Frequently Asked Questions
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Most Often Asked Questions and Answers about our Midwifery Practice and Philosophies:
1. What is a Certified Nurse Midwife?
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A certified nurse-midwife (CNM), is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives (ACNM). The ACNM believes that every family has a right to experience a safe and satisfying childbirth, attended by providers who respect cultural variations, human dignity, and the rights of consumers to freedom of choice and self determination. This includes respect for the client preferences regarding birth site. The education and preparation of Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) qualify them to practice in a variety of settings, including hospital, home and birth center. Midwifery practice as conducted by CNMs and CMs is the independent management of women’s health care focusing particularly on common primary care issues, family planning and gynecologic needs of women, pregnancy, childbirth, the postpartum period and the care of the newborn. The certified nurse-midwife practices within a health care system that provides for consultation, collaborative management or referral as indicated by the health status of the client. CNM’s and CM’s are certified by the American Midwifery Certification Board (AMCB) Certified nurse-midwives and certified midwives practice in accord with the Standards for the Practice of Midwifery, as defined by the American College of Nurse-Midwives. You can go to the ACNM website to learn more about the organization. (http://www.midwife.org/)
2. Risa, you started practicing in home birth, then in four New Jersey Hospitals, worked at St. Luke’s Roosevelt/Mount Sinai West, then Lenox Hill Hospital in New York City. Now you are focusing on Birth Counseling? Why the switch?
I am focusing on offering specialized birth counseling at this time, to help support all individuals who are pregnant, those seeking to get pregnant, and those with challenges in the post-partum period. My goal is to help women find the empowerment they deserve, by utilizing my unique form of holistic birth counseling. My experience in working in many health care settings including hospitals, birth centers, and home birth has allowed me to witness the problems that contribute to our nation's high maternal and infant morbidity and mortality rates. I feel I can make a difference by counseling mothers before they get into their birthing place to help prevent them from becoming statistics.
3. What if I need a planned Cesarean delivery? Can we work together for counseling ?
Yes, we will discuss your goals and the idea of having a "Gentle Cesarean.” I have been the initiator of "Gentle Cesareans,” and "skin-to-skin", and honoring the Golden Hour, at all hospitals I have worked in.
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My Cesarean section rate has been 5-10% and all Cesarean sections have been medically necessary. Guess what? Sometimes a laboring mother needs a Cesarean section to birth her baby. Yes, I said “birth." In my midwifery practice, Cesarean sections were medically needed for those patients and their babies who became high risk.
Sometimes a mother or her fetus will develop a high risk condition during the pregnancy, or a mother may have a pre-existing medical condition, and her baby may not be born vaginally for a variety of medical reasons. Even "low risk" healthy laboring mothers can encounter an unexpected challenge during labor, and a Cesarean section will ultimately allow the baby to be born safely. We strive for a "Gentle Cesarean Delivery." After the baby is born, the baby is checked by the pediatrician and then your midwife or nurse, (if baby and mama are medically healthy) brings your baby to you so that you can bond and breastfeed on the operating room table.
Whether you have a vaginal birth or a Cesarean section, holistic counseling will help you visualize a powerful and beautiful birthing experience.
4. I am over 40. I did IVF. I did IUI. I am not low-risk. Can I do birth counseling or post-partum counseling with you?
Yes! I review your medical records, and we talk about your vision and yearning for motherhood.
5. Do I need to have met you prior to my birth in order to benefit from your postpartum counseling services?
No, I have counseled women during the post-partum period without having met them prior to their delivery.
6. I would like to begin Birth Counseling with you. How “late" can I start and what is the protocol?
It is never too late! It is always an honor to be asked to serve as a midwife birth counselor.
7. I am pregnant with twins. Can we work together?
Yes we can! Get ready to hear about doubling your protein!
8. I would like to try for a VBAC (Vaginal Birth After Cesarean). Can you help me?
I have counseled and helped many women have their VBAC babies. I am most familiar with and sensitive to the special needs of VBAC mamas.
To start the process we would have a TOLAC (trial of labor after Cesarean) and VBAC consultation so we may learn about the unique circumstances leading to your prior Cesarean section/s. You would bring a copy of your operative report to discuss if you are a medically appropriate TOLAC/VBAC client.
9. How often will we be meeting for counseling visits?
These are customized, individualized visits, and therefore the counseling plan depends on how you feel.
The first session is 90 minutes, and subsequent sessions are 60 minutes. We create a birth counseling plan that works for your needs, and often they come up spontaneously.
Starting at 37 weeks, we meet as often as you like until your baby is born. These sessions can be 30 minutes. We will discover the areas of concern that would be most helpful to you in reframing and addressing your challenges, in order to facilitate a triumphant and empowered birth.
While the information below is given as a general overview, it can and many times, changes! If you happen to need me more or you need to schedule an extra session, I will always be available for additional sessions. This is the heart of my midwifery practice - one-on-one individualized care. This is what I do to foster excellent emotional well being and education during pregnancy.
10. Tell me more about birth counseling, why it’s important.
Holistic pregnancy, birth, and post-partum counseling sessions from an experienced, highly skilled and intuitive midwife helps individuals reframe a past medical or birth experience that may have left them feeling disempowered or disconnected from their baby. Counseling also helps those who have fears about pregnancy, labor, birth, mothering, or any other major issue in life that may impact birth, such as abuse, violence, abandonment, past traumas, etc. Unresolved fears often resurface during birth and birth counseling is an important and constructive way to clear them. Counseling is important for second or third time moms who may have felt “not heard,” “rushed,” or “disrespected,” at their prior births. After being in the birth room with thousands of mamas, I have seen the powerful results of counseling, with reduced maternal and infant morbidity, less Cesarean sections, and more “happy birthdays."
I am able to make referrals to other healthcare practitioners, as needed for pregnancy care.
11. How do you feel about Birth Doulas?
I love Birth Doulas! I have a list of those I recommend. If you have a doula you love, she can come with you to your counseling session.
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