We try to anticipate questions you might have about our services and provide the answers here. If you need additional information send e-mail to wbwc@emadisonriver.com.
How are birth centers different?
Birth centers were designed for healthy, low risk mothers and healthy babies. It's a very relaxed atmosphere in a birth center. It feels more like a nice country inn, or somebody's really well kept home, than a hospital. There is also a lot of privacy at the birth center because of its low volume. We don't have 15 or 20 women giving birth at the same time. One, or maybe two, women will be in the birth center at the same time. And, because it's the place where mothers have come for all their prenatal care, they are very familiar with it. They know the staff who work there. They know the birth rooms since they have looked at them several times and shown them to their parents, friends and their other children.
Through the educational program that goes on throughout the pregnancy, parents know what to expect once the mother goes into labor. A mother knows that she can wear her own clothes and that she can eat and drink in labor. She will be encouraged to get out of bed and walk around. She is able to choose her support people - whether it's her own mother, her sister or friend. The father of the baby is almost always there, unless there is some special reason for him not be. It's up to the mother to decide how she wants this to go. This is her labor and whatever makes her feel good is what the staff wants to do for her. The mother can labor in any position that is comfortable for her. We know that babies come out better when the mother is relaxed, so we try to provide an atmosphere where she feels confident and comfortable so that she will use her body well.
Birth centers promote breastfeeding. In fact, because we know that a baby is alert and will nurse well in the first hour after birth, breastfeeding is encouraged immediately. In this way, breastfeeding and the education and support of the mother in the breastfeeding process is established early on.
There are no routines in a birth center. There is no routine prep or enema or IV. We do not do the continuous electronic fetal monitoring that keeps a mother tethered to a machine. The baby's heartbeat is monitored, but it is monitored intermittently with a handheld doppler. Also, birth center care reflects a difference in philosophy about episiotomies. We don't cut routine episiotomies. Instead, we use warm compresses to ease the passage of the baby so the mother won't tear. The episiotomy rate in birth centers is about 12 percent while it is well over 90 percent in most hospitals.
The most important difference you will find in birth centers, (and a common reason that many people choose a birth center) is that there is no separation of mother and baby. Anything that is done for the baby - treatment or exam - is always done in front of the parents so that they may learn about their baby. The same staff takes care of the mother and baby together. The nurse-midwife, the nurse or the physician in the birth center care for them as a unit.
Now, what about problems? We know that people are going to have problems, so there are systems set up to deal with transfers to the hospital. We know that we are going to transfer about 12 percent of the women in labor and that the vast majority of these transfers are not emergencies. Only about two percent of women go to the hospital as emergency transports.
The birth center is affiliated with UNC Family Medicine and if a transfer is neccessary the midwife accompanies the family to the hospital where the acute care can be provided. We are located only minutes from UNC, which insures that, if the mother or the baby develop a problem, we can get them the level of care needed.
What services do you offer?
Women's Birth & Wellness Center provides services for all your women's health care needs. We offer wellness care and low-risk maternity care. We offer:
- Complete Physical Exams
- Laboratory Studies
- PAP Tests
- Breast Exams
- Treatment of minor gynecological problems
- Treatment of URIs, UTIs
- Menopause consultation and support
- Birth control & family planning & IUI
- Pre-Pregnancy Counseling
- Certified Nurse Midwives
- Midwifery & nursing care throughout labor & delivery
- Facility with Comfortable birth rooms, private baths and large tubs, family area with kitchen
- Immediate newborn care
- Breastfeeding support
- Postpartum home visit
- Telephone contact each postpartum day until home visit
- Postpartum visits at two & six weeks
- Nurse Midwife on call 24 hours a day
What is Women's Birth & Wellness Center's mission?
Women's Birth & Wellness Center is dedicated to providing women of diverse backgrounds with comprehensive well woman, maternity and preventative healthcare throughout the lifecycle.
How do I know if a birth center birth is right for me?
The majority of women are good candidates for a birth center birth. Many European countries utilize a midwifery model of care and out of birth is quite common and accepted. Women who choose an out of hospital birth are committed to maintaining optimum health and well being during their pregnancies and birthing naturally. For example they:
- Eat a healthy, well balanced diet
- Continue to exercise in preparation for their birth and recovery
- Educate themselves by reading from many different resources
- Ask questions during their prenatal visits
- Take advantage of community resources
- Prepare for birth by taking one of the many different childbirth preparation courses are offered in the area.
