health history and insurance prior to your appointment. Filling out this information in advance will maximize the time you get to spend with the midwife.
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Hydration will be vital if the midwife decides you need labs drawn, try to make sure you’re drinking enough water.
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Remember, partners, parents or friends are welcome to come with you, but we ask that you limit those in the room with you to three individuals total.
Will I get an ultrasound at my first visit?
Great question! While an ultrasound is not always medically indicated, you and the midwife will discuss the types of ultrasounds are available and whether or not you will need one.
Pelvic Health Physical Therapy
Initial PT Evaluation
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Prior to calling for an appointment, please be sure you have a referral sent to us.
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A few days prior to your appointment we will send a link to fill out paperwork. Filling this out ahead of time allows maximum time with the physical therapist.
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Please arrive 10 minutes prior to your scheduled appointment time to fill out a patient specific health questionnaire.
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Note any symptoms/problems you wish to address.
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It also never hurts to contact your insurance and inquire about your PT benefits.
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Comfortable clothing is a must.
Lactation
Non-MWHC Clients:
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We will send a link to you prior to the appointment in order to collect pertinent health and insurance information. Please fill this out prior to arriving or plan to arrive 10 minutes before your appointment.
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If you have questions or concerns regarding your breast pump, please feel free to bring it along.
Q: I just found out I’m pregnant, what’s next?
A: We suggest a Consult. This is an opportunity to come and meet with a midwife to discover if our philosophy of care is a good match for you and your family! This is a free, 30-minute visit to ask questions, learn more about our services, and tour the clinic and birth center.
Q: Are you in network with my insurance?
A: Midwifery & Women’ Health Care is contracted with all major insurance carriers and networks including but not limited to: Premera BCBS, Aetna, Cigna, Multiplan, EBMS, MODA, Tricare and the VA’s Community Care Network.
If you have further questions or concerns please contact your insurance or our billing department.
Q: Will my insurance pay for midwives?
A: Insurance coverage for any specific service depends on your specific plan. Please either contact your insurance or our billing team to discuss.
Q: How do I refill my Rx?
A: Log into the patient portal and request a refill OR Call our office and ask to speak with the nurse.
Q: Is it time for a pap smear?
A: A quick call to the nurse can determine if it is time for you to have a pap.
Please keep in mind though, that while a pap smear is a useful tool for cervical cancer screening, you should still visit us on an annual basis. Your routine visit is a good time for you and your nurse practitioner to share information or discuss any number of common concerns.
You also can talk together about whether you need a breast or pelvic exam.
Q: When and how will I get my lab / ultrasound results?
A: Our office nurse or a midwife will call to discuss any tests ordered. However, the patient portal contains copies of all blood test results, please log in to view them.
Q: Why Midwives?
A: Between 75-80% of all babies born worldwide are born with midwives. In most of the world midwives care for low risk women and physicians are only utilized when a complication arises. Midwives believe that pregnancy and birth are normal events that we need to support and nurture, but not “manage”. Obstetricians, trained in the “medical model”, believe that pregnancy is fraught with risk and therefore needs medical management. Prenatal care with a midwife is more about shared decision making, partnering to support the family, and appropriate, rather than routine, use of intervention.
Q: Do you provide primary healthcare services to your clients or only services related to maternity care?
A: We offer a full range of primary care to our clients, including preventative care. (click here to see our list of services)
Q: At what gestation should I start my care?
A: Midwifery and Women’s Health Care suggests that women start their prenatal care between 8-10 weeks gestation. It is around that point in pregnancy where the midwife should be able to detect fetal heart tones.
Q: Are midwives able to provide full spectrum maternity care or do I need to also see a doctor?
A: Midwives offer the full scope of care when it comes to maternity services. Families are offered all the same tests and procedures offered in regular OB care.
Q: Am I able to get ultrasounds within your office?
A: Our midwives are able to do limited ultrasounds in our office. Ultrasounds can be used for dating purposes, viability, fluid level checks and position verification. We refer out for more comprehensive ultrasound screenings.
Q: What if I have a complication during my pregnancy?
A: At Midwifery and Women’s Health Care, we have a close collaborative relationship with an obstetrician, Tania Hall, MD. We have an excellent working relationship with a group of OBGYNs that are available for consultation 24 hours a day. In the rare instance that care should be transferred to a physician during labor or birth, the midwives will remain involved in your care in a supportive role.
Q: What if I have a concern outside of normal office hours?
A: MWHC always has 2 midwives on call. If a client calls the office after normal office hours, we have an answering service that will page, call and/or patch through calls to our midwives as necessary.
Q: Can I choose which midwife I want at my birth?
A: Our practice uses a call schedule where 2 midwives are on call at all times. One of the benefits of a group practice is that during your pregnancy, you will be able to meet and form a relationship with each of our midwives. Our call schedule is strategically planned, as to not overtire or overwork the midwives; everyone gets equal call, and therefore you should have a well-rested midwife that you are familiar with at your birth!
Q: Do insurance companies pay for midwives?
A: Yes. While each insurance company has different rules for the reimbursement of midwives, the Affordable Care Act mandates that maternity care be covered. MWHC is contracted with all major insurance companies and PPO networks. Should there be a question about whether or not midwifery services will be covered, please remember that your insurance company is the authoritative source of information.
Q: Are certified Nurse Midwives able to prescribe medications?
A: Our CNMs DO have prescriptive authority. Referrals can be made to a physician, if a midwife feels something is outside of her scope to deal with appropriately. We also place intrauterine devices (IUDs) and offer other contraceptive options.
Q: What does “high-risk” mean (in regard to pregnancy)?
A: Depending on the condition, midwives can care for some high-risk clients in collaboration with a physician. Risk factors will be assessed throughout pregnancy, determining if a client is eligible or ineligible for an out-of-hospital birth. If it is determined that a client is ineligible for care in the birth center, they must plan to have a hospital birth with one of our CNMs (upon approval) or transfer care to an MD. Some of these risk factors are: maternal history of epilepsy or a seizure disorder, maternal history of diabetes, maternal history of a clotting or bleeding disorder, previous cesarean (VBACs are not allowed in birth centers, per State of Alaska guidelines, but our CNMs are able to do VBACs within the hospital, upon approval), multiple gestation, breech presentation, premature labor (<37 weeks).
Q: Do I have to know where I want to deliver prior to starting care at MWHC?
A: No. We know it is important for women to have care providers they trust and labor where they are most comfortable. We can spend time during your prenatal visits discussing the details of these options.
Q: Can I have a waterbirth at the birth center?
A: Yes! We are trained and comfortable with waterbirth at the Anchorage Birth Center. Many women enjoy spending time in our tubs and find it assists greatly with coping in labor. Most low risk women are eligible for a waterbirth, but not all.
Q: My partner is unsure of a birth center birth. How can I help educate them?
A: Most family members, once meeting the midwives, realize we are providing safe, comprehensive care. We suggest exploring this website for more information and letting them research, too. https://www.birthcenters.org/page/NBCSII
