Frequently Asked Questions
What is a licensed midwife?
A Florida Licensed Midwife is a graduate of a three-year academic Midwifery program. The Licensed Midwife also has eight semesters of clinical internship and must attend 75 deliveries, with 50 labor and delivery managements. The Licensed Midwife must pass the state board exam which is the North American Registry of Midwives national certification examination. Licensed Midwives in Florida are autonomous maternity care providers for low-risk, healthy women. Midwives also work collaboratively with physicians and offer childbirth services in the patient’s homes, birth centers, clinics and hospitals. Florida Licensed Midwives are eligible for reimbursement by private insurance and Medicaid. For more information about our staff midwives, please view the Our Team page.
How do I begin care with Sweet Child O' Mine?
At your first visit, we will do your lab work and physical exam, as well as regular prenatal care monitoring and a full orientation to your care.
When should I begin prenatal care? How do I reach the midwife if I have a problem?
You should begin care as soon as possible. It is best to begin care in the first trimester, before 13 weeks pregnant. Early prenatal care will give you an advantage, because the Midwife can assist you with nutritional counseling and easing of common discomforts such as nausea. We can usually hear your baby’s heart beat at about 10-11 weeks gestation (that is 10-11 weeks after your last menstrual period). Many women schedule their first appointment for right around this time. We can see you earlier, however, if you are having any difficulties or if you need early hormone level monitoring.
The midwife on call is always available to you if you are having an urgent concern. If you have an urgent concern, call us at 813-685-8404 and select option 2 for the midwife on call. In an emergency, please call 9-1-1. Once you set up your initial prenatal visit, we will initiate your online health records portal where you can enter your contact and health history information and view any prenatal records or labs as they are added. Through this health record system, you may also message your midwives. They will get an immediate email letting them know that you have contacted them. If you have a non-urgent question or concern, messaging your midwife through the health record system is the best way to contact her. You will get a prompt response, usually within one hour unless she is sleeping.
I am only weeks away from my due date. Can I switch care?
What does prenatal care include?
Why should I have a birth center birth?
Comfort—You will be more relaxed which will encourage labor to progress quicker and with less discomfort. You will be surrounded by the people you chose and midwives with whom you know and trust. After the delivery, you can return home to your own comfy bed within 3-6 hours after the birth. There will be no one waking you up every hour all night long to take your vitals.
Privacy—You will have complete privacy. You get to decide who comes to your birth and you are able to create your own intimate atmosphere within your birth suite. Since we are a small staff, you will not be cared for by strangers.
Personalized Care—During your pregnancy, we get to know you and your family, as well as your desires and wishes for your birth. Your birth plan is customized to accommodate your wishes. Would you like to avoid unnecessary labs and procedures? Would you like your partner to catch the baby? Would you like to be the one to announce if your baby is a boy or a girl? Do you want to keep your baby with you at all times? Do you want a waterbirth by candlelight?
Choice—Midwives believe that you should make the decisions regarding your care. In your care, everything is up for discussion and nothing is routine. We will help you be informed and educated, so that you can make the best choices for your family.
Bonding—Your baby will never leave your arms. We do not whisk the baby away for an immediate exam and care. After your baby is born, we place him or her on your belly and the baby generally stays skin to skin at your breast until breastfeeding is established. We will do a newborn exam when the baby is one hour old, but we do this with your baby right next to you in the bed. When you get up to shower, your baby can be held by Daddy or any person that you choose. With the whole family present at the birth or immediately after, bonding for the entire family is enhanced.
Avoid Infections—Less chance of getting hospital infections such as MRSA. We thoroughly clean every surface after each birth with germicidals.
Breastfeeding Support—We will encourage and assist you to breastfeed your baby soon after birth. We will follow up with a 24 to 48 hour visit and regular phone calls during the first week to help you with any difficulties you may be experiencing. Lactation consultants and the 24 hour LaLeche League hotline (1-800-LaLeche) is always available to you.
