SPECIAL BEGINNINGS

Birthing Center

Frequently Asked Questions

The dictionary definition of the word midwife is “with woman.” This meaning is derived from the practice of a midwife being “with a woman” throughout the time of her labor and delivery. The presence and assistance of midwives during childbirth dates to at least the time of the ancient Hebrews (see Exodus). While the profession of midwifery has experienced many positive changes since then, the role of a midwife being “with woman” during the birthing process remains at the heart of midwifery.

A fundamental premise of midwifery is that childbirth is a natural process and should not be burdened by unnecessary medical intervention. For this to take place, a woman must be allowed the time necessary for her labor and delivery to occur naturally - according to her own physiological processes. Regrettably, a woman is typically not allowed this opportunity in a hospital labor and delivery setting. Even in a hospital that utilizes the skills of midwives, a woman’s birth process is ultimately made to fit the rigid time constraints of the medical model.

Midwives who operate in alternative settings have both the dedication and the flexibility to see women through the natural birthing process. Efficiency is no longer measured by time, but by the comfort and satisfaction of a woman during the birthing process. Additionally, the alternative setting permits a woman to customize the birthing environment. A woman may, for instance, have quite specific ideas about who is to be present at the birth, the playing of music, the level of lighting, etc. In sum, the alternative setting offers a more natural and peaceful environment, validates a woman’s wishes and permits the expression of cultural diversities that traditional hospital settings do not.

One crucial and consequential distinction between midwives and obstetricians lies in the foci of their practices. This distinction and its implications are discussed at length in Effective Care in Pregnancy and Childbirth.

Because of time constraints, obstetricians caring for women with both normal and abnormal pregnancies have to make an impossible choice: to neglect the normal pregnancies in order to concentrate their care on those with pathology, or to spend most of their time supervising biologically normal processes. Midwives and general practitioners, on the other hand, are primarily oriented to the care of women with normal pregnancies, and are likely to have more detailed knowledge of the particular circumstances of individual women. The care that they can give to the majority of women, whose pregnancies are not affected by any major illness or serious complication, will often be more responsive to their needs than that given by specialist obstetricians (Enkin et al, 2000, p. 21).

Many midwives who practice today are direct entry - midwives who have received their labor and delivery training through apprenticeship programs. While most of these midwives do practice successfully on a broad scale, they lack the training and authority to diagnose and treat medical conditions that might arise before pregnancy, during pregnancy and during labor and delivery. In contrast, certified nurse midwives (CNMs or “nurse-midwives”) are amply trained and authorized to confront medical conditions that are potentially adverse to a woman and her pregnancy.

Nurse-midwives are registered nurses - with nursing experience - who have attended accredited midwifery schools to obtain special training and subsequent Certification. Thankfully, the occurrence of adverse medical conditions during pregnancy is rare. Still, by having the benefit of extensive medical training, nurse-midwives are able to diagnose and treat such conditions. The early diagnosis and treatment of a minor medical condition increases the likelihood that a pregnancy and labor and delivery will be safe and satisfying processes.

While many, if not most, people are familiar with the role of midwives in attending pregnant women, far fewer realize that nurse-midwives are equally qualified to see women for routine gynecologic issues. As with the majority of obstetricians, nurse-midwives have been trained in the proper diagnosis and treatment of many gynecologic medical conditions. The societal benefit of nurse-midwives acting in this broader capacity is enormous - especially when their practices are located in medically underserved areas such as the one selected for Special Beginnings.

The market for Special Beginnings services includes women from across the greater-Grand Prairie area. These women are of all ages, of all ethnicities, and from all socio-economic strata. Some are “Private pay” and others are “third-party pay” - Medicaid, Medicare and private health insurance. Many will choose to receive healthcare services at Special Beginnings because of convenience or because of economic and/or transportation barriers to other services, while others will choose Special beginnings because of lifestyle reasons. This especially will be the case for women during pregnancy.

Healthy, low-risk women today are increasingly turning to midwives for their obstetric care and labor and delivery services. On Sunday, July 4, 2004, this fact was underscored in a Dallas Morning News article that featured Becky Burpo, President of the Texas Consortium of Certified Nurse Midwives. There, Ms. Burpo notes, “More women are looking for midwives and there are lots of opportunities throughout the country. Midwives in Texas have reached a point at which they are catering to women at two ends of the spectrum. The indigent who seek care at publicly funded institutions such as Parkland, and affluent mothers who prefer the care of midwives at birthing centers.”

Nurse-midwives in Texas are certified by the American College of Nurse Midwifery (ACNM) and licensed by the state of Texas - both as registered nurses and advance practice nurses. Special Beginnings is licensed by the Texas Department of Health as a women's healthcare/birthing facility. Additionally, Special Beginnings is an active member of the National Association of Childbearing Centers (NACC). While these certification and licensure processes are thorough, they insure that Special Beginnings is a first-rate women’s health facility.