Women choosing a birth center birth understand that in most cases minimal medical intervention is safest for both mother and baby, and in fact support and patience are all that are needed as she births her baby. Sometimes, however, pregnancy and birth are unpredictable and intervention may be necessary to ensure the best possible healthy outcome. In such a situation, since a trusting and respectful relationship has been established between the family and the midwives, a discussion of risks, benefits and alternatives occurs with ample time for questions. Then, even is birth doesn't go as expected the family feels comfortable with the plan of care, and the midwife continues to be present and supportive during the entire process.
I have certain health problems, so how do I know if out of hospital birth is safe for me?
Many women have health issues that are well controlled by lifestyle or medication and can still birth safely at the birth center. Examples are:
- Thyroid disorders managed with medication
- Mild asthma
- Depression managed with counseling or medication
- Abnormal pap smears, or surgery on the cervix
- Pregnancy with a prior history of infertility,
- Women 35 or older.
- History of miscarriage
Some conditions make out of hospital birth potentially unsafe, or the extra support of a hospital preferable or necessary for some women. They following is a partial list of common medical conditions that would "risk out" a woman from the birth center:
- Uncontrolled hypertension or high blood pressure
- Diabetes requiring insulin or medication
- Prior surgery on the uterus
- A new patient with a prior Cesarean birth planning on a vaginal birth with a subsequent pregancy, or VBAC.
- At this time we can only offer VBAC's to our established patients whose prior pregnancy under our care ended with a Cesarean birth
- Bleeding, or blood-clotting disorders
- With a first pregnancy, being very overweight with a BMI higher than 35
- History of a blood clot
- Smoking more than 1 pack per day
You will be asked about your health history on you intake screening phone call, and any question will be discussed with the midwife and decided on an case by case basis.
What are my payment options?
We accept and file with all major insurance companies and Medicaid. Payment plans and sliding fee scales are available for the uninsured. For financial questions please contact our business director.
How do I change my ultrasound appointment?
If you have been scheduled for an ultrasound at UNC Hospital and you need to change your appointment please call UNC Ultrasound at 919-843-6094.
Frequently Asked Questions Regarding Counseling Services
How do I know if counseling is for me?
If you are in need of emotional support and help with improving your ability to cope, counseling may be a useful service for you. Both positive and negative events in our life can create stress which has an impact on our way of perceiving others, ourselves and the world around us. This can lead to both emotional and physical symptoms of stress including but not limited to: increased tearfulness or irritability; anxiety or nervousness; difficulty falling or staying asleep; changes in appetite, weight, energy, or motivation; decreased ability to experience pleasure or interest in normal activities. Counseling is a great way to receive confidential, non-judgmental support to help you manage stress and even prevent suffering from future stressors.
Do I need to be pregnant to receive counseling at WBWC?
No. Counseling services are available to any and all women patients of WBWC, as well as to women and couples in Chapel Hill and surrounding communities.
What kind of therapy is offered? Will I need to be in counseling for years?
Not all conditions and situations require long-term therapy. Using a variety of counseling techniques and theoretical approaches to accommodate your needs, Kate's strengths are in solution-focused brief therapy, cognitive-behavioral therapy, dialectical behavioral therapy, and interpersonal supportive psychotherapy. Counseling is offered at this time to both individuals and couples. Rather than creating a sense of dependency on the counseling relationship to get well, Kate's goal is to help support you in ways that better equip you to cope on your own by uncovering your strengths, enhancing your skills to manage emotions and stress, as well as providing you with new tools to improve your interpersonal relationships.
Do you accept insurance?
Yes. Most insurance plans are accepted, as well as Medicaid and self-pay.
How do I go about scheduling my first appointment with Kate Gotelli, LCSW, if I'm interested?
If you are already a patient at WBWC, ask your provider to make a referral or call the front desk at (919) 933-3301 and ask to schedule an initial evaluation with Kate Gotelli, MSW, LCSW. Both daytime and evening appointments are available.