Cost Savings—The average cost of prenatal care and an uncomplicated hospital birth is $16,000. Birth Center birth costs less than one-half the cost of a hospital birth.
May I take pictures and/or videotape?
Comfort—You will be more relaxed which will encourage labor to progress quicker and with less discomfort. You will be surrounded by the people you chose and midwives with whom you know and trust. After the delivery, you can return home to your own comfy bed within 3-6 hours after the birth. There will be no one waking you up every hour all night long to take your vitals.
Privacy—You will have complete privacy. You get to decide who comes to your birth and you are able to create your own intimate atmosphere within your birth suite. Since we are a small staff, you will not be cared for by strangers.
Personalized Care—During your pregnancy, we get to know you and your family, as well as your desires and wishes for your birth. Your birth plan is customized to accommodate your wishes. Would you like to avoid unnecessary labs and procedures? Would you like your partner to catch the baby? Would you like to be the one to announce if your baby is a boy or a girl? Do you want to keep your baby with you at all times? Do you want a waterbirth by candlelight?
Choice—Midwives believe that you should make the decisions regarding your care. In your care, everything is up for discussion and nothing is routine. We will help you be informed and educated, so that you can make the best choices for your family.
Bonding—Your baby will never leave your arms. We do not whisk the baby away for an immediate exam and care. After your baby is born, we place him or her on your belly and the baby generally stays skin to skin at your breast until breastfeeding is established. We will do a newborn exam when the baby is one hour old, but we do this with your baby right next to you in the bed. When you get up to shower, your baby can be held by Daddy or any person that you choose. With the whole family present at the birth or immediately after, bonding for the entire family is enhanced.
Avoid Infections—Less chance of getting hospital infections such as MRSA. We thoroughly clean every surface after each birth with germicidals.
Breastfeeding Support—We will encourage and assist you to breastfeed your baby soon after birth. We will follow up with a 24 to 48 hour visit and regular phone calls during the first week to help you with any difficulties you may be experiencing. Lactation consultants and the 24 hour LaLeche League hotline (1-800-LaLeche) is always available to you.
Cost Savings—The average cost of prenatal care and an uncomplicated hospital birth is $16,000. Birth Center birth costs less than one-half the cost of a hospital birth.
How is my baby monitored during labor?
Do you offer pain medication?
We offer nitrous oxide in labor for pain relief. Nitrous oxide, also known as laughing gas, is a 50/50 mixture of nitrous and oxygen that is self administered by the mother in labor before each contraction as needed. This can aid with relaxation and is a completely safe analgesic. No harm to mom or baby from nitrous oxide has been documented, and this form of labor pain relief has been used in Europe for years. Because IV pain medicines and epidurals carry a risk of harm to you and your baby, it is not safe to use these types of pain relief out of the hospital. However, in addition to the nitrous oxide, we have many techniques to help. One includes laboring in water, also known as the “aquadural”. Studies show that water therapy during labor helps a laboring mom relax, eases the discomfort of labor, and aids in the progression of labor. Other methods of natural pain relief that we use include:
- Continuous Labor Support by a caring & knowledgeable person (your Midwife & Doula)
- Change of Position and Scenery
- Walking
- Patterned Breathing & Relaxation Techniques
- Use of Birth Ball
- Music
- Massage
- Warm Shower or Bath
- Acupuncture, Acupressure, Reflexology
- Heating Pad, Warm Rice Sock
- Aromatherapy & Massage Oils
- Herbal & Homeopathic Remedies
- Avoiding Dehydration
- Hypnosis
- Visualization
At the birth center, you are able to move around freely, change scenery, eat and drink as you wish, and have whomever you’d like to be with you. These things make a tremendous difference in your perception of discomfort in labor. In contrast to hospital birth, you are not required to labor on your back. Laboring on your back is extremely uncomfortable and does not facilitate the labor process. Also in a natural birth, Pitocin is not used. Pitocin makes your contractions abnormally strong, so they feel much worse than normal contractions.
