1) What is the definition of a Nurse-Midwife?
Nurse Midwives are master’s level educated nurses who specialize in women’s health, including pregnancy, labor and delivery, and postpartum. We are board certified by the American Midwifery Certification Board and licensed by the state of California. We are also credentialed by UCLA Health to practice midwifery.
Midwives provide initial and ongoing comprehensive assessment, diagnosis and treatment. We conduct physical examinations; prescribe medications including controlled substances and contraceptive methods; admit, manage and discharge patients; order and interpret laboratory and diagnostic tests and order the use of medical devices. Midwifery care also includes health promotion, disease prevention, and individualized wellness education and counseling.
We view pregnancy and childbirth as a natural, physiological process. We are not physicians and so we do not perform surgery or take care of medically complicated pregnancies such as women with a history of heart disease, kidney disease or pre-existing diabetes. We see women before pregnancy, during pregnancy and after pregnancy and focus primarily on prenatal care and birth.
Our philosophy is based on 3 core beliefs:
a. Pregnancy and birth are essentially normal/natural physiological events.
b. Pregnant women, their families and the midwives are partners in care; and shared decision making is the cornerstone of our care during pregnancy and birth.
c. Technology should be used judiciously and only when there is good evidence for its use.
2) What happens during prenatal care?
Midwives specialize in medically low risk women. Women with pre existing medical conditions such as high blood pressure, insulin required diabetes, heart disease, history of uterine surgery (myomectomy or cesarean section) or women over the age of 42 should see a physician instead of a midwife. If you are not sure whether you should see a midwife or a physician please set up a consultation and we can direct your care as best appropriate.
During your initial prenatal visit, we review your health history, talk about disease carrier testing, routine genetic testing, review your routine prenatal labs, review routine ultrasounds that are offered. We discuss your mental and emotional health, good nutrition, and individualize your prenatal care visit, including telehealth and in person visits. We will talk about childbirth preparation classes, books, doulas, and how to prepare for a natural childbirth. We help you write a birth preferences list.
We monitor your and your baby’s health to make sure your baby is growing well and that you are healthy. We discuss normal signs and symptoms of pregnancy. We will be able to identify any symptoms that may suggest possible complications as your pregnancy progresses.
3) Where do you attend births? Do I give birth in a separate unit?
The UCLA nurse midwives attend births at The UCLA Santa Monica BirthPlace (Labor and Delivery unit inside the UCLA Medical Center, Santa Monica). We only attend births at UCLA Medical Center, Santa Monica and are unable to provide home birth services.
When you are with the midwife practice, you will give birth in a labor and delivery room at the hospital. All women giving birth will have a private room in the labor and delivery unit (L&D); there are no rooms specifically designated as midwife rooms. Additionally we do not provide water births or have labor tubs for hydrotherapy. Please visit the UCLA BirthPlace online to schedule an on-line tour and view several informative videos.
4) Who will be my midwife at birth and who else will be at my birth?
The midwife practice at UCLA is a group practice with 5 full time midwives and two part-time midwives (who only work in the Labor and Delivery floor). The goal is for you to meet all 5 full-time midwives during your prenatal visits. We all take turns working at the hospital. There is a midwife at the hospital 24/7, and one of us will be with you when in labor or if a problem arises. We encourage you to contact us in Labor and Delivery when you believe you are in labor or you have an urgent question/concern.
We are part of the UCLA Health care system and part of the UCLA OB/GYN department. We work with our department’s resident physicians who are part of the expert team that cares for you. You will meet the resident physician when you are in L&D. You are a patient of the midwives, so your care is under the supervision of the midwife. We help guide our residents in the midwifery model of care. We help future obstetricians understand un-medicated birth and limited intervention in the normal birth process. We occasionally have midwife students with us.
5) What are the labor and delivery unit protocols? Do I have to stay in bed during labor? Do I have to have baby monitors on me the whole time?
Our goal is for you to stay at home as long as it is safe to do so. Ideally you will arrive at the hospital in active labor and stay at the hospital until you leave with your baby. We have private rooms in the labor and delivery unit and the postpartum unit.
