Maternity Care

Our Services:

Routine Obstetric Services are offered in collaboration with each woman to guide health promotion across the “Life-Cycle” including Assessment, Evaluation, and Education/Resources based on one’s unique needs, with Treatment as deemed necessary.

General Obstetrical Care

  • Pregnancy tests
  • Pre-Pregnancy Visits
  • Counseling: abortion, adoption, parenting
  • Reproductive Medicine resources
  • Birthing Options
  • Lactation support (and Breast assessment)
  • High risk pregnancy evaluations
  • Labor and delivery care
  • Postpartum care
  • Pap smears and HPV testing (Cervical cancer screening)
  • Pelvic floor assessment
  • Vaccine assessment
  • STD screening
  • Depression and Domestic Violence screening

Midwifery cares for the essentially normal pregnant woman in meeting her childbirth needs. Midwives believe that women have choices throughout the natural process of pregnancy and birth, utilizing intervention when necessary. Midwives provide guidance and support in the context that the woman deems meaningful with respect to her cultural, physical, spiritual and emotional needs in the location of her choice when the pregnancy is uncomplicated. Midwives provide comprehensive prenatal care that meets and exceeds safety standards in providing a nurturing environment for mother, baby and family. Midwives can and do offer medication as requested by a mother in labor. Natural birth does not mean that intervention is not warranted to meet the woman’s comfort needs.

Obstetrics is the field of study as a medical specialty concentrated on pregnancy, childbirth, and the postpartum period. The word “Obstetrics” is for the familiarity consumers have with the word in its meaning as to the care for the pregnant woman and is not intended to imply that Midwives are physician specialists, though Midwives perform many of the same services safely; however, there are differences in practice ideology, services offered and education.

High Quality Care and Excellent Outcomes (for references see Midwifery care of low-risk women improves the infant mortality rate in hospitals and birth centers compared to physicians caring for women of equally low risk. Decades of research between these groups proves CNMs possess:

  • Lower rates of Cesarean birth
  • Lower rates of labor induction and augmentation
  • Significant reduction in the incidence of third and fourth degree perineal tears
  • Lower use of regional anesthesia
  • Higher rates of breastfeeding

In a review of maternity care processes of CNMs and physicians, researchers concluded that care processes are heavily influenced by the provider group. Women in the CNM group were more likely to receive:

  • Prenatal education focusing on health promotion and risk reduction behaviors
  • A more hands on approach with a closer supportive relationship with their provider during labor and birth
  • Fewer technological and invasive interventions

Researchers conducted a rigorous systematic review comparing midwife-led models of care and concluded that midwife-led care has benefit over other models of care for women of similar risk status. Women in the midwife-led models had:

  • A significantly higher chance for a normal vaginal birth, fewer interventions, and successful initiation of breastfeeding
  • Care during labor provided by a midwife that the woman knew
  • Increased sense of control during labor and birth experience

In comparing national benchmarking data of 90 midwifery practices to national survey and birth data on obstetric procedures, women receiving care from CNMs/CMs had:

  • Lower than the national average rate for episiotomy (3.6% compated to 25%)
  • Lower than the national average rate for primary Cesarean (9.9% compared to 32%)
  • Higher than the national average rate for breastfeeding initiation (78.6% compared to 51%)

Fewer Cesareans with Midwives (see for a list of references): Between 1970 and 2009, the cesarean rate in the United States increased dramatically from 5% to 33%. Today, approximately one in three women gives birth by cesarean. To date, no published research demonstrates that significant maternal or child health indicators have improved in the wake of the increased cesarean rate.

The US Department of Health and Human Services and other government agencies have come to a consensus that the primary cesarean birth rate must be reduced:

*According to the Centers for Disease Control and Prevention’s National Center for Health Statistics, the state of New Mexico, where CNMs attend one-third of all births, has the lowest cesarean rate of all 50 states.

*The 2011 Systematic Review of Advanced Practices Nurse Outcomes included 15 studies comparing cesarean rates of women cared for by physicians and CNMs. The findings demonstrated significantly lower cesarean rates for women cared for by CNMs than for women cared for by physicians in comparable populations.

*Women who received care in a collaborative practice of CNMs and obstetricians with the option for giving birth at a freestanding birth center were more likely to have a normal spontaneous vaginal birth. Specifically, the data in this study demonstrated that 80.9% of the women in the collaborative practice group gave birth vaginally, versus 62.8% in an all-physician practice.

