Labor of love: Central Texas birthing options
Labor of love: Central Texas birthing options
Written by Chantal Outon Friday, 07 November 2008
When Dr. Christina Sebestyen moved to Central Texas two years ago, she longed to open an obstetrics practice combining the nurturing attributes of midwifery with the urgent-care benefits of traditional OB hospital care. Sebestyen, who considers herself a “midwife in doctor’s clothes,” eventually opened her own practice — OBGYN North — and in August, brought a midwife-credentialed program to St. David’s North Austin Medical Center (St. David’s NAMC). Sebestyen’s is currently the only program of its type in Central Texas since the hospital-based midwifery programs at Seton Medical Center and Brackenridge closed several years ago.
“There has been such a need in Austin for this type of care brought into the hospital setting,” Sebestyen said. “This reopens an option to women that has been closed for the last few years.”
Misconceptions about midwifery abound in the U.S., even though midwives deliver the majority of babies in the world. A growing number of American women are now seeking alternative options to traditional hospital birthing.
Midwifery versus obstetrics
There are several differences between the midwife model of care and the more Westernized obstetric model of care. The midwifery model views pregnancy as a natural occurrence, while the obstetric model views pregnancy as a medical condition. Though traditional midwifery calls for natural childbirth, meaning no pain medications, Sebestyen’s program promotes choice. She said it is best for mothers to prepare for a natural birth, yet keep an open mind.
When patients begin laboring before the doctor or midwife arrives at St. David’s NAMC — the only hospital where Sebestyen’s patients may deliver — OB hospitalists step in. Also established in August, the OB hospitalist program works in conjunction with Sebestyen’s practice.
Hospitalist
Long a system used in internal medicine and pediatrics, hospitalists respond to patient emergencies. OB hospitalist programs are rare, but are gaining popularity, particularly since a normal laboring process can quickly become an emergency. With the addition of the new St. David’s NAMC Women’s Center, it is sure to become an essential service for the hospital.
“In obstetrics, things can happen so incredibly quickly,” said Dr. Enzie Briskey, one of three full-time OB hospitalists at St. David’s NAMC. “To be able to have a physician respond immediately is an amazing development.”
Insurance coverage
Another issue Sebestyen’s practice has solved for Central Texas mothers interested in midwifery involves insurance. Her practice accepts all insurance types, a convenience not often afforded to mothers choosing at-home births, said Faith Beltz, a certified professional midwife and licensed midwife working in Central Texas. Some insurance plans cover a portion of costs, but, regardless, Beltz said a home birth might be more affordable.
“A basic vaginal birth with a midwife costs between one-fourth and one-third of the same birth in a hospital,” she said.
At-home birthing
In Texas, direct-entry midwives like Beltz graduate from an accredited school of midwifery, pass a national exam and complete a birthing apprenticeship. Additionally, midwives are regulated by the Texas Department of State Health Services, which sets the rules and standards by which midwives practice.
Beltz, along with two assisting midwives, is present for all her patients’ at-home births and encourages mothers to birth at home without pain medication, so long as the mother does not display at-risk symptoms. But, like Sebestyen, she supports the mother’s choice above all. Should a complication arise during at-home labor, Beltz transports the mother to a nearby hospital.
Birth centers
Another option for mothers-to-be in Central Texas is a birth center such as the Austin Area Birth Center, which is staffed full time by five midwives. Here, mothers have many of the same options available to them as in Sebestyen’s practice. However, while some pain medications are available, epidurals are not.
“The goal for myself,” said Darlene MacAuley, founder of the Central Texas Birth Network, “is to be able to help more women by supporting the birth process and to help educate the community about the birthing options that are available in Central Texas.”
Midwife contact information
St. David’s North Austin Medical Center
- 12221 MoPac, Austin, 901-2700, http://stdavids.com/sdnamc.aspx
OBGYN North
- 12201 Renfert Way, Ste. 220, Austin, 425-3825, www.obgynnorth.com
- Midwives on staff
- Dr. Christina Sebestyen
- Dr. Andrea Campaigne
- Lisa Carlile, CNM
- Liane Miller, CNM
- Kathy Harrison-Short, CNM
Austin Area Birthing Center
- 4100 Duval Road, Ste. 2-101, Austin, 346-3224, www.austinabc.com
- Midwives on staff
- Joan D. Smith, RN, MSN, CNM, OB/GYN
- Jean E. Stokes, RN BSN CPM
- Roswitha Elisabeth Dowell, CPM
- Jennifer Liana, CNM, MSN
- Lauren Guehl, CNM
Midwife websites
- Texas Association of Midwives: Midwife Directory, www.texasmidwives.com/findamidwife.asp
- Department of State Health Services: Texas Midwifery Board, www.dshs.state.tx.us/midwife/default.shtm
- Heart of Texas Midwives, www.heartoftexasmidwives.com