When you first arrive, an external fetal monitor will be placed to evaluate the baby's heart rate. If safe to do, we will proceed with intermittent monitoring of the fetal heart rate. If continuous monitoring is necessary for the safety of your baby, we have portable monitors to assist in your comfort and mobility. We then determine if you are in active labor by doing a cervical exam. If you are less than 5-6 cm and it is your first baby, you may choose to return home since you are still considered in early labor.
Once you are admitted, a nurse will establish IV access. This is a requirement for a hospital birth; it will not prevent you from moving around or getting into the shower. You will not be connected to an IV pole. It is an IV access site in case of emergency or if you need IV fluids or medication.
If you wish to avoid an epidural, we encourage movement in labor, eating or drinking as tolerated and appropriate, changing positions, showering, utilizing a squat bar, and aromatherapy as coping mechanisms for labor. Patients may bring music, battery operated candles and a birth-ball to create a calming environment. During pushing we provide continuous support and encourage any position that is comfortable, safe and effective. We use warm compresses and perineal support to prevent tearing. After delivery, we promote delayed cord clamping and skin-to-skin with your newborn. If you desire pain medication, the anesthesiologist is available as needed.
6) Can I still have pain medication if I choose to have my prenatal care and birth with the midwives?
Patients have a choice when it comes to pain medication in labor and have many options including IV medication or a labor epidural. Your midwife will continue to care for you during labor and birth. The anesthesiologist will place the epidural. You can learn more on the video tab titled “Labor and Anesthesia”. The link is
Approximately 40% of the midwife patients decide to get an epidural for pain management; meaning approximately 60% of midwife patients proceed with a vaginal delivery without an epidural.
7) What happens if I need a cesarean section? What is your cesarean section rate?
The midwives work collaboratively with the UCLA Santa Monica OBGYN practice. At all times, 24/7, there is an obstetrician physician, a nurse midwife, and an anesthesiologist at the hospital. The midwife will consult and collaborate with the obstetrician and together they will care for you. Should a cesarean section become necessary, the obstetrician would perform the c/section either with the assistance of the midwife or a backup physician. After the surgery, the obstetrician physician will manage your recovery and the midwife is available for emotional support.
The current primary c/s rate for the midwife practice is 14%
8) What happens after I give birth?
After a vaginal delivery you will typically be transferred to the postpartum unit 1-2 hours after giving birth. You will rest and recover and work on breastfeeding in your private postpartum room. Women will generally stay 1-2 nights after a vaginal delivery and 3 nights after a c/section.
UCLA Medical Center, Santa Monica is a baby friendly hospital and everyone’s goal is to support breastfeeding. There will be a lactation consultant available to help answer any questions. All postpartum nurses are trained in breastfeeding and the midwife can also assist as needed. If you choose not to breastfeed or are having difficulty breastfeeding, formula is available per pediatrician recommendations.
Every day in the hospital there will be a visit by the midwife to assess mom’s health and a visit by the pediatrician to assess the baby's health. There will also be the birth clerk to help with birth certificate paperwork, a nutritionist, and sometimes a social worker to help provide resources for going home.
You will be provided with a lot of information to help support the transition into the fourth trimester.
After you leave the hospital you will follow up with the midwife for a 6 week postpartum check up. We can see you via Telehealth or in person prior to the 6 weeks as needed.
9) What type of insurance do you accept?
We accept any insurance that covers care at UCLA Health. If your insurance covers care at UCLA Health, then it will cover prenatal care and birth with the nurse-midwife group at UCLA Medical Center, Santa Monica. The midwives at UCLA are part of the UCLA OB/GYN department and not a separate entity.
10) Can I have my annual exam and/or pap smear with a midwife?
Yes, as certified nurse midwives we are able to provide routine gynecological care to women such as annual exams, pap smears, and birth control. If you are experiencing abnormal bleeding, breast issues or symptoms associated with menopause, please see our OBGYN colleagues for management and care.