The American Association of Birth Centers defines a birth center as a home-like facility existing within a healthcare system with a program of care designed in the wellness model of pregnancy and birth. Birth centers are guided by principles of prevention, sensitivity, safety, appropriate medical intervention, and cost effectiveness.
Birth centers provide family-centered care for healthy clients before, during, and after normal pregnancy, labor and birth. Many birth centers, including The Midwife Center, also provide primary gynecological care (annual exams, birth control, STI testing and more) to clients of all ages.
The Midwife Center is a nonprofit, free-standing birth center. Our prenatal, birthing, and postpartum care designed for healthy clients with a low-risk pregnancy who are interested in preparing for a natural birth, with medical intervention only used when necessary and not as routine. We provide a warm, personal and safe environment for you to bring your baby into the world. We have beautiful, nature-themed birth suites available with safety equipment and medications tucked away if they are needed. The staff of The Midwife Center welcomes doulas and additional support people as desired by the client in labor.
Our birth center provides a safe and nurturing environment where you are free to explore many different options in labor. You may:
- Choose your support team for your birth
- Wear your own clothes
- Eat and drink in labor
- Labor and birth in whatever position you choose
- Labor in Jacuzzi tubs
- Keep your baby skin-to-skin (no routine parent-baby separation)
- Water birth in two of our three birth suites
- Use nitrous oxide as an aide for coping with labor
Yes! Our Certified Nurse-Midwives and Nurse Practitioner take care of the reproductive health needs of clients of all ages – including annual exams, contraceptives, STI tests and more. You DO NOT need to have had previous prenatal/childbirth care at The Midwife Center to schedule a primary gynecological appointment. You are welcome to call The Midwife Center for gynecological services at 412.321.6880.
The Midwife Center's office hours are when we have appointments and when our staff can be reached for non-emergency questions, appointment scheduling, etc.
Monday - 9:00pm - 7:00pm
Tuesday - 9:00am - 5:00pm
Wednesday - 9:00am - 5:00pm
Thursday - 9:00am - 5:00pm
Friday - 9:00am - 5:00pm
Our midwives and nurses are on-call 24/7 to care for clients in labor and for emergencies.
We have walk-in hours for gynecological care every Friday. Click here to learn more about Wellness Walk-In Fridays.
Additionally, classes and events may occur at times outside of our office hours, including evenings and weekends.
Midwives are dedicated to the belief that the milestones and phases of many peoples’ lives, including growing into adulthood, pregnancy, childbirth and menopause are normal life processes. Midwives provide personalized, compassionate and thorough care. This includes comprehensive reproductive care for clients of all ages, including physical and emotional care for clients through pregnancy, labor, birth and postpartum period. A midwife is present during the labor and birth.
Appointments at The Midwife Center tend to be longer than other providers, including an hour for the first prenatal visit to allow for plenty of time for questions and information sharing. Similarly, a first visit for an annual gynecological exam is an hour and return annual visits are 40 minutes long.
The word “midwife” comes from Middle English and literally means “with-woman.” A Certified Nurse-Midwife (CNM) is trained as a nurse and as a midwife. Most CNMs have Master’s degrees, and all are certified by examination through The American Midwifery Certification Board. CNMs in Pennsylvania are licesed by the state of Pennsylvania and carry malpractice insurance. Across our state, midwives provide care in birth centers, hospitals, and in the home. Our midwives also work collaboratively with our midwive and physician colleagues at local hospitals to ensure the health of our clients through pregnancy, labor, birth, and postpartum.
Many other states also provide licensure for Certified Midwives and Certified Professional Midwives. At this time, Pennsylvania only provides licensure for Certified Nurse-Midwives.
Numerous studies have documented the safety of midwifery of birth center birth, including the 2013 National Birth Center Study II (NBCSII) and in 2014, The Lancet’s “Series of Midwifery.” The Midwife Center’s outcomes statistics are consistent with the NBCSII and are consistently better than national averages for c-sections, low birthweight and prematurity. Learn more about our statistics.
