FAQ

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. 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?

No. We are a cash pay only practice as of April 30, 2022. We charge $5000 for our services, including the birth assistant. Any labs, ultrasounds, OB consults (if necessary) or hospital transfer (if necessary) should be billed to your insurance. They will either be covered outright, or subject to your deductible, depending on your individual plan.

What if something goes wrong?

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. Over 90% of our in-labor transfers are for prolonged labor. We have worked hard to coordinate with the staff of our local hospital 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. The NH Certified Midwife has 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 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 parent and baby. We also feel that it is important to acknowledge that while out-of-hospital birth is statistically safe for low risk people, there are rare scenarios where complications can happen quickly, and either the baby or birthing person would be safer in a hospital setting.

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, and one assistant. The midwives often assist each other, meaning that the primary midwife calls another midwife in when it is close to the delivery of the baby. . Other times, we bring along an advanced, qualified 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 our midwives 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.

We also have 1-2 midwifery students in our practice at any time, and the students typically come to every birth- as well as prenatal and postpartum appointments. We believe that our students play a valuable role in our practice. If you would like more information on our students please inquire with a midwife.

What happens if two people go into labor at the same time?

Because we have four midwives in our practice, we are able to split up if needed, and bring in assistants as needed as well. In the occasion that someone take a vacation, we have back up midwives on call. Our goal is for our clients to have one of our midwives attending, and for them to know their assistant. While this isn’t always the case, most of the time you will know everyone present at your birth.