Waterbirth - A gentle option

Water has many soothing benefits and has been shown to calm and comfort - even during labor and delivery.

Often called a "gentle birth," waterbirth is a safe option for both mothers and babies. It has steadily gained in popularity in recent years as many women have found they prefer the calming effects of warm water to a traditional, or "land," birth.

During a waterbirth, the mother gives birth under water in a birthing tub. She may also spend part of her labor in the tub. This special tub is larger and deeper than a regular bathtub and it allows the mother to try a variety of different positions during labor and delivery. The baby emerges into the warm water before being brought out to take its first breath.

One common question is "doesn't the baby try to breathe under water?" Actually, babies start breathing when they feel the cool, dry air. The baby goes from the fluid in the womb, into the warm water of the tub. The baby is then gently brought out of the water. The mother can hold the baby immediately. It then takes a first breath of air. The umbilical cord is still attached and the baby continues to get oxygen through the cord.

Waterbirth benefits
Research shows the safety and advantages of laboring and birthing in water. A study published in Fetal Diagnosis & Therapy (5(5): 291-300) in 2000 reviewed three birthing options: waterbirth, birthing stool and bed. Births in water had the lowest rates of episiotomy, medication use and blood loss. Waterbirth babies had much higher oxygen blood levels. They also had higher Apgar scores. The study found that there was very low risk for infection. There were also no reported cases of babies breathing the water or other complications f the mother or child, related to the water.

Many women who've chosen waterbirth have experienced the following benefits:

• A birth that's as safe as a "land" birth
• Reduced pain and increased support to tense muscles
• Increased comfort and relaxation
• Decreased adrenaline production, allowing for a shorter labor
• Easier to move during labor and delivery
• Reduced pressure on the abdomen, better blood circulation and more oxygen to the mother and baby due to the buoyancy of the water
• Increased sense of independence, power and autonomy during labor and  delivery
• Reduced need for medical intervention and pain medication
• Reduced rate of Cesarean section
• Reduced rate of episiotomy, as water relaxes the pelvic floor muscles
• Father/partner may take a more active role in the birth experience

Advantages for baby:

• An easier, more gentle transition from mother's womb to an external "womb" of  water that is weightless, warm, wet and soft
• Decreased trauma at birth
• More blood flow to the baby due to better circulation of the mother
• Baby isn't stimulated to induce breathing, which results in less crying after birth  and a calmer, more alert state
• Bacteria is dissipated in the water, reducing the risk of infection to the baby
• Cord cutting after birth is delayed until it stops pulsating, allowing a continuous oxygen flow to baby
• Moms have reported better initial breastfeeding

During a waterbirth
The water temperature is kept between 95 and 100 degrees F. Staying in the water for too long (more than two hours at a time) or getting in the tub too early may slow labor down. Therefore, we recommend that you not get into the tub until you have reached about five centimeters in cervical dilatation.

You may be asked to leave the tub under the following circumstances:

• You become light-headed, dizzy or extremely fatigued
• The baby is experiencing distress
• There is a need to monitor the baby with the electronic fetal monitor (if telemetry is not available)
• Your temperature is above 100.4 degrees F.
• The amniotic fluid is meconium stained
• For the birth of the placenta
• For suturing, if needed
• To evaluate blood loss

Considering a waterbirth?
Certified nurse midwives (CNMs) from HealthEast Clinics offer waterbirth as an option at St. Joseph's Hospital and Woodwinds Health Campus. CNMs concentrate on the unique physical, emotional and social well-being of the expectant mother and her family. Offering individualized care, certified nurse midwives encourage women to make birthing choices - including waterbirth - based on their personal needs.

When choosing a waterbirth, it's important to discuss your decision with your midwife and meet the criteria listed below. If you plan to have a waterbirth, you will have some additional lab work done, including testing for hepatitis B, hepatitis C and HIV. You will also be asked to read the waterbirth information sheet and sign a consent form.