During your prenatal visits and childbirth classes you will be thoroughly prepared for your labor and delivery. Your midwives will train you in relaxation techniques and all the tools you will need for labor.
Is it safe to deliver out of the hospital?
Research has shown that planned, out-of-hospital birth with a registered, licensed or certified Midwife leads to fewer interventions and complications for both the mother and baby. The chances of you having a cesarean are greatly reduced out of the hospital (6% compared to 42% at our local hospital). Your baby will not be forcefully pulled out by forceps or vacuum. Your baby won’t be subjected to unnecessary tests and exams. It has been demonstrated that being confined to bed with continuous fetal monitoring, breaking the waters, and routine use of Pitocin and epidurals cause the majority of complications related to childbirth in the hospital. Avoiding these unnecessary interventions will only aid you in achieving a safe and uncomplicated delivery. Normally, birth is uncomplicated and does not require any intervention. The hospital transfer rate for planned out of hospital births nationally is 12% and the cesarean section rate is 5-6%. At Sweet Child O’ Mine, our transfer rate was 9% for the 2017-2018 reporting year. Our cesarean section rate was 6%. Maternal and neonatal injuries are significantly less out of the hospital as well (0% at Sweet Child O’ Mine). According to a recent study published in the Canadian Medical Association Journal, neonatal mortality is less with Midwife attended out of hospital birth than with Midwife or physician attended hospital birth. Researchers found that childbirth out of hospital with a registered Midwife is just as safe as a conventional hospital birth and has a lower rate of complications. [Canadian Medical Association Journal, Janssen et al, September 15, 2009. 181 (6-7)]
At Sweet Child O’ Mine, all the Midwives, Nurses and Birth Assistants are certified in CPR and Neonatal Resuscitation and are trained to deal with emergency situations. We have several medications which can be used to stop hemorrhaging, oxygen, IV supplies and antibiotics, suturing supplies and lidocaine. If there is a need to go to the hospital, we are located only a half mile from Brandon Regional Hospital or when there is time, we will often transfer to the USF Midwife Group at Tampa General Hospital.
What if the cord is around the baby's neck?
Actually, this is a rather common occurrence and not an emergency. One-third of all babies are born with the cord around their neck. Rarely, does this cause a problem. Once the head is born, the Midwife will feel around the baby’s neck to see if a cord is present. If the cord is around the neck, then the Midwife will either slip the cord over the baby’s head or will birth the baby’s body through the cord. If the cord is extremely tight, it can be clamped and cut, but that’s usually not necessary. During labor, we will listen during some of your contractions to see if there are any signs of a cord problem.
How do I obtain a birth certificate and social security card for my baby?
Your Midwife will submit the birth certificate which also requests a social security card, if you desire. A social security card will automatically be mailed to you within 4-6 weeks. To obtain a copy of the birth certificate you will need to contact Vital Statistics or go to your local Tax Collector or Vital Statistics office and pay a small fee.
What is your transfer rate?
Sweet Child O’ Mine Statistics for 2018
Reporting period July 1, 2017, to June 30, 2018
141 Babies Delivered – 116 Birth Center, 25 Home Birth
9.6% Transfer Rate in Labor (15 out of 156: 4 for waters released without sufficient contractions and progress, 11 for maternal exhaustion/failure to progress
56.7% Waterbirth
28.4% Suturing Rate
2.1% Postpartum and Newborn Transfer Rate
3 Postpartum Transfers (1 for retained placenta, 2 for suturing)
3 Newborn Transfers (1 for respiratory, 1 for undiagnosed diaphragmatic hernia, 1 low birth weight)
6.4% cesarean rate of those who began labor with us (10 out of 156)
Sweet Child O’ Mine Statistics for 2016-2017
Reporting Period: July 1, 2016 to June 30, 2017
125 Babies Delivered – 107 Birth Center, 18 Home Birth
8% Transfer Rate in Labor (11 out of 136: 5 for failure to progress, 1 for maternal exhaustion, 3 for fetal distress, 1 for thick meconium stained fluid, 1 for hypertension)
0 Postpartum Transfers
2 Newborn Transfers (1 for respiratory distress, 1 for questionable umbilicus)
5.1% cesarean rate of those who began labor with us (7 out of 136)
56.8% Waterbirths (71 of 125)
37.6% Laceration rate (47 of 125). 1 Episiotomy
Sweet Child O’ Mine Statistics for 2015-2016
Reporting Period: July 1, 2015 to June 30, 2016 (reporting period changed this year so there is overlap with 2015 Statistics)
104 Babies Delivered
10.3% Transfer Rate in Labor (12 out of 116: 7 for failure to progress, 2 for maternal exhaustion, 1 for pain management, 1 for PROM/waters released no contractions, 1 for fetal distress) 5 out of 12 transfers occurred in January, 2016. January/February are the heaviest transfer months each year.
