Connecticut Childbirth & Women's Center

Frequently Asked Questions

1. What is a Freestanding Birth Center?
A freestanding birth center is a homelike, out-of- hospital facility where a woman's choices in pregnancy and birth are supported and respected. This birth center meets all local, state, and federal health, fire and safety regulations and is licensed by the Connecticut Department of Health. Women can feel safe and secure in the fact that midwives and consulting physicians work together as part of a unified system of quality healthcare. Most of all a birth center provides a program of care that gives a woman confidence in her ability to give birth, balancing her need for human touch and companionship with her potential need for technology and medical intervention.

2. What is the difference between a freestanding birth center and a hospital birth center?
The major difference between freestanding birth centers and hospital birth centers is that hospitals create policies to care for people who are sick, while freestanding birth centers design programs for healthy pregnant women. Also, freestanding birth centers are based on the midwifery model of care which approaches pregnancy and birth as a normal family event until proven otherwise. Freestanding birth centers offer the personal yet comprehensive care that every expectant mother and her family deserve.

3. What is the cost for giving birth at the Connecticut Childbirth & Women's Center?
The total fee for prenatal care, birthing, and postpartum care at the Connecticut Childbirth & Women's Center is $5,200. This includes a midwifery professional fee of $2,700 and a $2500 fee for the use of the birth center.

The professional fee includes:

-24-hour availability of the nurse-midwife/physician team.
-Prenatal care.
-Labor and birth care.
-Newborn assessment.
-One and six week postpartum office visit.

The Facility fee includes:

-Orientation to care.
-Labor and birth supplies.
-Support and care by a registered nurse in addition to the nurse-midwife.
-Use of the center's facilities from admission to discharge.
-Availability of consultation with an attending obstetrician and neonatologist.
-A 24-72 hour postpartum home visit by a nurse-midwife or regisered nurse (if the family lives within a sixty minute driving distance).

4. How soon after the birth do the mother and newborn go home?
Providing that no complications arise, women may remain at the birth center for up to 12 hours after giving birth. However, most mothers choose to go home between 4 and 8 hours after the birth.

5. What if an emergency happens and I or my baby needs to go to the hospital?
In the unlikely event of an emergency, Connecticut Childbirth and Women's Center is directly across the street from Danbury Hospital. We are also equipped with all routine emergency equipment. The nurse-midwives are health care professionals trained to treat birthing mothers and their newborns until the ambulance arrives. In addition, the birth center has a transfer agreement with Danbury Hospital and an agreement with the local ambulance company to transport the mother and/or her newborn immediately to the hospital. The midwives have privileges at Danbury Hospital, thereby allowing them to continue caring their birthing clients in the event of hospital transfer.

In reality most transfers that happen are for completely non-emergent reasons such as a stalled labor requiring medication or the request for pain medication.

6. Who is a certified nurse-midwife?
A certified nurse-midwife is educated and licensed in the two disciplines of nursing and midwifery. She must pass a national certification examination given by the American College of Nurse-Midwives and must meet strict requirements set forth by the Connecticut Department of Public Health. She provides comprehensive care in all aspects of women's health. This includes low-risk maternity care, attendance at births, postpartum care, contraceptive counseling, screening and treatment of routine gynecological problems, history and physicals, as well as perimenopausal and postmenopausal consultation.

7. Is the Connecticut Childbirth & Women's Center certified by the American Association of Birth Centers (AABC) or other such national organization?
Yes. The Connecticut Childbirth & Women's Center is one of only approximately 50 birth centers in the United States accredited by the Commission for the Accreditation of Childbirth Centers, an arm of the American Association of Birth Centers (AABC). The birth center adheres strictly to all NACC guidelines and is based on the midwifery model of care. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has also completed a thorough evaluation. We were granted and have maintained full accreditation in August 1998.

8. What Makes Us Unique?
The Connecticut Childbirth & Women’s Center is one of the few accredited birthing centers in the United States and the only one in Connecticut. Here, the able midwifery staff of Women's Health Associates offer a full scope practice and provide safe, compassionate care to families from Connecticut, New York, and Massachusetts.

Low risk women may opt to birth upstairs in one of the Center’s beautiful, homey rooms, or across the street at Danbury Hospital where the midwifery staff is credentialed. More complicated, high-risk pregnancies will have their care co-managed with our physicians and these births are planned at the hospital. If ever there is a need to move from the birth center to the hospital, before, during or after birth, continuity of care with your midwife is maintained.

Our midwifery staff believes there is no one right way to have a baby. We support the use of complimentary medicine: chiropractic, acupuncture, herbal and homeopathic for those who desire them and yet still provide for those who want more conventional modalities. Our goal is to offer birthing families a full complement of options from natural water birth at the Birth Center, to a more traditional approach in a hospital setting. In all settings, we believe that pregnancy, childbirth, and early postpartum are events of life-affirmation -- not only physical, but also social, emotional, and spiritual-- and should be honored as such.

Our caring does not end with the birth, and we invite you to continue a relationship with our midwives for annual GYN exams & family planning.

