Midwifery Delivers Desired Birth Experience

Medical professional Kara Armato, 36, of Prairie Village, Kansas, knows state-of-the-art healthcare. As a nurse at The University of Kansas Cancer Center she sees every day the value of medical intervention in action. However, Kara had chosen a birthing center for her first 2 babies and appreciated the care of midwives.

“I liked having my first 2 births not be in a hospital setting,” she says. However, her husband, Michael, a certified nurse anesthetist at The University of Kansas Health System in Kansas City, made a suggestion for their third baby. “Since the anesthesia team does the epidurals in labor and delivery, he was the first person to tell me about the midwifery program at the health system, and we decided to check it out,” she says.

The University of Kansas Health System offers certified nurse midwives as part of their comprehensive obstetrics and gynecology specialties services. As a team, multiple midwives are able to provide prenatal care, postpartum care, women’s health services and primary care – in addition to hands-on labor and delivery at the No. 1 hospital in Kansas as ranked by U.S. News and World Report.

Kara was impressed.

“Every time I met with them, I was more confident and impressed in the care the midwifery program provides,” she says. “The health system is where I’d want any of my family to go for care, so it was a good fit.”

While Kara’s pregnancy progressed normally, she contracted COVID-19 near the end of her second trimester in May 2020. “At the time, there was very little data on COVID and pregnancy,” she says.

“One of the midwives called me with my COVID-19 test results and then followed up frequently to check on me and make sure we were okay,” Kara says.

During her COVID-19 infection, Kara became dehydrated and followed up with her care team for fluids, additional monitoring and an ultrasound.

Fortunately, Kara did not require hospitalization, but she felt reassured knowing that specialists and high-tech treatments were available should the need arise.

“The midwives were very hands-on with us during that time,” Kara recalls. “Since COVID-19 wasn’t a well-known condition in pregnancy, they checked in with one of the physicians to get another opinion, and that was reassuring. I knew the health system was exactly where I needed to be.”

The ability of the midwives to consult with board-certified obstetricians about any unusual or unforeseen circumstances is one of the benefits many patients appreciate.

“Because we’re part of an academic medical center, our certified nurse midwives are supported by a team of board-certified obstetric physicians,” says Valerie French, MD, an obstetrician/gynecologist and division director at the health system. “It’s actually unusual for them to need us. They practice independently, but they can turn to one of the physicians on our team if needed, and should an emergency arise during a birth, a doctor is always on site to assist.”

Dr. French notes that the traditional protocol with her patients is to discuss the labor plan but rely on a labor and delivery nurse to provide bedside support. Midwives, on the other hand, are present with the patient throughout labor, coaching them through movement and position changes to ease pain. The amount of intervention during labor is largely determined by the patient, and the midwives participate as little or as much as desired, always ensuring safety but being responsive to the patient’s needs and wishes.

“The midwives are great at sitting down, talking through the concerns of first-time, low-risk patients, and focusing on comfort, information and that personal connection,” Dr. French says. “We are dedicated to supporting our patients.”

Kara successfully delivered baby Ira without any medications or medical interventions through the support of midwife Marcia Houpe, APRN, MSN, CNM.

“Marcia arrived very quickly after I was admitted, and she was a very calming presence,” Kara says. “It was a wonderful experience for me. My birth experience was great.”

She recommends the midwives at the health system to anyone, regardless of the amount of intervention they want or preferred birth experience.

“If you know what you want your birth experience to look like, and you want someone there to support you in every possible way, the certified nurse midwives will be your biggest advocates,” she says. “Pregnancy is a huge thing to go through, and the midwives at the health system made it a wonderful experience.”