Frequently Asked Questions

Women have the right to seek care that is medically safe, that fits their lifestyle, and that recognizes their individual, psychological and economic needs. Transitions Birth Center was created to give moms an opportunity for a safe, out of hospital birth experience with Certified Nurse Midwives who are Advanced Practice Registered Nurses, a Certified Professional Midwife, and/or a physician.
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What are Certified Nurse Midwives?

CNMs are registered nurses with graduate education in midwifery. They have graduated from a masters nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME). This education includes a university degree as well as hands-on clinical training by practicing CNMs. They also have passed the national certification exam of theAmerican Midwifery Certification Board (AMCB). CNMs provide general women’s health care throughout a woman’s lifespan. These services include general health check-ups and physical exams; pregnancy, birth, and postpartum care; well woman gynecologic care; and treatment of sexually transmitted infections. CNMs are able to prescribe a full range of substances, medications, and treatments, including pain control medications. CNMs work in many different settings, such as hospitals, health centers, private practices, birth centers, and homes.

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Can I invite other people to my birth?

Of course! This is your birth. A dedicated adult must accompany any children under the age of 10.

However, there are good reasons and “not as good” reasons to invite people to your birth and we hope you will seriously weigh the pros and cons to having other people in your birth. Please only allow people who are supportive of you and your plans for your birth. Fear is a powerful force that can impact your body, your birth and your baby adversely. You need strong support and encouragement during your labor and you absolutely do not need to be taking care of other people’s needs, nor should you need to perform for them. It may seem like a good idea to have a lot of people you love with you in birth, but you should ask, what if it takes well over 24 hours? Will you be concerned about those people? Only invite those who will truly strengthen, affirm and help you. It IS all about YOU this day. This is YOUR birth.

Simply discuss your "dream birth" with one of our midwives to ensure that it aligns with the City of Jacksonville and AHCA fire codes.

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Who cannot give birth at Transitions?

Women with certain conditions may need the extra safety and support that only a hospital environment can provide. This includes women with:
* Previous Cesarean birth
* Breech at term
* Labor occurring before 37 weeks or after 42 weeks of pregnancy, if risk criteria are met

Other women may have conditions that require high risk prenatal care, as well as hospital birth, and “risk out” of birth center care. This includes, but is not limited to, women with:
* Chronic high blood pressure or a cardiac condition
* Excessive tobacco use
* Clinically significant malnutrition or obesity
* Multiple gestation (twins)
* Diabetes requiring oral medication or insulin
* Very high or very low BMI

Each client’s medical history will be reviewed individually by our Certified Midwives

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What complications can be handled at Transitions?

Our midwives are skilled and trained in all birth complications and emergencies with the plan to transport to the hospital (less than a mile from our facility) in the event for needed intervention, or an emergency, if birth is not imminent. Our midwives are prepared to handle the following complications:

Post-partum hemorrhage/excessive bleeding that can be controlled with the use of medication. If necessary an IV can be started to replace fluids. The mother can be transferred to the hospital by ambulance, if necessary.

Infant resuscitation. A midwife certified in Neonatal Resuscitation will be present at every birth. The training includes resuscitation, suction, and intubation to establish an airway. Transitions Birth Center has neonatal resuscitation equipment.

Perineal tears. Midwives are trained to repair tears and episiotomies using a local anesthetic.

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Will the baby be monitored?

Yes, we will diligently monitor your baby using an intermittent method in regular intervals (and, additionally, anytime we determine it is necessary for your baby's safety). We use a hand-held doppler which gives you freedom to move and assume any position you wish. We also have waterproof dopplers for monitoring if you choose to labor and/or birth in a birthing tub (when possible).

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How do I get started?

Send an email with your name, phone number, date of birth, and estimated due date to info@transitionsjax.com. We generally respond to emails within two business days.

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What should I bring when in labor?

