Hospital Midwife Delivery - Help!

Updated on April 24, 2010
R.A. asks from Saint Paul, MN
8 answers

I'm newly pregnant with my second kid. The first one was born back home in Canada, but we moved to St. Paul a few months ago. I had a wonderful out of hospital delivery experience last time, but due to financial reasons, it's not realistic for us to plan for a home birth this time.
Im looking at having a midwife attended delivery in the hospital, but I don't know where to find info about how it works. I've heard great things about St. Joes, it's nearby and my insurance would cover it 100%, so I'm leaning toward delivering there.
My questions are more about the logistics of it all. From what I understand, I would see the same midwife at all (or almost all) my prenatal appointments, but when I go to deliver, it would likely be the on call midwife who would attend the birth? Are they normally there throughout the labor? Or do you labor with a nurse (or many nurses, if you take breaks and shifts into account...) and the midwife shows up at the end to catch the baby?
Are they normally open to minimal interventions, especially monitoring? I would much prefer them using a doppler than a fetal monitor strapped to my belly!
Are you stuck in the hospital for a day or two after? Or do you get to go home after a couple hours?
What about post partum care? Last time, my midwife visited me at home twice after I delivered, do CNMs do that too?
I know some questions are pretty specific, I did make an appoitnment with a midwife (HealthEast on Grand) who might be in a better position to answer all of this, but I don't want to waste her time or mine if this is really not what we're looking for.

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answers from Minneapolis on

I delivered my 2nd baby at St. Joe's last October using the Generations Women's Clinic in Shoreview. I had gone to a HeatlhEast midwife meet and greet (which they have every few months at St. Joe's), and really liked them, but went with Generations because there are only 3 (maybe 4 now) midwives in the practice, and I really wanted to get to know all the midwives who might be on call when I went into labor. I made appointments with each midwife, then stuck with my favorite towards the end of my pregnancy. With Health East, you can meet all the midwives at your clinic, but I think since there are several locations, those meet and greets are your only opportunity to meet them all.

Both practices are very open to minimal interventions. I think you're required to have a fetal monitor for 15-20 minutes when you first get to the hospital, but if everything looks good you're done with that. If I remember right, they let you go after a day if everything went fine. Maybe sooner if you really wanted to leave. After the delivery, you go in for a post partum visit at 6 weeks, but I think there's an option to have a hospital nurse visit you at home if you want.

As far as laboring at St. Joe's, I waited until the last minute to get there, and my baby popped out 5 minutes after getting into the room. In fact, a wonderful Health East midwife named Rebecca ended up catching the baby, because my Generations midwife didn't make it in time. Both midwife groups, and the hospital are very supportive of low intervention labors, and I think if you want to be left alone during labor, the midwife and a nurse will check in on you until it's time to deliver. During delivery, I think there would be the midwife, and maybe two labor nurses.

You should take a tour of St. Joe's. It really put my mind to rest, and got me almost excited about a hospital birth, because it seemed so non-hospital like. They also offer water births if you are interested. It's a bummer insurance doesn't cover home births, but if you need to have a hospital birth, I'd say St. Joe's is the way to go.

1 mom found this helpful


answers from Minneapolis on


I had my last two babies at St. Joe's and loved it. I too used Generations in Shoreview. They were great. Mary delivered my second and Penny delivered my third.

My labors were relatively short, and I did most of it at home (had phone contact with the midwives to let them know when I was heading in). I was at the hospital for 5 hours before Joey came and 2 hours before Rebecca. I also did water births for them, so once I got past the initial monitoring, there really wasn't any more but for a few checks here and there - which they did in the tub.

One thing I really appreciated about Generations was that Penny came in on her night off so I could have the water birth I wanted... the on-call midwife was already with 2 laboring mom's at St. Johns and they don't have birthing tubs. I thought it was going a bit beyond the call of duty to come in so I could "do it my way". She wasn't my favorite midwife to see in the office, but I think she was pretty good during labor. Very calm and hands off.

My midwives did not visit me after I left the hospital. I didn't see them again until the 6 week check. I think that's standard here.

Tour St. Joe's. See if you can talk to a nurse named Vicky. She's amazing. :) She gave me my tour and ended up being my L&D nurse the first time I delivered there.

Feel free to send me a message if you have more questions.




answers from Minneapolis on

You will need to ask these questions of the midwife when you meet as their procedures might be different. I had my baby with the midwives of Park Nicollet at Methodist Hospital in St. Louis Park. I would recommend them. I met with each of the midwives in the group, a different one at each prenatal appt, so that I was comfortable with whoever was on call when I went into labor. She stayed with me throughout the whole labor and delivery. I was able to go home 24 hours after the birth. I had a nurse that visited me at home a few days later. I had minimal interventions, and was able to be in the bathtub for part of the labor. I had an overall positive experience.



