Alternative Birthing Center, W&I Providence? - Mothering Forums

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#1 of 29 Old 03-24-2011, 09:29 AM - Thread Starter
 
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Hi Ladies!

 

I'm due at the beginning of May with our first, and we had our hospital tour last night, and I'm interested in the Alternative Birthing Center at Women & Infants...but, I'm wondering if anyone has had an experience there??

 

My thoughts:

 

  • Like I said, its our first - yes, I'm nervous, but I'm pretty sure I can do this without the option of an epi. 
  • I like the atmosphere SO much better than the L&D rooms, just much more relaxed and quiet. 
  • I'm with the Center for Ob-Gyn, currently seeing an OB who I love but have met the midwives as well, if I have to switch that would be OK with me -  (I think that's the case, but I'm not sure?)
  • I am not comfortable with the Early Discharge option...but from what I see, its an OPTION, you don't have to use it...
  • I would like the peace of mind of "some" monitoring which I think you still get at the ABC?

 

I think that's it for now...any insight, stories, experiences would be MUCH appreciated!

 

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#2 of 29 Old 03-24-2011, 09:58 AM
 
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 have you done a search on this forum?  Lots of us have had great experiences there and this topic comes up regularly!

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#3 of 29 Old 03-24-2011, 10:27 AM - Thread Starter
 
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Yes, the last ones that came up were from 2008, so I didn't know if anything had changed through the last few years :)

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#4 of 29 Old 03-25-2011, 11:18 AM
 
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hm, weird.  well, I had my ABC birth a year ago this week!  great experience, exactly what I wanted: everyone left us alone and respected all of our wishes.  You can definitely do it!  yes, early discharge is optional (standard is 2 nights).  Just write a birth plan and make sure your midwife, doula etc know your wishes.  (and yes, you need a doula if you are going to have a natural childbirth!  see http://doulasri.org/ and this forum to find one)

 

good luck, you will be so glad you did it!

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#5 of 29 Old 03-25-2011, 12:40 PM - Thread Starter
 
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Thanks! :)

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#6 of 29 Old 03-25-2011, 01:28 PM
 
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Birthing at the ABC is a great option if you don't risk out and if you're comfortable with a large group practice of rotating care providers.  It is very easy to risk out of the ABC because of restrictive hospital policies regarding who can birth there and who can attend births there.  Are you currently seeing an OB or a MW?  Generally speaking, the Center for OB-GYN is not as ABC-friendly as some of the other practices.

 

If you are planning a hospital birth, you can find out about all the birthing facilities in the state here on the Rhode Island Birth Network site.  

 

Good luck!


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#7 of 29 Old 03-25-2011, 02:35 PM - Thread Starter
 
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Thanks, I'll check out their website. 

 

I've been with an OB, but have met all the midwives in the practice as well...I would guess I'd need to formally switch to one of them soon!

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#8 of 29 Old 03-26-2011, 05:55 PM
 
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House kat, Hi, and congrats on your pregnancy and soon to be baby!!

I birthed my ds last year ( March ) in the new ABC. I also have had 2 previous births in the old ABC that was way downstairs. I have had great experiences with all 3 actually. I did not have a doula for any of my births, but everyone is different, has different experiences and different labours.

I really loved the ABC, I had women's care for my 1st pg, then OB-GYN Assoc. for my subsequent 2.

I toyed with the idea of early discharge the last 2 times, but for whatever reasons decided to say at the hospital, and I could not have had a better experience. The nurses were awesome, they respected my wishes, went out of their way to support and empower me and get me what ever I needed. I really cannot say enough good about them.

I am really pro-bf and they supported me 110% of the way, roomed in all the time, and encouraged lots of  bed sharing.

 

In hindsight, I would have a doula for my 1st labour, I think it would have helped greatly. If I was having another baby, and my insurance was compatabile maybe I would go w/ mary Mumford hailey at memorial.


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#9 of 29 Old 03-27-2011, 02:47 AM
 
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note on doulas, some women don't NEED them to have a natural birth (I don't), But I'm getting one for my third, I know I can do it, I just want a more comfortable birth!

