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Answers to Your Questions about Giving Birth
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Einstein Healthcare Network
2:09
The chat with Dr. Kim and Michelle Barcus will take place right here on December 5 at noon. Please feel free to post questions ahead of time using the blue box below. There will be no audio or video during the chat, just answers to your questions.
*** Tuesday, December 5 ***
Einstein Healthcare Network
11:58
Dr. Kim and Michelle are in the house. We will get started in two minutes.
cool 1
12:03
Hello out there! Welcome!  We look forward to a wonderful discussion about pregnancy and childbirth here at Einstein Healthcare Network.
Wilmer
12:03
Are midwives accredited medical professionals? Who's responsible for their accreditation?
Einstein Healthcare Network
12:07
Wilmer, great question.  Certified Nurse Midwives and Certified Midwives hold graduate degrees in Midwifery from education programs accredited by the Accreditation Commission for Midwifery Education.  Eligible candidates then sit for a national certification exams which are accredited through the American Midwifery Certification Board.   More information can be found through the American College of Nurse Midwives website. - Michelle
Daniel
12:09
Midwifery doesn't seem especially modern. Can you talk about why it's in use and its usefulness in the birthing process?
Einstein Healthcare Network
12:10
Daniel, Midwifery is like many disciplines in medicine that have been around for centuries. It is useful because our current understanding of pregnancy and delivery have been validated by numerous studies that support many techniques and treatments that are used by midwives. These techniques involve less intervention and more collaboration with patients, providers and their support systems. - Cheung Kim
Judy
12:10
Why are most consumers no longer looking for hospitals with low C-Section rates?
Einstein Healthcare Network
12:14
Judy, I feel many consumers are looking at c-section rates when choosing where to give birth. However, it is not the only thing being sought.  While Einstein Montgomery does have a low c-section rate , we also enjoy a collaborative model of care with a commitment to physiologic birth.  - Michelle
Rachel
12:15
If I initially opt for no epidermal and then want one once I go into labor  can I still get one?
Einstein Healthcare Network
12:17
Rachel, Absolutely!  Nothing is set in stone! - Michelle
Vee
12:20
How  does the presence of a doula effect cesarean and vacuum, forceps, epidural, and overall medical intervention rates?
Einstein Healthcare Network
12:20
Vee, this is a great question! Doulas are very effective on many levels. Studies show that during pregnancy, their influence promotes healthier babies by reducing low birth weight. The benefits of breast feeding, when desired, are also promoted. During labor, there is a reduction in epidurals, cesareans and birth trauma as well. Doulas are wonderful!  - Cheung Kim
Amanda
12:22
Do the pelvic exercises (I think they are called kegels?) doctors recommend you do during pregnancy really help with labor?
Einstein Healthcare Network
12:25
Amanda, Pelvic floor exercises, Kegels, can help with pushing efforts in labor. I feel the greatest benefit comes after delivery during the post partum healing process and for months afterwards .  - Michelle
Sue
12:27
What puts a patient at higher risk C section vs VBAC? (If patient only had c section for breech baby, all stages of labor were achieved and healthy patient) Would you suggest trying VBAC?
Einstein Healthcare Network
12:28
Sue, Vaginal Birth after Cesarean or VBAC, is a reasonable and safe option for most women who become pregnant after having a cesarean, including for breech. Certain criteria make it safer, such as the incision on the uterus. If the incision is horizontal, the risk of rupture is lower and therefore supported by OB and Midwifery. Cesarean is a surgery and has higher overall risks than a VBAC, but we individualize each person to see which method of delivery is safer. I would talk to your provider to see if you are eligible and would want to VBAC after learning all the facts for you.
Sharon
12:28
Do the various breathing techniques they tell you about in child birth classes really help you during labor?
Einstein Healthcare Network
12:33
Sharon, Having a strategy for coping with labor whether it is through specific breathing exercises or mindfulness/ meditation practice most definitely can have an impact on your labor. Effective coping through labor can aid in labor progress and result in successful, healthy delivery! - Michelle
12:35
For information about Maternity Care at Einstein Medical Center Montgomery, visit: https://www.einstein.edu/obstetrics-and-gynecology/obstetrics/maternit...