We have all the necessities, but want to remind you that it will be different from a hospital stay. This will be more like packing to stay overnight in a hotel. Bring your labor playlist to connect to our Bluetooth speakers. Some people like to have a sports bra or bathing suit top for the tub, but others prefer to just have something comfortable to put on after the birth. We encourage you to have snacks and drinks that you would like during labor and something to eat after your baby arrives. If you have food that needs to be refrigerated, please be sure to pack a cooler with ice packs. We have pads, mesh panties, ice packs, and ibuprofen for your stay here, but you will also want to stock up on some of these for when you get home. Bring clothes to wear home, clothes and blanket for the baby, as well as your car seat installed. You will definitely need to have a baby thermometer for home, so bring this with you if you need help with how to use it correctly. Discuss your questions with one of the midwives during a prenatal visit and we can give you other more specific ideas.

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Will your midwives attend a homebirth with me?

No. Our midwives specialize in birth center and/or Ascension -- St. Vincent's Southside births. In addition, our midwives are prohibited from attending home births as a doula, photographer, labor support, or any other capacity.

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Do you accept insurance?

Transitions Birth Center is NOT in network with any insurance providers. We enter a contract with you, the patient, not the insurance company. Insurance companies should not stand in the way of you having the birth experience of your choice. We will, however, help you advocate for yourself with your insurance company in order to seek reimbursements if they provide gap exceptions for delivery at our birth center. Your insurance company's gap exception policy may allow your payments made to Transitions Birth Center apply toward your deductible, in-network benefits, and may even reimburse you for the care that you prepay and receive at our facility.

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What is your refund policy?

Refunds are given based on our Financial Policy with respect to services rendered. Please review our Financial Policy for more details regarding this topic.

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What are Certified Professional Midwives?

Certified Professional Midwives (CPM)® in the state of Florida are licensed, independent midwifery practitioners with a 3-year intensive training in midwifery.  Our CPMs have graduated from a non-nurse midwifery program accredited by the Midwifery Education Accreditation Council.  This education is based on the European model of midwifery that includes nursing, obstetrics, gynecology and pharmacology as well as hands on clinical training by practicing CPMs or CNMs with out-of-hospital experience. They have also passed the national certification exam of the North American Registry of Midwives.  The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.  They provide comprehensive, holistic midwifery care from preconception to postpartum and beyond.  In Florida, this includes collaborative care with physicians for higher risk pregnancies and prescriptions for medications and treatment plans.  Licensed midwives work in a variety of settings including health care clinics, physician offices, and birth centers in addition to providing home births.  Occasionally, they also work in hospital settings.

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Do I need a doula?

A doula is a professional labor support person. We love doulas and strongly recommend them! We easily integrate good doulas into the birth as we find them to be so helpful to both the partner and the mother. Doulas help moms understand their labor process, and knowing when it's time to leave home. A doula is typically available throughout mom's laboring process, whether at Transitions Birth Center or if there is a transfer to Ascension/St. Vincent's Southside and remains by mom's side until mom leaves our facility.

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Is a birth center safe?

The National Birth Center Study II, conducted by the American Association of Birth Centers (AABC) and published in the January/February 2013 issue of the Journal of Midwifery & Women’s Health, highlights the benefits for women who seek care at midwife-led birth centers. Findings also reinforce longstanding evidence that midwife-led birth centers provide safe and effective health care for women during pregnancy, labor, and birth.

The study, which included more than 15,500 women who received care in 79 midwife-led birth centers in 33 US states from 2007 through 2010, found that fewer than one in sixteen (6 percent) of participants required a cesarean birth compared to nearly one in four (24 percent ) similarly low-risk women cared for in a hospital setting. Expecting families who choose the birth center setting in the U.S. can expect high-quality, family-centered care. Less than 2% of women who choose the birth center setting will require an urgent transfer for either mother or newborn. The stillbirth and newborn death rates are comparable to rates seen in other low-risk populations. The information provided by the new National Birth Center Study II will help women and families make evidence-based, informed decisions about their babies’ births.

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What services/procedures cannot be done at Transitions?

If any of the following are needed, a transfer from the Birth Center to the hospital is required. The situation causing the transfer determines whether the nurse-midwife will deliver you at the hospital or whether Family Medicine or OB/GYN physicians will become involved for the delivery.