When considering a waterbirth, an expectant mother must:

• Not have medical conditions such as hypertension or a maternal infection
• Not have had a previous Cesarean section
• Not be pregnant with multiples
• Be at least 37 to 42 weeks gestation
• Have a low risk pregnancy
• Have a fetal heart rate that is reassuring
• Not have a baby that is in a breech position
• Not have placental abnormalities
• Not have a baby that is expected to be above normal size, creating the likelihood  of a difficult birth

Make an appointment
To schedule an appointment with a certified nurse midwife, contact one of the following clinics:

HealthEast Macalester/Groveland Clinic at 651/326-5650

HealthEast Roselawn Clinic at 651/326-5700

HealthEast Salud Integral at 651/326-4900

HealthEast Woodbury Clinic at 651/232-6700

Medical Staff

The following HealthEast Clinics have doctors and certified nurse midwives who deliver babies at St. Joseph's Hospital.

To find out about providers from other clinics who deliver at St. Joseph's, call HealthEast Care Connection at 651-326-CARE (2273).

HealthEast Macalester/Groveland Clinic
45 Snelling Ave. N.
St. Paul, MN 55104
651-326-5650

HealthEast Rice Street Clinic
980 Rice Street
St. Paul, MN 55117
651-326-9020

HealthEast Roselawn Clinic
1983 Sloan Place, Suite #1
St. Paul, MN 55117
651-326-5700

HealthEast Salud Integral
797 East 7th Street
St. Paul, MN 55106
651-326-4900

HealthEast Certified Nurse Midwives

Bringing a baby into the world is a miraculous event, deserving of the best care and planning along the way. HealthEast Care System has a passion for caring about patients, even the very smallest. Today, women have many choices when it comes to giving birth, and a growing number are opting to use a certified nurse midwife. Many enjoy the ability to build a strong relationship with their caregiver, in addition to appreciating the natural approach to prenatal care, labor and birth.

What is a certified nurse midwife?
A certified nurse midwife is a registered nurse who has received advanced education in midwifery and a national certification from the American College of Nurse Midwives. In the United States, the profession dates back to the 1920s, and today there are more than 7,000 Certified Nurse Midwives practicing in all 50 states.

According to the American College of Nurse Midwives, these health care professionals attend nearly 9% of all births in the United States, or more than 270,000 each year. At HealthEast, certified nurse midwives attended the births of 400 babies last year, and that number continues to grow.

A natural choice for many
Certified nurse midwives focus on birth as a natural event, providing support to women throughout the normal process of labor and delivery. Stressing the importance of the non-medical, as well as the medical, aspects of pregnancy, childbirth and breast feeding, they concentrate on the physical, emotional and social well-being of the mother and her extended family.

Tailored care
During pregnancy, midwives guide parents-to-be through a maze of questions, including those about proper nutrition, exercise, sleep and travel. Offering individualized care, certified nurse midwives encourage women to make birthing choices unique to their personal needs. They can choose from a variety of labor options, including the freedom to move around, massage, a rocking chair, a deep tub or shower, a birthing ball, moist heat, pain medication and waterbirth. Once the baby is born, certified nurse midwives play an important role in a couple's transition to a family, offering individual patient education and support.

Believing that pregnancy and birth are normal life processes, midwives tailor their care to the individual needs of each patient. In addition to being with a woman from active labor through birth, certified nurse midwives are qualified to administer medications, order labor epidurals and perform some medical procedures, if necessary. Preferring to minimize technological interventions, they stress education, counseling and continuous hands-on care during labor, birth and postpartum.

When additional support is needed
Sometimes births become complicated, and additional support is needed. Certified nurse midwives are trained to recognize and manage complications early and collaborate with physicians to ensure optimum care for all patients. At HealthEast, there are comprehensive Maternity Care facilities available, with special at-risk care units, on-site surgical suites and level II nurseries staffed with neonatologists and nurse practitioners.

Beyond delivering babies
Midwives provide a wide range of services for well women from puberty to menopause. The word "midwife" actually means "with woman," yet most people still think of midwives only in connection with the birth of a baby. At HealthEast, they do much more.

Yearly gynecological exams
While many adult women choose midwives for their yearly gynecological exams, midwives make an excellent choice for young women transitioning from pediatric care to adult medical care.