9. What Happens at my First Visit?
The first visit is a very important time for us to get to know you and your family. A thorough history is taken; we need to know about you, your family and the paternal history. Your diet, exercise habits, medications, etc., are very important to the health of you and your baby. We will advise you on changes or additions to your current regime that we feel may provide an optimal outcome.

A physical examination is also performed. If you are due for your pap smear it may be done at this or another visit.

We will discuss your plans and the course of your care; appropriate testing, genetic screening, ultrasounds you may want, blood work that will be done, the frequency of visits and so on.

You and your family, of course, will have plenty of time to ask your own questions of us! This is a great time, if you haven’t already, to tour the center.

10. What Happens at Subsequent Visits?
All of your appointments are scheduled for 30 minutes. This allows us about 20-25 minutes of “talk time” per visit. We try very hard to run the office visits on time. You will follow a routine course of visits, generally once a month until 28 weeks, then every two weeks until 35 weeks, and then weekly until 40 weeks. Of course that may vary according to your particular situation.

When you arrive, you will be welcomed by the front desk and encouraged to use the rest room to obtain your weight and dip your own urine for protein and glucose. In the exam room we will check your blood pressure, and discuss your general health and your perception of the baby’s movements.

The midwife will allow sufficient time to let you ask questions that you may have. She will let you know what testing is “coming up” for you and your baby. Then she will examine your belly and listen for the baby’s heartbeat. If you are in the latter half of pregnancy she will measure your uterus from the top of your pubic bone to the top of the uterus (also called the fundus) to see how many centimeters it is. If you have brought other children with you she will probably see if they would like to help perform these “belly chores”.

She will review any testing that had been done in a prior visit with you and your family and will order ultrasounds or tests that will be due before your next visit. There is time to discuss any feelings or concerns. We believe that the body, mind and spirit are all important components of prenatal care.

11. What Tests are required? May I “Opt-Out” of Any?
Only low risk women may birth in the center. It is very important that some testing be done to ascertain that both you and your pregnancy are, and continue to be, low risk. You are required to have initial blood work done during your first trimester. We need to know that you are not anemic, that you are immune or non-immune to Rubella, whether or not you have ever been exposed to Syphilis, Hepatitis B, or HIV. We must know what your blood type is and whether or not you have developed any antibodies.

Later in pregnancy you will need to have your hemoglobin repeated as well as your HIV and Syphilis status (per Connecticut state regulations). This is also a time that your glucose tolerance test is done.

A GBS culture is performed at approximately 35 weeks gestation.

All genetic testing is optional, and available for families that desire it: CVS, First Trimester Screening, Amniocentesis, and/or AFP testing.

Ultrasounds are performed on a limited basis in the midwifery office, such as early ultrasound for dating, fetal position, and/or fluid checks. Complete anatomy ultrasounds are referred out to the faculties near our office in Danbury. If you prefer we can refer you to the facility of your choice in a location close to your home.

12. Can I have a water birth?
Waterbirth is a wonderful option; helping to ease labor discomfort and providing a natural space in which to birth for those families choosing it. Statistically around 25% of our moms birth in the water with another 60% choosing water for labor discomfort.

13. Can I choose an epidural? Can I change my mind about epidurals/pain medications?
Of course. Some labors prove to be longer or harder than anticipated. If you change your mind for any reason, and decide you want the options available at the hospital, we simply transfer over to Danbury Hospital, which is right across the street, and continue there. Your midwife will be with you, and order the necessary interventions/medications. She will continue to manage your labor and birth collaboratively with our backup physician.

14. What if I need antibiotics for Group B Strep?
All patients are checked to see if they are carriers of Group B Strep (GBS), between 35-37 weeks gestation. Women who are positive will be given IV antibiotics as suggested by the Center for Disease Control (CDC) guidelines. Positive GBS status does NOT risk you out of birth at the Birth Center.

15. If I have risk factors, can I still choose to birth at CCWC?
Risk factors rarely risk you out of our midwifery care, but there are some very strict guidelines that risk women out of birthing at our birth center such as: Twins, breech presentation, labor before 37 weeks gestation, labor after 42 weeks gestation, certain medical conditions including but not limited to insulin dependent diabetes.. These are conditions that are best cared for in the hospital setting, with your midwives working in collaboration with our physicians. There are also risk factors that can arise during the labor that would risk you out.

We will discuss this with you personally and in detail at a Meet & Greet visit, and throughout your prenatal course of care.

16. How do you monitor the baby’s heartbeat during labor?
We monitor they baby throughout labor using the hand-held Doppler, listening intermittently at prescribed intervals according to the stage of labor, and what we are hearing. The Doppler can be used underwater for water births.. We follow the accepted national guidelines of the American Association of Birth Centers (AABC), which are adopted from both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse Midwives (ACNM) guidelines. They are proven to be safe and efficient at following the well being of the baby during labor. Of course if at any time if we hear a heart rate that is non-reassuring we would transfer from the birth center to the hospital for continuous fetal monitoring.

