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.

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.

Can I invite other people to my birth?

Of course! This is your birth. The City of Jacksonville and ACHA fire codes permit five (5) people per laboring mom (this number excludes our staff). 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.

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

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 is equipped with suction, oxygen, laryngoscopes, and ambu-bags. The infant can be transferred to the hospital by ambulance, if necessary.

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

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 covers for our dopplers for monitoring if you choose to labor and/or birth in a birthing tub (when possible).

How do I get started?

First, schedule a complimentary consultation appointment to ask any questions and make sure you feel comfortable with us and our services. When you are ready to schedule your first prenatal visit simply contact us and we will happily help you begin your journey!

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.

Do you accept insurance?

Transitions Birth Center is NOT in network with any insurance providers. We will help you work with your insurance company to seek reimbursements if they provide gap exceptions for delivery at birth centers.

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.

What are Certified Professional Midwives?

A Certified Professional Midwife (CPM)®  is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.  The guiding principles of the practice of CPMs are to work with their clients to promote a healthy pregnancy and provide education to help them make informed decisions about their own care. In partnership with their clients, CPMs carefully monitor the progress of the pregnancy, labor, birth, newborn, and postpartum period. They recommend appropriate management if complications arise, collaborating with other healthcare providers when necessary. The key elements of this education, monitoring, and decision making process are based on evidence-based practice which includes thoughtful integration of the best available evidence, coupled with clinical expertise, and the client’s values and needs.

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. A doula is typically available throughout mom's entire laboring process, whether at Transitions Birth Center or if there is a transfer to Ascension/St. Vincent's Southside. Doulas help moms understand their labor process, and knowing when it's time to leave home.

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.

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.

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

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. The midwife may go to the hospital with you to make a "warm hand-off" to the hospital team.

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, we have made arrangements with the highly trained Neonatal team at Ascension/St. Vincent's Southside to continue care for your newborn. All of your postpartum care will continue the same as if you delivered at Transitions Birth Center.

When do I begin care?

We begin care at 28 weeks. Once you have completed all prenatal labs, anatomy ultrasounds, and glucose screening with your current provider, please call us to arrange forwarding your records to us.  This will typically occur between 24-26 weeks of pregnancy.

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.

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.

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.

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.

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.
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Our Classes
Education is the key to informed decision-making. Our childbirth education classes are meant to empower our clients to make the decisions that are best for their own families.

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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 10 years of professional delivery experience.
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