Family planning and pre-conception counseling
Midwives are trained to provide personalized attention to the needs of couples as they begin their family planning.

Nutrition counseling
Proper nutrition for pregnant women is crucial to the healthy development of their babies, as well as to their own health and comfort during pregnancy.

Health maintenance and disease prevention counseling
From caring for a woman's general medical needs to treating vaginal infections and counseling about sexually transmitted diseases, certified nurse midwives often become primary care providers for many women.

Peri-menopause counseling
Women today have more options for managing menopause symptoms than ever before. Certified nurse midwives can help them unravel the choices, from hormone replacement therapy to alternative medicine.

For more information
To explore the HealthEast Nurse Midwifery option, contact HealthEast Care Connection at 651/326-CARE (2273) or 1-866-326-CARE (toll-free).

Clinic and hospital options
Certified nurse midwives see patients throughout their pregnancies at the following HealthEast Clinics locations:

• HealthEast Macalester/Groveland Clinic
• HealthEast Roselawn Clinic
• HealthEast Salud Integral
• HealthEast Woodbury Clinic

Hospital options for labor and delivery include:

St. Joseph's Hospital - where the Maternity Care Center includes 16 private, home-like suites for the entire process of labor, delivery, recovery and postpartum care. Minnesota's first hospital, St. Joseph's has a long tradition of welcoming babies into the world and continues to provide unparalleled care and attention to detail. In 2001, St. Joseph's Maternity Care Center and staff ranked number one among Twin Cities hospitals for patient satisfaction, according to HealthPartner's OB patient satisfaction survey.

Woodwinds Health Campus - a unique combination of personal amenities and professional expertise, set amid natural surroundings. At Woodwinds, the healing environment includes private birthing suites, a unique blend of traditional and complementary medicine, and panoramic views overlooking natural woodlands. Click here to learn more about Maternity Care at Woodwinds.

HealthEast Certified Nurse Midwives are members of the American College of Nurse-Midwives, and are adjunct faculty of the University of Minnesota School of Nursing.

Tour St. Joseph's Maternity Care

Take a tour with a prenatal educator

We offer scheduled tours with a prenatal educator for families who want to see the Maternity Care Center before birth. The hour-long tours are free.

To register, call HealthEast Women's Care at 651-232-8080.

Tours are offered:

If you'd prefer to take a tour outside of the scheduled times, call the Maternity Care Center at 651-232-3022.

Virtual tour

Click here to take a virtual tour of St. Joseph's Maternity Care Center.

(requires the use of Macromedia Flash)

Prenatal classes

We offer a variety of prenatal classes to meet the needs of your family. Classes are not just for expectant moms - dads, partners, grandparents and other family members are welcome, too!

Prenatal classes fill quickly, so please register in advance to have the best chance at getting into the class of your choice.

To meet your needs, we offer a variety of childbirth preparation classes:

• Preparing for Birth (5 week course)
• Preparing for Birth - Online
• Preparing for Birth - Weekender
• Preparing for Birth - Refresher

We also offer:

• Becoming a Single Parent
  (classes meet at St. John's and Woodwinds)
• Breastfeeding Basics
• Bringing Baby Home
• Caring for Your Newborn (formerly called "All About Babies")
• Cesarean Birth Class
• Dads-to-be
• Daddy and Me
• HypnoBirthing (class meets at Woodwinds)
• New Brother, New Sister (formerly called "Sibling Class")
• Prenatal Nutrition: The Truth About Eating for Two
• Sign Language for Hearing Babies and Toddlers
• Vaginal Birth After Cesarean (VBAC)

Click here for a complete list of prenatal classes at St. Joseph's Hospital.

Can't find a convenient class time at St. Joseph's?
Most prenatal classes are also offered at St. John's Hospital in Maplewood and Woodwinds Health Campus in Woodbury. You're invited to take classes at any of our three locations, regardless of where you plan to give birth.

Click here for a list of prenatal classes at HealthEast Hospitals (St. Joseph's, St. John's and Woodwinds hospitals). Or click here to search for a class.