3 Postpartum Transfers (retained placenta)
1 Newborn Transfer (transient apneic episodes)
6.8% cesarean rate (8 out of 116)
52% Waterbirths (54 of 104)
29.8% Laceration rate
Sweet Child O’ Mine Statistics for 2015
105 Babies Delivered
5.4% Transfer Rate in Labor (6 out of 111: failure to progress due to nuchal cord-2, failure to progress due to posterior positioning of baby-2, PROM, water broke and labor did not kick in strong enough-1, meconium stained amniotic fluid-1.
4 Postpartum Transfers: retained placenta-3, transferred to be with baby/exhaustion-1.
2 Newborn Transfers: respiratory distress-1, transient apneic episode-1. Both babies were stable on arrival and remained for observation in the NICU for 5 days.
4.5% cesarean rate (5 out of 111)
52% Waterbirths (55 of 105)
20.9% Laceration Rate (22 of 105, half were waterbirth)
Sweet Child O’ Mine Statistics for 2014
85 Babies Delivered
2.3% Transfer Rate in Labor (2 out of 87: 1 for failure to progress in second stage, 1 for maternal exhaustion)
0 Postpartum Transfers
1 Newborn Transfer (respiratory distress)
2.3% cesarean rate (2 out of 87)
51% Waterbirths (43 of 85)
22.3% Laceration rate
Sweet Child O’ Mine Statistics for 2013
76 Babies Delivered
7.3% Transfer Rate in Labor (6 out of 82: 3 for premature rupture of membranes without sufficient contractions, 1 for maternal fever, 2 for failure to progress in second stage) All transfers were non-emergency car transfers.
0 Postpartum Transfers
0 Newborn Transfers
2.4% cesarean rate (2 out of 82)
50% Waterbirths (38 of 76)
30% Laceration rate
Am I eligible for midwife care?
Most healthy woman experiencing a healthy pregnancy and expecting a normal delivery are eligible for Midwife care. When you first call or visit us, we will ask you some questions about your health and your medical history to see if you are eligible for care. At your consultation, the midwife will review with you your health history to see if you are eligible for care.
At your first visit, we will do a complete physical exam and lab work to verify that you are in good health. The Midwife will continue to monitor your health throughout your pregnancy. If you have diabetes, high blood pressure, epilepsy, or have had a prior cesarean section, you are not eligible for a birth center birth.
Some other reasons that may risk you out of care are twins, breech at 37 weeks, severe anemia, low platelets at nirth (below 100), cholestasis, too little amniotic fluid (5 or lower), abnormality of the baby, pre-eclampsia, HELLP syndrome, preterm labor (before 37 weeks), Gestational Diabetes, high blood pressure, growth restriction-baby is not growing sufficiently, postdates (over 42 weeks), placenta previa (not resolving), smoking or drug use, some auto-immune diseases, Hepatitis C or other infections that could affect the baby.
If you have questions about your health history and eligibility, please call us at 813-685-8404 extension 7.
What about payment? Do you take insurance and Medicaid?