17. What if I need to go to hospital during labor?
While no one wants to consider the possibility of changing plans, it is a reality that we do sometimes need to birth at the hospital instead of the center for safety's sake. In that event we try and make the transition as smooth as possible. Care is co-managed by your midwife and one of the physicians from Women’s Health Associates. We are very happy with the staff at Danbury Hospital as they will go out of their way to try and make your stay and birth as comfortable as possible. All procedures and tests will be explained and choices, when appropriate, offered to you and your family. Families who have birthed at Danbury Hospital have overwhelmingly positive comments about their experiences.

18. How long can I stay at the Birth Center after giving birth?
After your natural birth in the Center you and your family will have time to bond together, recuperate, breastfeed and get to know each other. Discharge is 4-12 hours after birth. Most families stay around 6 hours. The midwife or RN will come to your home (provided you live within one hour of the center) 24-72 hours after birth to follow-up with a home visit. We will examine both mother and baby; check vital signs, and recovery status of new mother. We will weigh the baby, check vital signs, perform another physical exam, and check for jaundice. We will help & support breastfeeding, answer questions and offer guidance, all in the comfort of your own home. At this time we will also perform the metabolic screening (typically called a PKU) test on your baby. If you live further than one hour from the center we will help you arrange a visiting nurse from your area for a home visit.

19. Who examines my baby after birth?
After the birth of your baby, the midwife will perform a complete newborn exam. The pediatrician you have selected will be notified of the birth and the status of your baby. A written copy of this physical exam is provided to your pediatrician as well as a summary of the labor and birth for their records. Of course if any abnormalities are found or if your it is determined your baby needs additional medical care or support, your baby will be transferred to Danbury Hospital across the street where there are staff neonatologists available, as well as a Level II NICU.

20. Does my baby get the routine tests after birth?
Before you go home; usually within the first hour after birth, your baby will have his or her first physical examination performed in your room and in your view by the midwife. The baby will, at this time, have an injection of Vitamin K and instillation of erythromycin eye ointment. We will weigh and measure your baby at this time.

Your baby will have the PKU metabobolic-screening test performed at the home visit on the 1st or 2nd postpartum day. At that time we will also check for jaundice using a Transcutaneous Biliruben Meter. A state mandated hearing test will be performed at our office at the time of one-week postpartum visit. The PKU and the hearing test are recorded in the state computer system, and the results are given to you and your pediatrician.

21. What if I want my son circumcised?
Circumcision is a personal decision. This procedure is performed at 6-10 days of age in the obstetrician’s office. It will be done by either a qualified midwife or by an obstetrician at this time using a local injectable anesthetic.

22. I just found your practice on the Internet…I’m already 36 weeks pregnant…. can I still come to you?
A good many of our patients transfer into our practice during their pregnancy. While we always appreciate having many months to get to know you and your family it is possible to transfer to us very late in pregnancy provided you have had regular, routine, low risk prenatal care and are able to supply us with a copy of your complete prenatal records including laboratory work that has been done and any ultrasound reports.

23. I have other children at home. Can I bring them to my appointments?
This is a family event, and we welcome children at the office, and your prenatal visits. Our waiting room is child friendly, with a selection of toys and books to entertain them. Children usually enjoy being the midwife’s “helper” during the belly checks in the exam room.

24. Can I bring them to the birth?
Of course! This is a family affair, and children are always welcome. You can chat with us throughout the pregnancy about how best to prepare your older children for the birth, and we do require that an extra support person be available and assigned to the children throughout the labor, birth and your stay at the Center.

25. I’m a busy woman. I prefer to not have to go to the laboratory for my blood testing. Will you draw my blood at the office?
No problem, and one of the features our patients love; the convenience of nearly all lab work done right in our office.

26. Is it true that you have had female doctors deliver at the center?
Doctors, lawyers, judges, stay-at-home moms, bus drivers, teachers, nurses; you name it……we cater to a very diverse population of families from all walks of life. All sorts of families that are interested in birth that is natural, safe and satisfying seem to find their way to us!

27. How do we obtain the birth certificate and social security number for our baby?
Before you are discharged from the center you will need to fill in Connecticut state worksheets that will be sent to Hartford. From there a social security number is generated and mailed to your home, no matter where you live. The birth certificate is generated and sent to the Town Hall, clerk’s office, in Danbury within about 2 weeks. You may go there and, after showing identifying information, secure a certified copy of your child’s birth certificate. There is a small fee of around $5 associated with the birth certificate. The manner in which these two documents are secured is identical to how they are handled in a hospital delivery.

If you are not married to your partner you will need to fill in paternity papers or if in a same sex relationship; civil union documents.

Paternity papers need to be notarized. There is a notary in our office for your convenience.

28. How can I find out more about the birth center?
We offer free, thirty minute, individualized tours for families that are considering the center. This “meet and greet” is a great time to come see the center, speak with a midwife and get a feel for whether this is a good “fit” for you. There is never any pressure during the visit. We want you to decide for yourselves whether you’d like to receive care here with us. You may make this appointment for regular office hours by calling us at 203-748-6000.

Frequently Asked Questions

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