More than 80% of pregnant people are low-risk for complications for pregnancy and birth, so most pregnant women and people are good candidates for midwifery and birth center care. Midwifery and birth center care is best for healthy people who are ready to take an active role in their health care. We ask that clients work with The Midwife Center staff to keep healthy and low-risk for the entire pregnancy and birth by:
- Attending all appointments
- Attending required classes as necessary
- Asking questions during prenatal visits
- Taking advantage of community resources and letting your TMC team know if there is something we can help you access during your care with us
- Continuing to exercise in preparation for birth and recovery
Relationship with UPMC Magee
We work collaboratively with our midwife and physician colleagues at UPMC Magee-Womens Hospital, West Penn Hospital, and Jefferson Hospital.
What happens if you need hospital care:
- A transfer of care from The Midwife Center to a midwife or physician for an in-hospital birth may occur for clients who develop a risk factor during pregnancy that means a hospital birth is more appropriate.
- If you develop a complication during pregnancy and are no longer eligible for a birth at the birth center, but are still appropriate for midwifery care, you have the option of transferring your care to the Allegheny Women’s Health Midwifery Practice at Jefferson Hospital.
- If complications arise during labor that require hospital care, The Midwife Center will facilitate a safe, immediate transfer to UPMC Magee-Womens Hospital, West Penn Hospital, or Jefferson Hospital.
- The Midwife Center is not able to do VBACS (Vaginal birth after cesarean deliveries) at the birth center. We recommend you establish care with the Midwives at Magee or The Allegheny Women's Health Midwifery Practice at Jefferson Hospital.
Midwives are well-trained to recognize any complications that may affect the health and safety of you and your baby and will consult with physicians and hospital-based staff as needed for complications.
If your pregnancy is no longer eligible for a birth at The Midwife Center, your TMC care team will help transition your care to an appropriate provider. This sometimes can be hospital-based midwifery care at Jefferson Hospital or Magee or it may require physician care at the hospital of your preference. Please be reassured that the team at TMC will help you transition care smoothly if you need a different care provider during your care with us.
If complications arise during labor, clients are transferred to Magee Hospital, AHN West Penn Hospital, or Jefferson Hospital. The location of your transfer depends on your insurance and the urgency of the transfer. Your care at Magee or Jefferson will be with hospital-based midwives if possible, while all families transferred to West Penn will receive physician care. If a c-section, forceps or vacuum delivery is needed, it will be performed by physicians.
TMC will facilitate all transfers of care for our clients. We will follow up with you by phone after your birth and in most cases are able to see you for your postpartum visits at TMC
The Midwife Center believes in the right to have a Vaginal Birth After a Cesarean section (VBAC). TMC supports our excellent midwife colleagues who offer this option in a hospital-based setting. Please seek this option through the Midwives at Magee or the Allegheny Health Midwives at Jefferson Hospital.
Many people have health issues that can be well-controlled by lifestyle or medication, and can still give birth safely at the birth center.
Examples are:
- Thyroid disorders managed with medication
- Mild asthma
- Depression managed with counseling or medication
- Abnormal pap smears or surgery on the cervix
- Pregnancy with a prior history of infertility
- Age 35 years or older
- History of miscarriage
- Rh negative blood
- Mitral valve prolapse
- Medical conditions which do not affect pregnancy or medical problems which may affect pregnancy, but are well-managed with a plan of care
Some conditions make a birth center birth potentially unsafe, or the extra support of a hospital is preferable or necessary for some clients. The following is a partial list of common medical conditions that would make a client not eligible for a birth center birth:
- Development of high blood pressure with or without preeclampsia
- Large or small for gestational age babies as clinically indicated
- Too much or not enough amniotic fluid
- Very low platelet count
- Labor before 37 weeks or after 42 weeks
Some situations (either pre-exisiting medical conditions or pregnancy induced) may risk a client out of TMC for the prenatal period and birth care:
- Twins
- Gestational diabetes requiring insulin
- Bleeding or blood-clotting disorders
- History of a blood clot
- Placenta previa
- BMI over 40
- High blood pressure before pregnancy or in pregnancy
- Breech presentation in labor
- History of seizure disorder
- History of previous cesarean births
Once you contact us for prenatal care, our intake process will include questions about your health history.