Registering for prenatal classes

• Mail or fax back the registration form
  
  
• Call HealthEast Care Connection at 651-326-CARE (2273) to register by phone, with a credit card

Class sizes are limited and registrations are prioritized by date received. Early registration (at least 12 weeks before a class date) is encouraged.

For more information, call HealthEast Care Connection at 651-326-CARE (2273).

Need help finding a conference room?
Click here for a map of St. Joseph's lobby level, including many of the hospital's conference rooms.

General information

• If you'd like, you may bring two pillows and a blanket to each Preparing for Birth class.
• You may bring a support person to all prenatal classes. Please note that childcare is not available.
• Classes may be canelled due to bad weather. For class cancellation info, call HealthEast Care Connection at 651/326-CARE (2273) after 4 pm.
• We reserve the right to cancel any class due to insufficient registration. If this occurs, you will be notified by phone or mail. Alternative classes will be offered whenever possible.
• Contact your insurance carrier for possible reimbursement of class fees.
• If you are hearing impaired, please call 651/232-5733 at least two weeks prior to class start date to arrange for interpreter services.

Parenting skills classes

TotSaver
The TotSaver course was developed by the American Heart Association (AHA) and the American Academy of Pediatrics. It is helpful for anyone who cares for children. Topics include infant and child safety; causes of cardiac and pulmonary arrest; and cardiopulmonary resuscitation (CPR) and foreign body airway obstruction (FBAO) management.

For additional information, call HealthEast Care Connection at 651-326-CARE (2273) or click here for dates and times.

Early Childhood Family Education (ECFE)
The ECFE program in your community offers classes, home visits and drop-in opportunities for parents and their newborns. Along with your baby, you will play and learn together. ECFE is part of the Community Education Program in your school district. To find an ECFE program in your area, call 651/582-8402 or go to www.ecfe.info.

Welcome Baby
We have partnered with ECFE to bring this exciting class into our hospitals' Maternity Care Centers. During your hospital stay the ECFE educators will help you discover new and exciting information about your newborn. This class is offered weekdays at St. John's, Woodwinds and St. Joseph's hospitals. Ask your nurse for details. For more information, call 651/748-7282.

Minnesota Department of Health

Visit the Minnesota Parents Know website for information on a variety of pregnancy, birth and parenting topics. Brought to you by the Minnesota Department of Health.

Waterbirth - A gentle option

Water has many soothing benefits and has been shown to calm and comfort - even during labor and delivery.

Often called a "gentle birth," waterbirth is a safe option for both mothers and babies. It has steadily gained in popularity in recent years as many women have found they prefer the calming effects of warm water to a traditional, or "land," birth.

During a waterbirth, the mother gives birth under water in a birthing tub. She may also spend part of her labor in the tub. This special tub is larger and deeper than a regular bathtub and it allows the mother to try a variety of different positions during labor and delivery. The baby emerges into the warm water before being brought out to take its first breath.

One common question is "doesn't the baby try to breathe under water?" Actually, babies start breathing when they feel the cool, dry air. The baby goes from the fluid in the womb, into the warm water of the tub. The baby is then gently brought out of the water. The mother can hold the baby immediately. It then takes a first breath of air. The umbilical cord is still attached and the baby continues to get oxygen through the cord.

Waterbirth benefits
Research shows the safety and advantages of laboring and birthing in water. A study published in Fetal Diagnosis & Therapy (5(5): 291-300) in 2000 reviewed three birthing options: waterbirth, birthing stool and bed. Births in water had the lowest rates of episiotomy, medication use and blood loss. Waterbirth babies had much higher oxygen blood levels. They also had higher Apgar scores. The study found that there was very low risk for infection. There were also no reported cases of babies breathing the water or other complications f the mother or child, related to the water.