*CNM/CMs are the predominant care providers within birth centers in the United States. Preliminary data from the American Association of Birth Centers online data registry 2007-2010 for 15,661 women who presented to 76 different birth centers in labor demonstrate excellent outcomes (S. Stapleton, personal communication, November 7, 2011). Findings related to women and infants transferred to the hospital in labor or after birth included the following:

  • No maternal mortality
  • Neonatal mortality of 1.6 births/1,000 (national neonatal mortality rate 6.1/1,000)
  • Cesarean rate 6.1% (national cesarean rate 33%)

Preparing for a Healthy Pregnancy includes: Attend all prenatal visits in a timely manner; Eat a healthy diet; Take medications/supplements recommended and avoid anything, even over-the-counter medications and herbs, unless specifically discussed with your Provider; Take folic acid daily (800 to 1000 mcg); Discuss and follow recommendations for activity, work and exercise; Do not smoke, decrease and quit smoking if presently smoking, and avoid other people’s smoking; Do not drink alcohol; Avoid people with colds/infections. Once fetal movement is felt by the mother, monitor the baby’s moves every day and report these to your Provider at visits; if sudden changes are noted with decreased fetal movement, this must be reported immediately. Report any preterm contractions, vaginal bleeding, leaking of fluid from the vagina, sudden swelling (face, hands, feet), vision problems, severe headache, upper right quadrant/epigastric or abdominal pain immediately. If you believe that you have an emergency medical situation, call 911 and go to the nearest hospital immediately.

High-risk pregnancies: A pregnancy is considered high-risk if the woman or baby has an increased chance of health-related problems. Some of these conditions can be identified and managed by the midwife independently with increased surveillance. However, some conditions are best treated by a collaborative approach with a physician and the midwife. And there are situations whereby the woman and her family must be attended to by a Maternal Fetal Specialist and/or must be transferred to a specialty practice for needed treatment and care for an optimum outcome for mother and/or baby. These situations also impact the chosen place of birth: home, birth center or hospital. Every situation, every pregnancy and every patient is different. Our practice strives to provide the most satisfying experience for the family within the parameters of safety. The goal of care is to intervene before there is a problem and thereby prevent avoidable complications. In this endeavor, the provider(s) or location of care is an important factor. We aim to participate in the delivery for each family in the best setting, for the safest outcome, with the best provider suited to guide care.

Several conditions deemed to be high-risk are as follows: Diabetes, Cancer, High Blood Pressure, Kidney disease, Epilepsy, Personal use/abuse of alcohol, Personal use of illegal drugs, Personal history of smoking, Age younger than 17 or older than 35, Pregnancy with more than one baby (twins, etc.), Personal history of 3 or more recurrent miscarriages in a row, A baby with a known genetic condition or anomaly (Down’s Syndrome, heart condition), Patient with active infections that may have fetal complications (CMV, HIV, Hepatitis, Chickenpox, Rubella, Toxoplasmosis, Syphilis), Previous pregnancy with Pre-term Labor and Delivery, History of Pre-eclampsia or Eclampsia in a previous pregnancy, Use of certain medications that carry fetal risks (Lithium, Phenytoin {Dilantin}, Valproic acid {Depakene}, Carbamazepine {Tegretol}), Personal History of cardiac problems, Sickle cell disease, Asthma, Lupus, Rheumatoid arthritis, and previous uterine surgery, to name a few and each must be discussed on an individual basis.

Over-the-Counter Medications deemed safe to take as directed during Pregnancy:

Over-the-counter or commonly bought medications without a prescription can cause complications during pregnancy and are not generally recommended, such as aspirin and ibuprofen, though these same medications may be indicated for some medical complications in some situations. Please call our Midwives before taking any medications or supplements, even the ones listed below. Herbal remedies are also not recommended and need to be discussed before taking during pregnancy. Please note that our practice does not endorse any brands listed which are only provided for informational purposes.


  • Mucinex/Mucinex DM
  • Sudafed
  • Tylenol Cold
  • Throat Lozengers
  • Vick Vapor Rub
  • Chloraseptic Spray
  • Zicam


  • Maalox
  • Mylanta
  • Tums
  • Rolaids
  • Pepcid
  • Zantac


  • Emetrol
  • Peppermint
  • Ginger gum


  • Colace
  • Metamucil
  • Fibercon
  • Milk of Magnesia


  • Kaopectate
  • Immodium AD


  • Tylenol


  • Phazyme


  • Perparation H
  • Anusol
  • Tucks


  • Benadryl
  • Claritin


  • Monistat