 

I toyed with going to the ABC, but I think you have to go through triage first?  I'm waiting at home as long as possible so I'm going to Kent because I know I can check in quickly.  Tollgate OB-GYN, Christine Pfeiffer & Deb White, they give me care like I'm seeing birth center midwives.  A little VERY natural friendly practice in RI that seems to be a secret...I have heard of WONDERFUL experiences at the ABC, but I have also witnessed a dissapointing, stressful, experience where they were risked out.  Once you're in the regular W&I rooms you never know what the nurses will be like.  So It's a gamble. 


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#10 of 29 Old 03-28-2011, 05:32 AM
 
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I meant to go to the ABC with my last baby, but she ended up deciding to stay 2 1/2 weeks past her due date- my blood pressure finally shot up, my fluids were low, and my midwife (from Women's Care) finally strongly recommended an induction, which I agreed to. So the birth was in the regular W&I birthing room. It ended up being a pretty easy, non-traumatic experience, and I didn't use an epidural. My labor was only 3.5 hours. 

 

I really had no complaints even about "risking out" of the ABC. The most annoying things were a) the monitor on my belly & tube in my hand and b) the various nurses that came and went and hearing them yak at the nurse's station right outside the door (they have a right to yak, but in my sensitive state, I found their discussions about lunch orders, vacation plans, etc really irritating).

 

I thought I might be into the early discharge option, but I actually really appreciated having someone change my sheets, bring me my meals, etc. for two days.  Being in the hospital was worth it just for the ease of all the "sanitary" products, clean linens, etc. There's no way I could have made things that comfortable in my own home.

 

I didn't have a doula, and think I would have actually hated having someone else in the room telling me what to do. I found that I really just wanted to be alone and found even my husband's petting my arm to be beyond irritating.  I discovered that I am one of those people who isn't really interested in sharing the experience. My midwife was terrific and pretty much left me alone to do my thing- maybe she could sense that's what I needed. So maybe think about what level of company/support makes you most comfortable when  you are sick or hurt before deciding to use a doula.

 

Hope this was useful, even though I didn't end up birthing in the ABC!

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#11 of 29 Old 03-28-2011, 06:22 AM - Thread Starter
 
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Thanks everybody for sharing! 

 

We had our birthing class yesterday, and I'm thinking that between my husband and my mom, I'll have plenty of support in the room, and at times, possibly too much! (my husband tends to get a bit silly when he's nervous haha)

 

I have an appt this morning w/ my OB and I'm going to talk to her about all this, and see where we end up!  I know there is a chance that even if I plan it out that way, it won't end up at all that way...the room could be taken, I could have complications, etc etc.  I'm just happy to have options at this point, and looking forward to being done being pregnant, and having our little girl here in 6 weeks (give or take) ;-)

 

:)

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#12 of 29 Old 03-28-2011, 06:31 AM
 
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Wow, I am a little surprised by what is coming across as an anti-doula sentiment in this thread, especially since the OP didn't even mention doulas in her inquiry.  While I certainly understand that everyone labors and births differently, no doula I know would EVER tell a mom "what to do" during her labor!  On the contrary - and ESPECIALLY for a first birth - doulas provide emotional support (and physical support IF needed - everyone is different) to both birthing women and their partners before, during, and after birth.  Far from being just an extra person in the room, the presence of doula significantly decreases the length of labor, the need for unnecessary medical intervention, and the likelihood of a Cesarean delivery.  Additionally, doulas are sometimes the only person on a birth team who is providing evidence-based information (rather than litigation-based protocol and standard hospital procedural jargon) to a family which might enable them to make truly informed decisions about their care.

 

Ella and greenebeene - I am delighted to hear your experiences at W&I were positive.  I myself just arrived home this morning after attending a beautiful birth with a first-time mom who risked out of the ABC because of GD and still had an empowering, unmedicated birth with a midwife from her practice she had never even met.  But it could have just as easily gone another way if she had ended up with a different midwife from the same practice on call, or a L&D nurse who was less supportive of unmedicated labor.  