answers from Minneapolis on

I used the HealthEast Midwives in 2006 to deliver at Woodwinds and was very pleased with the experience for the most part. I saw a different midwife at nearly every appointment because there were so many of them at the Woodbury office and one of them ended up attending for part of my labor.
I believe the HealthEast midwives labor-sit regardless of the hospital you deliver at. When I was admitted I spent most of my time with a nurse or just my husband until I was in active labor and then the midwife was there the whole time. There was a change in shifts for both the midwives and the nurses but the second shift was fully informed about my stage of labor and high blood pressure and I wasn't at all troubled by the change.
I had a birth plan and was very insistent that we have minimal interventions and they respected that completely. I did have to have pitocin to induce b/c of the high blood pressure but otherwise had no medications. I did have an episiotomy but only after an hour of pushing and after a discussion of the ramifications with the midwife. She indicated she wouldn't normally do it but I was starting to tear and we needed to get my daughter out.
Midwives to not do home visits afterwards, however, the HealthEast system does have nurse practitioners that they will send out the day after (or two days after) you go home. My only follow-up with the midwife was at my 6-week check up.
In all, I was very pleased with my experience. Good luck with your pregnancy!



answers from Minneapolis on

My experience is with the midwives at the U of M, who deliver at Fairview Riverside. It is a large practice and it is true that you can't always see the same midwife even for prenatal appointments, and the on-call midwife delivers, and is with you, like a doctor, only when needed. I've heard that St. Joe's is a much more "private-feeling" practice with a more personal touch. As for monitoring, they are pretty good about meeting your requests in your birth plan, unless you are at some risk. My birth plan was out the window because as a v-bac patient they insisted on precautions like IV and regular monitoring, though they did allow me to be hooked up to a telemetry monitor. If you don't have risks, you can probably have a calm, unintrusive labor. The amount of time the midwife spends with you during labor will depend on how busy she is, and its usually a nurse from another organization that does home visits, and only if you request it. I hope your labor and baby's birth goes exactly how you want it. Its your baby and your personal experience - don't be afraid to stand up for yourself and what you want as a family.



answers from Minneapolis on

Hi R.,
Congrats on your upcoming birth! I work as a doula and while I haven't had the chance to attend a birth at St. Joe's, everyone I know who's been there says it's the closest thing to a home birth that you could get at a hospital. I gave birth with the midwives at Methodist almost 7 years ago myself. The midwife is there more than most OBs, but they are in and out (mine did stay past the end of her 24-hour shift to help me finish my 2 hours of pushing). They're usually open to more minimal interventions as long as there's not a reason to do otherwise. Most hospitals do have you stay for about 48 hours afterward (since that's what most insurance plans allow for, with a visit from a PHN later in the week after you go home), but you could always leave AMA if you really wanted to. I don't know of any hospital-connected CNMs doing home visits after the birth.
There are a couple of birth centers in the Twin Cities that you could check out as your insurance may cover them -- Morning Star in St. Louis Park and Health Foundations in St. Paul. There has been pending legislation that would require all insurers to cover birth centers the same way they cover hospital births, but I'm not sure of its current status.
Good luck to you!



answers from Minneapolis on

I birthed both of my babes at Woodwinds, and if you're hospital covers St. Joe's it will also cover Woodwinds. It is a wonderful birth center. For my #2, I also wanted minimally invasive care, and stated the specific things in my birth plan and brought it with me in my early 30's week appt so they had it in my chart. I might be a bit random here, so please forgive me....

I didn't want to be strapped to EFM, and they obliged using only doppler. The MW on call did check in often, but I also didn't want constant interruption, I had a birth attendant along with my husband to get me what I needed and to let the staff know if they were needed. I did have to argue to be able to walk out of the ward's 'circle', and had to come in every 50 minutes or so to get doppled, but the nurse could check me at the door and we turned and kept walking. My labor was long, I fully believe because I didn't want a Halloween baby and so I labored for 50 hours. When we were there the first time, after 12 hours, the mw said that they would have to start intervention since I was there for so long, but since my water hadn't broken we agreed that it was safe for me to go home. The HealthEast mw's always have one at one hospital - St. Joe's, St JOhn's and woodwinds, and just travel back and forth depending on their birth 'load'. And they always have a back up available, so if you don't like one, you can always ask for another. But they also are scheduled like regular hospital staff. A new one comes on at 7ish am, 3 pm and 11ish pm or something like that. Being my second, I was asked how long I'd like to stay, and if there are no big breaks in the placenta and no drugs, I think the earliest I could go was around 4 hours after birth. But really check with your insurance, if you have a high deductable plan, it might be worth it to go with one of the centers listed below or a home birth mw, the ones I've found in the Cities all top out at $5k. I had to pull all the numbers together for both for my husband.

With the MW groups, you would have a postpartum appt 6 weeks after, but there may have been one about a week or so after. I can't remember right now...

Woodwinds also welcomes photographers to come in and document your birth journey, which some other hospitals don't even let the husband have a camera for litigation purposes! The two birth centers also have excellent recommendations for photographers.
Good luck!



answers from Minneapolis on

Have you considered one of the new birthing centers that have just opened/are opening in the twin cities? There is one in St Louis Park called Morningstar and one in St Paul on Grand Ave, I think it's called Healthy Beginnings or something like that.
I work in OB at a metro hospital and had my 4th child at home. Most midwives do not labor with their patients, nurses come and go according to their shifts and "break each other". Many nurses are not comfortable with the doppler and insist you spend some time on the fetal monitor.
I am guessing that if you enjoyed your homebirth, that you would be happier with a birth center birth, than a hospital birth. I also encourage you to consider contacting some of the local lay-midwives. Mine accepted a payment plan and I was able to get all of it reimbursed through my HSA. It may not be as unaffordable as you think.
Best wishes - enjoy baby #2!

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