The baby’s heartbeat is monitored throughout labor using a hand-held ultrasound device called a Doppler. A midwife or nurse will listen intermittently depending on what stage of labor you are in. If at any time TMC staff hears a heart rate that is non-reassuring, they will transfer you to the hospital for continuous fetal monitoring.
In many cases you can transfer your care to The Midwife Center during the middle of your pregnancy. It is required that you present your medical record for review by TMC’s Clinical Director so that you can be deemed appropriate for TMC care. Please continue to attend your regular prenatal care with your current provider and complete all necessary lab work and ultrasounds while you are waiting to transfer care to TMC. Learn more here.
Children, friends, doulas, and family members are welcome at appointments at The Midwife Center. Any adult you would like in the room during your birth at the birth center is welcome. However, an additional adult who is NOT your primary support person must accompany children throughout labor and postpartum.
There are two times that routine lab work is done during pregnancy: after the initial visit and at approximately 28 weeks. Lab work can be done at The Midwife Center or in a lab, and is covered by insurance. Please learn more about getting lab work at The Midwife Center. Additional tests may be done if necessary. Tests that are normally done include:
- Complete blood count
- Blood type, Rh, Antibody screen
- Hepatitis B
- RPR (State required Syphillis test)
- Rubella titer
- Urinalysis
- HIV
- Gonorrhea and Chlamydia
At 28 weeks:
- Complete blood count
- Antibody screen (if Rh negative)
- 1-hour glucose test (screens for gestational diabetes
At 35-37 weeks:
- Screening culture for Group B Strep
We will support the techniques learned in your childbirth classes to help you cope with pain in labor. We also have birth balls and lotions for massage available. Most clients get some relief in the Jacuzzi. Clients who labor in upright positions with the support of family and the TMC team report that labor is far more manageable and empowering.
We are pleased to be one of the few places in Pittsburgh and the surrounding area to offer Nitrous Oxide for pain relief. Nitrous is an odorless, tasteless gas-mixed with oxygen. It is widely used in several countries including the UK, Finland, Sweden, Canada, Australia, and New Zealand. It is inhaled through a mask during contractions and provides a feeling of euphoria that dulls the intensity of the labor pain and reduces anxiety. Women remain awake and alert, using the gas as needed. There are no negative effects on labor and no risk to baby. One study showed it decreased the length of labor.
Since we began using it in 2016, our midwives report that it is an excellent tool to be used when women might have otherwise transferred for an epidural. Unfortunately, at this time most insurance plans do not cover Nitrous Oxide. The out-of-pocket cost is between $50-$200 depending on the length of time spent using it. Learn more about Nitrous Oxide.
We also have short acting pain medication available that can be given through an IV or as an injection. It is often given for sleep/rest, but can be useful for pain relief as well.
Our new birth suites offer the option of laboring and birthing in water for clients who are eligible. The Meadow and Mountain rooms have free standing birthing tubs that may be used for laboring in water and birthing in water, and the Forest Room offers a jet Jacuzzi that may be used for laboring in water. The benefits to laboring and birthing in water are:
- A decrease in episiotomy rates
- A decrease in 3rd and 4th degree tears
- Increased maternal satisfaction
- Possibly shorter labors
- Possibly less intervention needed to help labor along
- Possibly less anesthesia
The midwives will discuss this in detail during your prenatal care. Learn more about Hydrotherapy from the American College of Nurse-Midwives (PDF)
Studies so far have not found that treating pregnant women for GBS before they go into labor is effective.
The more effective treatment is to give clients antibiotics during labor with intravenous (IV) antibiotics. The CDC recommends this treatment for all women who test positive for GBS. This treatment greatly decreases, but does not eliminate, risk to the baby from GBS. The treatment is recommended by the Nurse-Midwives in either the birth center or the hospital. Ideally, the client will receive two doses of antibiotics before the birth.