 

While the ABC is a great option for women who stay low-risk, the overall stats at W&I are not great and there are other hospitals in the state with significantly lower rates of epidural anesthesia.  If this is important to the OP, those options are well worth exploring.


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#13 of 29 Old 03-28-2011, 09:11 AM
 
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I'm sure doulas are helpful to a lot of people.  It's not anti-doula to say that it would not have been for me, and suggest that someone should know themselves to figure out if that service would be helpful to them. 

I was very comfortable with the support and level of expertise of my midwife.

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#14 of 29 Old 03-28-2011, 09:40 AM
 
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I was responding to the post that said you NEED a doula to have a natural birth, which rubbed me the wrong way, because I birthed just fine naturally with no one.  That's all.  I'm very pro-doula. 


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#15 of 29 Old 03-28-2011, 11:01 AM
 
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I have been dragging my feet in regards to creating an account, but had to respond to your post.  I had my DS back in early November at W&I.  I originally went to Center for Ob-Gyn (up to 28 weeks), but after having a few conversations with my midwife (Kiersten Crawford), I decided that I needed to change practices.  The reason I made the change was that she mentioned that the midwifes at Center for Ob-Gyn are not always on-call at W&I, and you may end up with an OB.  If that is the case, then you cannot use the ABC (this was according to my midwife).  She suggested that if I had my heart set on using the ABC I should use either Women's Care or ObGyn Associates.  I ended up picking Women's Care.  I loved my midwife at Center and hated switching, but thought it was for the best.  I had a really good relationship with her and still kind of wish I had stayed with her.  

 

A few things about the ABC.  It is easy to risk out of it, but do not let that prevent you from trying to go for it.  The tub and/or shower are constantly broken and/or being fixed, which sucks.  The nurse that was assigned to me in the ABC was amazing.  She was very low key and referred to my birth plan throughout labor.  After laboring in the ABC for 12 hours and making no progress (plus 48 hours of labor at home to get from 1cm to 6cm) I had to be admitted to a regular L&D room.  Luckily I got a huge room with a great view and private shower (I think it was L&D #7).  

 

Regarding the monitoring.  There really is nothing to worry about.  They do it often enough to give you piece of mind, and you get to move around unencumbered when they are not.  When my water broke there was a fair amount of meconium so they would monitor longer my DS then they would have otherwise.

 

Good luck with everything.  Enjoy these last few months of pregnancy! 

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#16 of 29 Old 03-28-2011, 11:14 AM
 
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Natalie, I wasn't responding to your post at all.  Clearly no one NEEDS a doula to birth.  That doesn't mean a doula doesn't add to the experience for the mother or partner, as you know - especially in the context of an institutional system with which a laboring woman may be unfamiliar and may be bombarded with overt and covert messages about her body's ability to birth without drugs.  A doula can be an important antidote to this mentality.

 

Greenebeene, I appreciate your clarification.  I think it was this statement in particular that seemed negative and to suggest that a doula's presence would have detracted from the experience.
 

Quote:
Originally Posted by greenebeene View Post

 

I didn't have a doula, and think I would have actually hated having someone else in the room telling me what to do.

 


I respect your position that you didn't need additional support and that's great that you got your midwife and the respectful experience you deserved.  But regardless of whether they NEED it or not, I have never heard anyone say that a doula's presence at their birth did anything but further enhance the experience for themselves and/or their partner.  I guess I take umbrage at the idea that a doula - any doula - would ever tell a laboring woman what to do.  This depiction of a doula as someone who gets in the way is one that we face professionally from partners and care providers unfamiliar with what we do and one that we work hard to counter.

 

 


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#17 of 29 Old 03-28-2011, 11:26 AM
 
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I'm not interested in having any more back-and-forth about it except to say that it's perfectly legitimate for me to feel like having someone else around would not have been helpful. Different people have different needs, and its probably more important to make the decision about what you need based on what you know about yourself than on any other factor.  I know people who have loved having a doula around, and a few who did not love it.