Many women who've chosen waterbirth have experienced the following benefits:

• A birth that's as safe as a "land" birth
• Reduced pain and increased support to tense muscles
• Increased comfort and relaxation
• Decreased adrenaline production, allowing for a shorter labor
• Easier to move during labor and delivery
• Reduced pressure on the abdomen, better blood circulation and more oxygen to the mother and baby due to the buoyancy of the water
• Increased sense of independence, power and autonomy during labor and  delivery
• Reduced need for medical intervention and pain medication
• Reduced rate of Cesarean section
• Reduced rate of episiotomy, as water relaxes the pelvic floor muscles
• Father/partner may take a more active role in the birth experience

Advantages for baby:

• An easier, more gentle transition from mother's womb to an external "womb" of  water that is weightless, warm, wet and soft
• Decreased trauma at birth
• More blood flow to the baby due to better circulation of the mother
• Baby isn't stimulated to induce breathing, which results in less crying after birth  and a calmer, more alert state
• Bacteria is dissipated in the water, reducing the risk of infection to the baby
• Cord cutting after birth is delayed until it stops pulsating, allowing a continuous oxygen flow to baby
• Moms have reported better initial breastfeeding

During a waterbirth
The water temperature is kept between 95 and 100 degrees F. Staying in the water for too long (more than two hours at a time) or getting in the tub too early may slow labor down. Therefore, we recommend that you not get into the tub until you have reached about five centimeters in cervical dilatation.

You may be asked to leave the tub under the following circumstances:

• You become light-headed, dizzy or extremely fatigued
• The baby is experiencing distress
• There is a need to monitor the baby with the electronic fetal monitor (if telemetry is not available)
• Your temperature is above 100.4 degrees F.
• The amniotic fluid is meconium stained
• For the birth of the placenta
• For suturing, if needed
• To evaluate blood loss

Considering a waterbirth?
Certified nurse midwives (CNMs) from HealthEast Clinics offer waterbirth as an option at St. Joseph's Hospital and Woodwinds Health Campus. CNMs concentrate on the unique physical, emotional and social well-being of the expectant mother and her family. Offering individualized care, certified nurse midwives encourage women to make birthing choices - including waterbirth - based on their personal needs.

When choosing a waterbirth, it's important to discuss your decision with your midwife and meet the criteria listed below. If you plan to have a waterbirth, you will have some additional lab work done, including testing for hepatitis B, hepatitis C and HIV. You will also be asked to read the waterbirth information sheet and sign a consent form.

When considering a waterbirth, an expectant mother must:

• Not have medical conditions such as hypertension or a maternal infection
• Not have had a previous Cesarean section
• Not be pregnant with multiples
• Be at least 37 to 42 weeks gestation
• Have a low risk pregnancy
• Have a fetal heart rate that is reassuring
• Not have a baby that is in a breech position
• Not have placental abnormalities
• Not have a baby that is expected to be above normal size, creating the likelihood  of a difficult birth

Make an appointment
To schedule an appointment with a certified nurse midwife, contact one of the following clinics:

HealthEast Macalester/Groveland Clinic at 651/326-5650

HealthEast Roselawn Clinic at 651/326-5700

HealthEast Salud Integral at 651/326-4900

HealthEast Woodbury Clinic at 651/232-6700

Preparing for your hospital stay

Bringing a baby into the world is a miraculous event, deserving of the best care and planning. At St. Joseph's, we share your excitement, and take incredible pride in our staff and Maternity Care Center.

Pre-register for your hospital stay

Before your hospital stay, please complete a pre-registration form.

You can choose one of the three options below:

• Fill out and submit the form online - you'll be directed to a secure form on the HealthEast web site
  
  
• Print out the form (pdf) and mail it back to us
  
  
• Send in the form you get from your clinic

If you have questions about the form, call admitting at 651/232-3168. We also suggest that you consult your insurance company to determine your benefits and if you need pre-authorization.

Writing a birth plan

A birth plan (pdf) is a listing of the choices and preferences you and your partner have about labor, birth and your hospital stay.

Give a copy of your birth plan to your doctor or midwife and bring a copy to the hospital. The staff will work to follow your plan. However it's important to remember that your safety and your baby’s safety is their priority. Depending on the course of your labor, some of your requests may not be possible.