The majority of babies who get early-onset GBS disease show signs in the first 12 hours. If a client tests positive for GBS, the family may be asked to stay the full 12 hours after birth. The CDC recommends that all babies whose mothers carry GBS be observed for 48 hours after birth. This can be accomplished by during immediate postpartum visits.
At the birth center, the midwife will perform a newborn physical exam before discharge. In addition to faxing a copy of the exam to the chosen pediatric provider, a copy will be given to the family. It is required that infants be seen by a pediatric provider by 72 hours of age.
For those delivering in the hospital, a pediatrician will examine the baby and will make a plan for follow up with a pediatric provider after discharge.
- Newborn Metabolic Screening (these are done at the routine immediate postpartum visit).
- Newborn Hearing Screening (same as above).
- Congential heart disease screen (same as above).
Antibiotic eye ointment and the vitamin K injection are recommended and available at the birth center. Both procedures are mandated by the state, but families may decline them with informed consent.
Clients typically leave the birth center between 4-12 hours after giving birth. Because clients and their support people are well-prepared before the birth they are usually ready to go home before 12 hours postpartum. You may stay up to 12 hours if medically necessary.
Our nursing staff will provide thorough teaching for care of you and your baby before discharge. Our nurses also provide immediate postpartum visits within 24-48 hours, and no more than 72 hours, after birth to check on you and your baby.
- Immediate postpartum visit within 24-48 hours, and no more than 72 hours, after birth by TMC nurse.
- All screening required by the PA Department of Health is performed at the immediate postpartum visit, including newborn screen, hearing test, and congenital heart disease screening.
- Visit to your chosen pediatric care provider within 72 hours of birth.
- Phone calls from a TMC nurse for first time mothers and others in need of additional support.
We do not perform circumcisions in-house, but we can provide a list of healthcare providers and help with a referral to those who do.
If your birth is at the birth center you will be given paperwork to fill out after your birth. Staff will process your birth certificate and social security number request.
If your birth is at the hospital, the process is similar but the hospital staff will do this for you.
The Midwife Center accepts most private and public (Pennsylvania Medical Assistance) insurance plans for pregnancy, childbirth and primary gynecological care. For people who do not have private insurance, our staff can provide guidance for applying for Medical Assistance. For those who are not eligible for Medical Assistance we can make arrangements for self-payment. In some self-pay cases, we can also offer discounted services depending on the client’s household size and income.
Please speak with your insurer to find out if they cover our care. Learn more about insurance and payments we accept at The Midwife Center.
The Midwife Center is pleased to offer a variety of services for people who speak different languages. Our client-facing staff is trained in using phone, video, and in-person interpretation services and can also arrange for in-person interpretation for some services. We also have several staff people who speak Spanish and many of our forms are available in Spanish.
The Midwife Center retired the Con Mujeres program, which served Spanish-speaking people once a month during walk-in hours, in order to make all of our services more accessible to people who speak Spanish and other languages. We are pleased that with partnerships with interpretation services, clients can be seen any time of the week with any TMC provider.
Our building is designed to be accessible to people of all physical abilities. If you have a physical or mobility disability, our goal is to accommodate you with an appointment room specifically designed for people using assistive devices. This room also includes an accessible exam table that allows for more functionality than a traditional exam table. When scheduling your appointment please let the TMC staff know that you would appreciate an appointment room that is designed for someone with an assistive device.
If you have specific questions, concerns, or needs regarding access to TMC, please feel free to contact us at 412-321-6880.
Yes! The Midwife Center provides services to any person who is seeking primary gynecological, prenatal, birthing, and postpartum care. As long as the care you need is within our scope of practice, we welcome people of all gender identities. The Midwife Center’s staff is trained to provide affirming care to LGBTQIA+ community members. We strive to create a safe, inclusive, and satisfying experience for all clients. We can also support LGBTQIA+ clients in connecting to other affirming resources in the region as needed or requested.