* Anesthesia. Epidural anesthesia is not available at the Birth Center. Pain medications in labor are used sparingly because they can cause respiratory depression in the newborn. Coaching, support, and hydrotherapy are used routinely. Labor and birth are hard work. It is our goal to help women and their families make labor a positive experience for everyone.

* Vacuum, Forceps or Cesarean Birth. These procedures are done by our consulting physicians in the hospital, when medically necessary.

* Pitocin Induction or Augmentation. Because this requires the use of continuous electronic fetal monitoring (EFM) and immediate access to surgery should it be indicated, delivery is done at the hospital, often by the nurse-midwife.

* Continuous Fetal Monitoring. If there is a need for continuous EFM, a transfer is required and care is often continued by the midwife.

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What happens if I need to be transferred?

If, during your prenatal care with us, you need a physician’s care for medical reasons, you can transfer to the practice of your choice. The most common causes are poor fetal growth, fetal malpresentation, going beyond 42-weeks, or maternal hypertension. These complications require high-risk rather than low-risk prenatal care and thus a transfer out of the birth center. Most of our patients will proceed through their pregnancy without complications. We keep our Medical Director informed of your progress in pregnancy, in the event a transfer out is necessary.

In labor, most transfers are non-emergent, and can be made by car. The most common reasons are prolonged rupture of membranes (PROM) without active labor and occasionally for pharmacologic pain relief. In the event of an emergency in labor, an ambulance will be called.

Whether a transfer is non-emergent or emergent, Ascension St. Vincent's Southside Hospital is located located 0.4 miles from our birthing center!

Infants may occasionally be admitted to the hospital, usually for observation of respiratory problems. These transports are usually via ambulance. In the event of an emergency involving an infant, the highly trained Neonatal team at Ascension/St. Vincent's Southside will continue care for your newborn. All of your postpartum care will continue the same as if you delivered at Transitions Birth Center.

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When do I begin care?

We begin care as early as 20 weeks but no later than 28 weeks (We want to get to know you!). Initial prenatal labs, genetic screening, and anatomy ultrasounds will be completed with your current provider. Please email (info@transitionsjax.com) to arrange forwarding your records to us.  This will typically occur between 24-26 weeks of pregnancy.

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Do you offer tub labor/waterbirth?

At Transitions Birth Center, each of our two private suites have their own large birthing tubs. Often referred to as “the Midwives epidural”, there are many benefits to laboring in water:
* Reduces sensory stimulus, thus producing less stress-related hormones
* Increases production of pain inhibitors, i.e., endorphins
* Decreases blood pressure – Increases ability of the mother to focus
* Reduces the sensations of pain
* An analgesic effect
* Increases skin elasticity, reducing the amount of perineal tearing
* Makes it easy for mom or dad (with midwife assistance) to “catch” their own baby because of the buoyancy of water
* Gentler birth for baby unless circumstances require another position, you may give birth in whatever position or place feels best to you.

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Does a pediatrician see my baby?

No, however, the midwife will perform standard newborn procedures including a metabolic screen and a basic physical examination. In addition, she will administer Vitamin K and erythromycin, at mom's direction. If you don't have a pediatrician selected, we will refer you to one of our Pediatric Pathway Partners.

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How much does this service cost?

The Transitions Birth Center Care package is $7,500. Please review our Financial Policy for more details regarding this topic.

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How do I pay for services?

Payments can be made via cash, check, or credit card. To make payments online, click here or contact the office to request an emailed invoice via Square.

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Our Core Values
Women have the right to seek care that is medically safe, that fits their lifestyle, and that recognizes and respects their individual, physical, spiritual, psychological, and economic needs.
Faqs
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Our Classes
Education is the key to informed decision-making. We strongly recommend education classes, especially for first-time moms. Those classes provide the knowledge and tools to empower our clients to make the decisions that are best for their own families.
education classes
Your Experience
Our beautiful, homelike birthing center gives you the opportunity to have the kind of birth YOU want to have in a safe environment. We partner with CNM, APRN and CPM midwives -- all with a minimum of 20 years of professional delivery experience.
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