Get a sample birth plan (pdf)

Where to go and what to bring

To help you prepare for your trip to the Maternity Care Center, we've put together a checklist of items (pdf) to bring to the hospital.

When the time comes for you to go to the hospital, please use the Emergency Care Center entrance and a member of our staff will escort you to your room in the Maternity Care Center.

Breastfeeding support

St. Joseph 's Maternity Care is an advocate for breastfeeding and is committed to providing support and education. However, we also understand that breastfeeding is not for everyone. Whether or not you choose to breastfeed, your decision will be supported and respected by our staff.

Before your baby is born
We offer a prenatal class called Breastfeeding Basics to help expectant parents learn about breastfeeding. The class provides the basic, essential information needed for success and includes:

• Benefits of breastfeeding
• Preparing for breastfeeding
• Role of the support person
• Avoiding and solving problems

In the hospital
All Maternity Care nurses have specialized training to support lactation (breastfeeding). Individualized education on breastfeeding is provided by our nursing staff.

After you go home
After discharge, you can get breastfeeding support by telephone or by scheduling an appointment with a certified lactation consultant.

Call 651-232-3147 to schedule an appointment. Please note that you will need a doctor's order for insurance to cover the visit.

Postpartum Depression

In the days just after giving birth, many women experience "baby blues," with symptoms that can include:

• Mood swings
• Sadness
• Crying spells
• Loss of appetite
• Sleeping problems
• Irritability
• Restlessness
• Loneliness

These symptoms - caused by wildly fluctuating hormones - are completely
normal, not severe and generally go away within a few days to a couple of
weeks after birth.

For some women, however, these symptoms are far more intense and persist longer than a few weeks. In this case, the woman may be suffering from postpartum depression (PPD). The difference between PPD and baby blues is that PPD can occur anytime in the year following birth, it affects a woman’s well-being and long-term ability to function, and it’s a serious disorder that requires medical attention.

Other signs of PPD may include:

• A lack of interest in your new baby
• Thoughts of hurting yourself
• Fear of hurting your baby

If you experience any of the above feelings or have concerns that you may be suffering from PPD, please contact your doctor or midwife immediately. Many options are available to treat PPD such as medication, therapy and support groups.

Help is available

To learn more about PPD or find resources in your area visit:

• Postpartum Support International's web site or call their toll-free help line at 800-944-4PPD (4773)
  
  
• www.Women'sHealth.gov - information on depression during and after pregnancy
  
  
• Depression During and After Pregnancy (pdf), frequently asked questions about depression, published by the Minnesota Hospital Association

Newborn photos and online nursery

St. Joseph's offers the opportunity to capture images of your little one through the services of Lisa Bosman Photography. Photos are optional and packages start at $45.

If purchasing a photo package, you can choose to have your baby's photo posted on our online nursery, where friends and family can see your new baby. For your security, we require online nursery visitors to enter a password to see your newborn.

When you are admitted to the hospital, you will get a brochure on newborn photography.

Click here to go to our online nursery.

If I want photos taken of my baby, what do I need to do?

Newborn photos are generally taken the morning after your baby is born.
If you would like your baby's photo taken, please call Lisa Bosman Photography at 612/245-2843. It's important to call the day your baby is born so you can get on the photo schedule for the following day.

Images of your baby are captured while he or she rests in your arms. Please bring an outfit for your baby to wear and a blanket to use as a "backdrop" in the photo.

How do I access the online nursery?

To access the online nursery, go to www.healtheast.org/nursery .

• Choose the hospital from the drop-down menu.
• Next, choose your baby's birthdate.
• Click on the Search button.
• Click on your baby's name.
• Enter the password that you chose in the hospital. (Passwords must be eight (8) characters and include letters AND numbers.)
  Please note: it is your responsibility to share this password with your family and friends.

If you have trouble accessing your baby's information, please contact HealthEast at WebInfo@healtheast.org .

When are photos posted on the online nursery?

Generally, photos will be posted within three (3) business days after being taken. For security purposes, your baby's photo will not be posted on the web site before he or she is discharged from the hospital. Newborn photos will stay up on the web site for about two months.