This topic has hijacked the op's thread and I don't think it needs to continue.

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#18 of 29 Old 03-28-2011, 03:55 PM
 
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ok.  just clarifying what I was responding to in case there was any confusion.
 

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Originally Posted by laneysprout View Post

Natalie, I wasn't responding to your post at all.  Clearly no one NEEDS a doula to birth.  That doesn't mean a doula doesn't add to the experience for the mother or partner, as you know - especially in the context of an institutional system with which a laboring woman may be unfamiliar and may be bombarded with overt and covert messages about her body's ability to birth without drugs.  A doula can be an important antidote to this mentality.

 

Greenebeene, I appreciate your clarification.  I think it was this statement in particular that seemed negative and to suggest that a doula's presence would have detracted from the experience.
 


I respect your position that you didn't need additional support and that's great that you got your midwife and the respectful experience you deserved.  But regardless of whether they NEED it or not, I have never heard anyone say that a doula's presence at their birth did anything but further enhance the experience for themselves and/or their partner.  I guess I take umbrage at the idea that a doula - any doula - would ever tell a laboring woman what to do.  This depiction of a doula as someone who gets in the way is one that we face professionally from partners and care providers unfamiliar with what we do and one that we work hard to counter.

 

 



 


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#19 of 29 Old 12-06-2011, 02:33 PM
 
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I had a my second son at the ABC at W&I. I was planning on having mny first there too but there was meconium in the fluid so I risked out. I still had a great experience at W&I even though that birth didnt go a splanned. With my second I took a hypnobirthing class and believe me I was as skeptical as the next person but it totally worked! 100% natural, quiet beautfiul baby boy. After birth I was up and walking around because I had no drugs and only natural tearing. It was AMAZING! I cannot recommend it enough. Take the class for the ABC if you can and I would highly recommend hypnobirth classes. I still use the techniques today for blood work, dentist appts, pain etc. I am planning another ABC birth there in July. Good luck!

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#20 of 29 Old 01-16-2013, 03:15 PM
 
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Hi! I was wandering if some one have more information about Alternative Birth Centers in Providence, RI. I went to the OBG for my first appointment and the midwife said me about that. But, the Women & Infants Hospital have just one room. I need to do my schedule but if the day of my delivery are other patience, I need to move to other room, a ordinary room. I want to delivery in my home in a pool, you know, the homebirth, but I don´t have a car and if I have a problem, it will be horrible. Also, I´m foreigner in America, then for me the system of the health care is really different. Thank you!

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#21 of 29 Old 01-21-2013, 10:38 AM
 
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I will be the doula at a birth at the Alternative Birthing Center at W&I in July.  I'm also wondering what to expect since I haven't done a birth there yet.  Is there really only 1 room?  What happens if someone is already laboring there?


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#22 of 29 Old 01-22-2013, 05:57 AM
 
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Quote:
Originally Posted by FootprintsDoula View Post

I will be the doula at a birth at the Alternative Birthing Center at W&I in July.  I'm also wondering what to expect since I haven't done a birth there yet.  Is there really only 1 room?  What happens if someone is already laboring there?


Yes there's only one room if it's taken you go to a regular room.  It's all on the same floor. 


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#23 of 29 Old 02-07-2013, 03:30 PM
 
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whats the protocol after birth? does the pediatrician come and give the eye drops/vac/vitamin k shot or does someone who works there like a nurse do that??

 

I am asking because I dont have a pediatrician yet, I have 4 months to go and the pediatricians I spoke to, they don't do consultations and they said I cant meet them they are "too busy".

 

so basically it would be my first time seeing them (not knowing whether I like them or not) 

 

secondly, I dont want my child vaccinated, thats why I ask, who usually does the vacc, so I know who I need to talk to / fill out a waiver or whatever the nessassary protocol.

 

 

thanks!!

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#24 of 29 Old 02-07-2013, 03:42 PM
 
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Quote:
Originally Posted by AnnaRI86 View Post

whats the protocol after birth? does the pediatrician come and give the eye drops/vac/vitamin k shot or does someone who works there like a nurse do that??