7Midwife care offers a significant savings to you. The fees for Midwife care and birth center delivery are less than half the cost of low risk obstetrical care and hospital birth. Remember that your OB’s fee is less than half of your total fee since it does not cover the hospital fees. Your maternity care at Sweet Child O’ Mine includes all prenatal exams, labor and delivery, initial postpartum care, complete newborn exam, two day postpartum visit, a two week postpartum visit, a six week postpartum exam, and filing of the birth certificate. Please call us for information regarding the fee for our services.
We are in network with most plans offered by Blue Cross Blue Shield, United Healthcare, Humana, Cigna, Aetna, AVMED and 1st Health. We do not accept Tricare or any Medicaid HMOs at this time; however, we do offer a reduced rate sliding scale fee for those who qualify for Medicaid. Please call our office at 813-685-8404 extension 7 to find out about your insurance coverage. We utilize a third-party billing company that can verify your insurance benefits for you to see what your insurance will cover and what your responsibility will be.
We will work with you by arranging a flexible payment plan. We accept cash, money order, VISA, MasterCard and Discover. Services and products that are not included in the fee are vitamins, lab fees, ultrasound, RhoGAM, medications, specialist services, registration fee, doula services, nitrous oxide, birth center package and homebirth package.
If you are self pay or out of network, you will be provided a full Good Faith Estimate that includes the estimated total cost of services you are requesting. The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.
Do I need an obstetrician in addition to my midwife?
No. Licensed Midwives are independent practitioners and offer complete prenatal care and lab testing. You will be referred to an obstetrician if any situation arises that requires obstetrical care or physician consultation.
May my family and children come to prenatal visits?
We highly encourage family participation. Children love to be a part of prenatal exams, especially listening to the baby’s heart beat. This is all part of the important bonding process for your family. During the pandemic, we are asking to minimize those present, wear masks, and if anyone is feeling ill to not come to the birth center facility.
May my family be present for the birth?
Outside of pandemic restrictions, you can have as many people with you during labor and birth as you’d like. Please speak with our staff and your midwife team about your birth plan and current practices. Our facility features a family lounge area where your family can rest, bring in food, watch videos and make themselves comfortable. We do recommend, however, that if you plan to have more than two persons with you, that you wait until very close to the birth to call everyone in. Having lots of people around you during labor will only slow down your labor progress and make you feel pressured. You may also have your children present at your birth, if you’d like. If you decide to have your children present, we encourage preparation for them ahead of time and require that the children have a designated support person other than your primary support person.
May I have a waterbirth? Is waterbirth safe?
The Yes! Waterbirth is an all-natural method to reduce the stress of labor. You will be more relaxed in the water and experience less discomfort. Your baby will be born in a gentle way into the same environment that he or she is currently in…water.
Waterbirth is safe, because the baby is protected by the “Dive Reflex.” The baby has been in water throughout the whole pregnancy, so until air hits the baby’s face, the baby will not breathe. The baby continues to receive oxygen through the umbilical cord just as he or she did before birth. The midwife will bring the baby out of the water within a few seconds after the birth.
At Sweet Child O’ Mine, each of our birth suites have their own birth tubs. The Garden Room contains the Harper’s Freestanding Birth Tub which is a stationary, fiberglass tub. This tub is 6 feet long and 30 inches wide with a depth of 24 inches. This tub features ozone which sanitizes the water, air jets, lights, a spray nozzle, and handle bars. The Serenity Suite and Mandala suite have the Birth Pool in a Box tub which is an inflatable oval, portable birth tub. It is 5 feet in diameter and sufficiently deep to cover your entire abdomen. This tub gives you plenty of room to move around and even in a kneeling position you are still submerged in water. The sides are soft and there is a built in seat and cup holder. Your partner may get in the tub with you as well if you like. The water is kept warm by the insulated tub walls and reheating. The Waterbirth option automatically comes along with the Birth Center Waterbirth Spa Package.
What do I bring to the birth center when I am in labor?
What is a doula?
