Gentle Birth Clinic

Frequently Asked Questions

1. What is a Certified Nurse-Midwife (CNM)?
2. What type of education and background does Carey Ryan have?
3. What is the philosophy of childbirth at Gentle Birth Clinic ?
4. How does prenatal care at Gentle Birth Clinic differ from that of other providers?
5. What about formal childbirth education classes?
6. Do you perform routine lab work and prenatal tests in your practice?
7. If I want to use your practice for care do I have to have a homebirth?
8. What will you do to insure that my birth at home is safe? What if a complication occurs?
9. Who can I have at my birth?
10. Can I walk, bathe and/or eat during labor?
11. When do you come to my house and how long do you stay after the birth?
12. Do I have to deliver lying down?
13. What about waterbirth?
14. Do you use drugs for pain control?
15. Do you routinely perform episiotomies?
16. Do you encourage holding the baby and breastfeeding right away?
17. Can I have a homebirth if I am older (over 35)?
18. What about homebirth after a previous Cesarean-section?
19. Will insurance pay for your services?
20. How do I find out more?

2.	Q: What type of education and background does Carey Ryan have?
	A: Carey was a nurse for twenty years. She has a Master's Degree in Communication as well as Nurse Midwifery. Carey is married and the mother of six. All but one of her children were born at home.

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3.	Q: What is the philosophy of childbirth at Gentle Birth Clinic?
	A: We believe that the woman's body is designed to perform all the functions of life including giving birth. The best preparation for birth should begin prior to conception. Parents-to-be should hold the critical vote in the decision making process for themselves and their unborn child.

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4.

Q: How does prenatal care at Gentle Birth Clinic differ from that of other providers?

A: We believe that care should start as early as possible; preferably prior to conception but at least no later than six to eight weeks into the pregnancy. We emphasize nutrition utilizing the Institute of Medicine Guidelines for Nutrition in Pregnancy. We strongly recommend elimination of white sugar, white flour and preservatives. We set target weight gain goals with our clients using their body mass index and adjusting for stress, multiple pregnancy, tandem lactation and lab results. All of our appointments are 45 minutes long and we emphasize education and the formation of a written birth plan. Carey Ryan is present at all prenatal visits and many of her staff rotate through the office so that the client knows the people who will be attending her birth.

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5.	Q: What about formal childbirth education classes?
	A: We currently suggest ICEA certified classes in private practice and/or sibling classes through one of the local hospitals. Our prenatal care emphasizes education and all of our clients are encouraged to ask questions. In addition we have a large (over 7000 books!) lending library available to women and their families. Feel free to come and browse our 3rd floor!

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6.	Q: Do you perform routine lab work and prenatal tests in your practice?
	A: All of the pregnancy labs and cultures done as a standard of care in the United States are done at the office and we do a one hour glucose screening; however, we do not rountinely perform MSAFP test or ultrasounds (both are available if necessary or desired).

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7.	Q: If I want to use your practice for care do I have to have a homebirth?
	A: No! We understand that homebirth is not for all. We offer several packages of care including prenatal care only and prenatal care with doula (labor support) services. You can also utilize the practice for consultation regarding nutrition, herbal preparations and more. We have worked with most of the area physicians and in all of the hospitals.

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8.

Q: What will you do to insure that my birth at home is safe? What is a complication occurs?

A: Most importantly, we know that good prenatal care creates low risk pregnancies and prevents most labor and delivery complications. In addition we bring the necessary medical equipment to create a safe place for birth in your home. If a complication occurs requiring additional medical services, we will transfer you to a preselected hospital. Finally, we choose a consulting physician ahead of time so that we can inform them of any status changes and utilize them when needed.

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9.	Q: Who can I have at my birth?
	A: Anyone you want! We encourage sibling participation if they are prepared. We also believe in labor support in addition to the father-to-be. Anyone who will help and encourage your natural labor and birth is welcome.

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10.	Q: Can I walk, bathe and/or eat during labor?
	A: Absolutely!!! We encourage women to change their position and activity frequently so as to facilitate labor. We require that women snack while laboring so that they have energy to labor and push well.

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11.	Q: When do you come to my house and how long do you stay after the birth?
	A: We will come to your house at your request. We like to attend the entire labor. We will remain with you until you and the baby are stable and then we will visit at 24 and 72 hours to make sure you are doing well.

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12.	Q: Do I have to deliver lying down?
	A: Only if you want to and it is a position that works well for you and the baby. We can help you try different positions for pushing and delivery. We have a birthing stool and we bring it to all of our births.

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13.	Q: What about waterbirth?
	A: We have a portable spa available to our clients. Many women labor in the tub and some choose to have their baby while immersed in the water.

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14.	Q: Do you use drugs for pain control?
	A: We do not use synthetic drugs for pain management. There is too great a risk of complications for both the mother and the baby. We do, however, provide herbal preparations for pain and anxiety. We can also use homeopathy, therapeutic touch and massage for comfort.

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15.	Q: Do you routinely perform episiotomies?
	A: Absolutely not! We believe that routine episiotomies are unnecessary and we use several techniques to promote stretching and reduce tearing during birth. Currently our episiotomy rate is zero!

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16.	Q: Do you encourage holding the baby and breastfeeding right away?
	A: Most definitely! All of our clients breastfeed and this frequently occurs before the cord is cut.

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17.	Q: Can I have a homebirth if I am older (over 35)?
	A: Yes! Our mothers come in all sizes, shapes and ages! We do not consider a woman high risk just because she has reached a certain maturity.

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18.	Q: What about homebirth after a previous Cesarean section?
	A: We will review your records and in most cases we can plan a homebirth. We support VBAC (vaginal birth after Cesarean) and we can advocate your plan with your physician if you want or need a hospital birth.

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19.	Q: Will insurance pay for your services?
	A: Insurance companies are now required to reimburse clients for nurse-midwifery services if they would pay for the same services provided by a physician. Many of our clients find that their insurance company is willing to review an initial denial and we can provide statistics and information for them to submit. Our costs are 50-60% less than hospital based birth and that is a big selling point.

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20.	Q: How do I find out more?
	A: Call Gentle Birth Clinic at 515-279-9617 to set up a consultation during which we can address your personal concerns and questions. Or, see our Request for additional information page.

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