 

I am asking because I dont have a pediatrician yet, I have 4 months to go and the pediatricians I spoke to, they don't do consultations and they said I cant meet them they are "too busy".

 

so basically it would be my first time seeing them (not knowing whether I like them or not) 

 

secondly, I dont want my child vaccinated, thats why I ask, who usually does the vacc, so I know who I need to talk to / fill out a waiver or whatever the nessassary protocol.

 

 

thanks!!


A nurse would do all these things.  And you can decline any/all of the above, just let them know. 


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#25 of 29 Old 02-08-2013, 02:12 PM
 
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good to know, thanks!

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#26 of 29 Old 02-09-2013, 06:11 PM
 
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Hi Minerva,

 

Yes the healthcare system is really different in America. 

 

You do have the option to birth at home with midwives. http://rihomebirth.com/

 

Also, I would recommend looking into Memorial Hospital in Pawtucket.  Dr. Magee or Dr. Morton are very highly regarded and give much more personalized care then the large practices can sometimes offer at W & I.    W & I has a pretty high cesarean rate so if you did get risked out of the ABC there is a chance you might have a provider with a high section rate.  At Memorial you will not get risked out so you don't have to worry about any of that and they have lower cesarean rates then at W & I.

 

Good luck!
 

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#27 of 29 Old 03-05-2013, 09:32 AM
 
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As a midwife who attends births in the ABC, I just wanted to clarify that if a woman risks out of the ABC for an obstetric complication, the midwife involved will continue to take care of that women in the regular LDR. The C-Section rate in the group I work for is consistently about 12% and I believe the other group of midwives who attend births have a similar rate. 

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#28 of 29 Old 03-09-2013, 07:49 PM
 
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So glad you posted with this information fbclement!  12% is really good!  You all should publish your stats, it would be an excellent marketing tool and womyn need to know more details about their options...   And better from the source then a bystander like me, lol!

 

I am guessing I met someone from your practice yesterday, she was really nice!  I am kicking myself for not having this conversation with her... 

 

For my part, I have understood from talking with other birth-workers and mom's posts over the years that risking out of the ABC, where womyn have had wonderful experiences, can mean that they do fall under a doc and that, depending upon who that is, can be good or difficult transition.  I apologize if I misrepresented that situation!

 

It is great to know you all are able to stay with womyn for that continuity.  So, for clarity, do you transfer for collaborative care, or is it like when I transfer someone from home, I become more like labor support and the doc makes all the decisions?  It is probably not quite like that as I am guessing that you do the delivery still but that maybe how collaborative or dictatorial depends upon the doctor available at the time?  Who takes the transfer?  I have only ever worked with a private practice or MFM at W & I?  Why does it become necessary to 'transfer' when the ABC is on the L n D floor (this may be obvious, but I have always wondered why that is...)?

 

Does your practice offer to 'special' womyn?

 

Thanks so much, and again so glad you posted! 
 

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#29 of 29 Old 03-16-2013, 07:47 AM
 
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So to answer some of your questions...when a woman transfers out of the ABC it is for some level of intervention that cannot be done in the ABC. Common examples are for non reassuring fetal heart tones requiring more than intermittent monitoring, no labor progress (although we can be very patient and try a lot before reaching this point), mother requesting an epidural. It is ultimately the midwife's decision and the midwife continues to care for that woman in the LDR, rarely does the OB become involved unless there is a real problem. Women can and do have lovely, unmedicated births in rooms other than the ABC. If continuous monitoring of the baby is indicated we advocate the use of telemetry, a system that allows the woman to be ambulating, in the shower, in the jacuzzi, wherever.

 

As for "specialing" women, on occasion that is done but is not a common practice, it is up to the individual midwife. However the 2 groups of midwives that use the ABC are committed to providing 24/7 midwifery coverage and while maybe different personalities we all share a commitment to the philosophy of birth as a normal process and are advocates for the women we take care of in labor.

 

Hope that is helpful!

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