A Doula is a professional labor support person. The Doula offers information, support, tips for dealing with labor, and helping your partner to be the best labor support person he can be. Achieving a natural birth is a team event. Unlike the Midwife and birth assistant that have other duties, the Doula is there just to support you and give you exactly what you need in labor. If you chose, a Doula will work with you during your pregnancy to come up with a birth plan customized to you. She will then support you and your partner through your whole labor and delivery with comfort measures and suggestions to make your birthing easier. There are also postpartum Doulas that help care for you after delivery and assist with breastfeeding. Please check out our doula service.
What if there is an emergency?
Healthy women with normal pregnancies generally stay healthy and have normal births. Most problems that develop during pregnancy or birth have clear warning signs well ahead of time, and we can calmly plan for preventing or managing a problem.
Your Midwife is highly trained, experienced, and able to quickly identify and manage any situations which are outside of normal. If a complication arises, we have emergency equipment including oxygen, IVs, medications to stop hemorrhage, and resuscitation equipment. All of our team is trained in emergency procedures, including CPR and neonatal resuscitation. If a hospital transfer becomes necessary, your Midwife has a plan in place for transfer and will accompany you to the hospital where you can receive the obstetrical care that you require. Our area hospital is only a half mile from the Birth Center. When there is time, we often transfer to directly to the USF Midwives Group at Tampa General Hospital.
Stalled labor or failure to progress is the most common reason for hospital transfer. Although we must resolve the situation in a timely manner, it is not truly an emergency and we have plenty of time to try various natural methods to get labor progressing. If we can’t get labor progressing or there is some other non-emergency transfer, the mom can be driven to the hospital in her own car, accompanied by the Midwife.
Please review our statistics, including transfer rate and cesarean section rate. We publish our statistics every year.
Sweet Child O’ Mine Statistics for 2018
Reporting period July 1, 2017, to June 30, 2018
141 Babies Delivered – 116 Birth Center, 25 Home Birth
9.6% Transfer Rate in Labor (15 out of 156: 4 for waters released without sufficient contractions and progress, 11 for maternal exhaustion/failure to progress
56.7% Waterbirth
28.4% Suturing Rate
2.1% Postpartum and Newborn Transfer Rate
3 Postpartum Transfers (1 for retained placenta, 2 for suturing)
3 Newborn Transfers (1 for respiratory, 1 for undiagnosed diaphragmatic hernia, 1 low birth weight)
6.4% cesarean rate of those who began labor with us (10 out of 156)
198 Patients accepted into care
17.4% (32) Antepartum Transfers before admit in labor (Breech-5, Preeclampsia/HELLP-2, Preterm Labor-4, Gestational Hypertension-2, IUGR-2, Gestational Diabetes-1, 2nd trimester miscarriage-1, Cholestasis-1, Hx preterm labor/Makena injections-1, Postdates >42 weeks-5, Premature Rupture of Membranes without Contractions-3, Precipitous home delivery taken to hospital-1, Elective pain management in early labor-1, Elective induction-2, Meconium stained fluid-1)
What about tearing?
We work hard to prevent and minimize tearing. We do this by encouraging good nutrition during pregnancy, perineal massage, perineal support, oil, hot compresses, warm baths, and avoiding episiotomy. Your Midwife will teach you how to push, so that you ease the baby out in a slow, controlled manner. Baths and/or waterbirth are also good ways to help prevent tearing. The warm water softens the tissue and allows it to gently stretch during birth. If you do need stitches, the Midwife will suture after the birth with local anesthesia. If necessary, the Midwife is trained to cut an episiotomy; however, this is rarely necessary.
Do I need a pediatrician?
Yes. We will provide you with a list of pediatricians that can aid you in your selection according to your needs. Your Midwife will complete a physical exam on your baby shortly after birth. She will weigh and measure your baby, and administer vitamin K and eye ointment, if you desire. The Midwife will also do the Newborn Metabolic Screening (PKU) test on the second day after the birth. After your baby is born, contact your pediatrician and schedule a visit within 48 hours.
