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Midwife Center for Birth and Women’s Health Provides Care throughout Reproductive Lifespan

For many women who seek out an alternative to delivering a baby in a hospital setting, The Midwife Center for Birth and Women’s Health is the ideal solution. The nationally accredited Midwife Center, located in the Strip District, is the country’s largest freestanding birth center, along with one of the busiest: last year alone, more than 400 babies were born in the practice, and more are expected this year. We spoke with Executive Director Christine Haas about midwifery as well as the services and programs the center offers.

North Hills Monthly (NHM): What is the Midwife Center’s mission?

Christine Haas (Haas): Our mission is to promote wellness by providing exceptional client-centered, primary gynecological pregnancy and birthing care in southwestern Pennsylvania’s only independent birth center.

NHM: What is a midwife’s role during pregnancy and birth?

Haas: Midwives are experts in reproductive health for people of all ages. What a lot of people don’t realize is that they can provide gynecological care throughout a person’s lifespan. People come to get annual visits and contraceptive care, so it’s really providing care throughout the reproductive lifespan and focusing on prevention while taking care of the whole person. Whether its prenatal or gynecological visits, we have longer appointments, which includes more time to share information about health, and develop the best plan to be healthy and stay healthy throughout the pregnancy or whatever part of life you’re in. It’s also just spending more time and working with people throughout labor so they have a healthy birth. After birth, we also provide postpartum visits.

NHM: Do midwives replace obstetricians?

Haas: Ideally, somebody would come to us throughout their whole pregnancy, though we have people who transfer into our care mid-pregnancy and receive all their care with midwives. If they are healthy and low-risk, there is no need to have an obstetrician involved, although we do have collaborating OBs so if a risk factor were to arise during pregnancy, they are there to collaborate with the midwives. If need be, care will be transferred to an obstetrician if risk factors develop that make them no longer appropriate for midwifery care.

NHM: What is the Midwife Center’s approach to care?

Haas: It’s about looking at reproductive health, including pregnancy and birth, as a normal part of life, not as an illness. It is nothing that needs to be treated in the hospital necessarily, though our partnerships with obstetricians are important to the birth model. It’s about taking care of the whole person and keeping them healthy and spending time with them to make sure they have the tools to keep healthy. Our birth center consistently has better maternal and infant outcomes, including lower preterm birth weights, lower rates of C-sections, and lower low-birthweight rates.

NHM: What kind of training does a midwife undergo?

Haas: Certified Nurse Midwives are required to obtain and keep a nursing license. In addition to that, they go to midwifery school. In Pittsburgh, there is a midwifery program at the University of Pittsburgh; that is a doctorate level program. We have two staff members who have doctorates, but it is more common to have a master’s degree in nursing to be a Certified Nurse Midwife.

NHM: What other services do you offer at The Midwife Center?

Haas: As a licensed birth center, we obviously offer birthing services as well as prenatal and postpartum care. We offer primary gynecological care, including annual visits and contraception and other services related to gynecological health.

Women Fridays is a program we developed in 2002 as a way to make our gynecological services more accessible. It was a walk-in program every Friday afternoon, but during the pandemic, we changed that to same-day scheduling. That way, we can screen people before they come into our facility as well as control how many people we have in the waiting room.

We also have a full-time behavioral health specialist. She offers short-term therapy for people who are coming to the center for pregnancy care, which includes a postpartum support group. During the pandemic, it’s all been by Zoom, and it’s been very well attended. Attendance increased by 75 percent this year as people really needed support as their regular support systems haven’t been as accessible. That was an important program addition we are able to do with our physical expansion in 2017.

We also have a breastfeeding support/lactation specialist on staff and a breastfeeding class. We have an in-house lab so we can take care of lab work at our center and have a full-time community engagement coordinator.

NHM: Can you describe your facility?

Haas: It is a 100-year-old, three-story building on Penn Avenue, which we expanded in 2017. The first floor includes our birthing suites. The idea of a birth center is that it’s more of a homelike setting; it’s more comfortable and looks less clinical, but still has all the safety equipment. The three birth suites look more like a bed-and-breakfast and have queen beds to accommodate the whole family. Our two new suites have water birth tubs.

We are one of the few facilities that offers nitrous oxide as a comfort measure during labor. All the safety equipment and supplies are tucked away, so when you walk in, it is not readily apparent that they are there.

The second floor is all of our appointment rooms, where our prenatal and postpartum appointments take place. We also have a lab and waiting room. The third floor is administrative offices and a classroom, though it hasn’t been used during the pandemic. Usually, we have childbirth education and infant care and breastfeeding classes there, and people were coming in to teach physical therapy and yoga. All of our classes have been taught via Zoom during the pandemic, but we hope we can start back up in person again when conditions allow.

NHM: Are there any myths about midwifery you’d like to dispel?

Haas: I think one of them is that midwives don’t provide gynecological care. A lot of people assume we don’t take any insurance, including Medicaid, which is untrue. Another myth is that midwives are opposed to pain relief. We offer many options at the birth center. We have water birth tubs, nitrous oxide and other forms of pain relief at the center. If people want or need an epidural, we don’t do that at the birth center, but that can be part of the conversation. If someone needs that, then being at the hospital with a midwife or obstetrician is a choice.

NHM: What makes The Midwife Center of Pittsburgh unique or makes it stand out from other such places across the U.S.?

Haas: It’s more of a comprehensive health center; we have other services like behavioral health. We focus on reaching out to the community because there are a lot of people who are still unaware of everything that we do at The Midwife Center. We are involved locally, statewide and nationally to improve conditions for midwives and birth centers to make sure that they are reimbursed in an equitable way for the care that they provide, and we’re involved with statewide and national organizations to see how we can improve outcomes overall.

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