Guest
12:37
Hello. I sent a few questions prior. What is the likelihood of a c-section for patients who have a hx of a myomectomy and/ current fibroids?
Einstein Healthcare Network
12:37
Guest, fibroids in pregnancy are important considerations. The simple answer is the size, location and number are determining factors. Anything greater than 2 inches (4cm) can obstruct the ability of the baby to deliver vaginally. Also, the location near the birth canal can block or delay the labor. Lastly if there are alot of fibroids, this makes the muscle of the uterus less effective in labor. Prior myomectomies or removal of fibroids are surgeries that could scar the muscles of the uterus. If the fibroids were large or many, the scars will be a factor in how well the uterus can function and also if the scars are deep, then labor is not recommended. -Cheung
12:41
To make an appointment at the Fibroid Center at Einstein or for more information about fibroids, call 267-763-1030, or visit http://philadelphiafibroids.com
Laura
12:43
Is there an age limit for women who want to deliver with a midwife?  not older than age 35?  40?
Einstein Healthcare Network
12:44
Laura, there isn't an age limit (thankfully). While women over 35 have a small risk for genetic issues and pregnancy complications, most of these circumstances are well within the scope of care by midwives. -Cheung
Derek
12:44
Do perineum massages really help with preventing tearing?
Einstein Healthcare Network
12:49
Derek, this is a question we hear often. Perineal massage has mixed reviews in the literature in how effective it is in reducing tearing during delivery.  There was a large study performed in the UK looking at which strategies work best in reducing the severity of vaginal tearing. It was found that using a warm compress during crowning was the most effective way to reduce tearing.  Massage was a close second.  - Michelle
Tara
12:49
What is the current thought on the safeness of using vacuum assistance in delivery?
Einstein Healthcare Network
12:49
Tara, performing a vacuum assisted delivery by a skilled provider is a safe alternative to a cesarean. If the vacuum doesn't work, then the only option is to do a cesarean. Not everyone has this as an option. So it's use is specific to certain situations. - Cheung
Guest
12:52
Seems as though there are a lot of variables with fibroids. Depending on all of the above, what's the chances of carrying full term? What are your experiences?
Einstein Healthcare Network
12:52
Guest, if the fibroids are numerous, it could influence early labor. In general, most persons will get to full term. I suggest you reach out to your provider or contact us if you want. I'd be happy to address your specific needs. - Cheung
Wright
12:54
Are there data that show the efficacy of home births versus those in a hospital or other medical environment?
Einstein Healthcare Network
1:00
Wright, In the low risk woman a home birth can result in less interventions and good outcomes.  However, not all pregnancies and women are candidates for home birth.  Here at Einstein Montgomery we feel our culture of care successfully promotes  bridging the gap between the desire for low intervention and the ease of access to higher level of care when needed.  - Michelle
Lewis
1:02
What have researchers discovered about the health of women in underserved populations relative to that of their peers?
Einstein Healthcare Network
1:02
Lewis, your question is important to me, since I have a degree in public health! Underserved populations have worse outcomes for many reasons such as; access to services, information to promote health, social barriers from cultural and economic reasons. Einstein's mission is to represent these voices and has spent the last 150 years advocating for our communities and at risk persons. - Michelle and Cheung
cool 1
1:03
Thank you everyone for all the wonderful questions!  We enjoyed answering your inquiries. We look forward to doing this again.  Best, Michelle and Cheung
For more information or to make an appointment with Cheung Kim, MD, or Michelle Barcus, MSN, CNM, please contact Women’s Associates for Healthcare at 484-622-7940.

The information contained in this chat is not intended or implied to be a substitute for professional medical advice. Einstein has a talented team of primary physicians and specialists who you can contact or make an appointment to see to discuss your specific medical problems; but most importantly, you must always seek the advice of a physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Nothing contained in this chat should be used for medical diagnosis or treatment.
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