EPFMC Nurse-Midwife FAQs
Eisner Pediatric & Family Medical Center (EPFMC) nurse-midwives care for women who want natural childbirth in a hospital setting. We deliver babies at California Hospital Medical Center. EPFMC's nurse-midwives have been providing care to the medically underserved women in our Los Angeles neighborhoods for 20 years. We enjoy a supportive working relationship with OB/GYN physicians.
Women often have many questions about the type of care nurse-midwives can provide them - before, during, and after pregnancy - so we've put together this page. Below, we answer some of the questions we are asked most frequently on the topics of midwives, prenatal care, hospital births, VBAC (vaginal birth after c-section), postpartum care, and more.
The Questions We Get Asked Most Often
Answers to the Questions We Get Asked Most Often
All Eisner Pediatric & Family Medical Center midwives are certified nurse-midwives (CNMs). Certified nurse-midwives are nationally board certified and provide primary health care services to women throughout their lifespan. EPFMC nurse-midwives are advanced practice nurses as well as midwives. This means that we have advanced skills and hands-on knowledge in diagnosing, evaluating, and giving care. EPFMC nurse-midwives can:
- Perform your annual physical exams
- Write prescriptions for you, including contraceptives
- Order lab tests to screen for or diagnose conditions
- Perform gynecological exams
- Provide family planning and contraceptive services
- Offer prenatal care, including performing regular exams throughout your pregnancy
- Assist you with developing your birth plan
- Manage your labor and delivery
- Offer VBAC (vaginal birth after cesarean section)
- Offer health education and counseling
- Provide postpartum care for you
During your prenatal care visits, you will meet with your nurse-midwife. She will work with you to monitor your health and your baby's normal growth. Prenatal visits are a good time to discuss your concerns, preferences, and what to expect as your pregnancy progresses. Regular prenatal visits allow you to:
- Monitor your vitals and your baby's growth
- Get advice on managing pain and discomfort
- Screen for risk factors and get referred to a physician in our practice if necessary
- Learn where and how to access resources for yourself and your family
- Discuss your birth plan
- Schedule a Maternity Tour at California Hospital Medical Center
We encourage expectant mothers to join our CenteringPregnancy program, in which you will be grouped with other pregnant women who are at similar stages in their pregnancy. We ask you to meet once a month for 90 minutes, during which you'll receive a prenatal checkup. You'll also learn skills for taking care of yourself during your pregnancy and charting your baby's progress. These meetings provide connection, support, answers from your nurse-midwife and other mothers, and other benefits for participants. Get more information on this prenatal care service, the only recognized CenteringPregnancy program in Los Angeles. Also, learn how attending our prenatal classes can prepare you for your pregnancy, delivery, and postpartum care for you and your baby.
Who will be there to assist at my birth? For healthy, low-risk women, our nurse-midwives will be your primary care providers. EPFMC nurse-midwives will deliver your baby during a hospital birth at California Hospital Medical Center. Board-certified obstetrician-gynecologists (OB/GYNs) are always available if needed. If complications arise, the nurse-midwife will consult with an OB/GYN. For high-risk pregnancies, our physicians will be your primary care providers. However, our nurse-midwives can remain instrumental in your prenatal care and delivery experience. California Hospital Medical Center, where we deliver, is a teaching institution, so medical students, midwife students, or medical residents may ask your permission to be involved in your care.
Board-certified obstetrician-gynecologists (OB/GYNs) are always available if any complications arise during your prenatal care or birth.
We will make every effort to respect your birth wishes, whether they are communicated in a written birth plan or verbally. We encourage you to discuss your birth wishes with your nurse-midwife at your prenatal visits.
EPFMC nurse-midwives are nationally recognized VBAC (vaginal birth after c-section) specialists. Seventy-five percent of our patients who attempt a trial of labor after a cesarean section (TOLAC) are successful. We received the Best Distinction award from the ACNM (American College of Nurse-Midwives) in recognition of these results when compared nationally with practices of similar size:
- Lowest rate of primary cesarean section
- Lowest rate of epidural use
- Lowest rate of 5-minute infant APGARs below 7
- Lowest rate of NICU (neonatal intensive care unit) admissions
An APGAR tests how well a baby is doing immediately following birth. It is performed 1 minute and again 5 minutes after the baby is born. Scores below 7 tell us the baby may need immediate medical attention.
Eisner Pediatric & Family Medical Center nurse-midwives were honored for having the lowest rate of primary c-sections among practices that deliver 500 or more babies each year. Of the women admitted and managed in labor by the CNMs, less than 10% had a cesarean section.
This depends on your healthcare plan or coverage. EPFMC offers many plans, including Medi-Cal, which does cover hospital births. Contact our Managed Care Operations at (213) 747-5542, ext. 3202, to get answers or help with coverage.
During your prenatal visits and in Centering Pregnancy, we'll discuss your preferences and options for handling pain during labor and delivery. EPFMC nurse-midwives received the Best Practice distinction award from the ACNM for the lowest rate of epidural use among practices of similar size. We offer Lamaze and exercise classes as part of the prenatal education program at EPFMC. Both can help prepare mothers for delivery without medication. Epidurals and intravenous sedation are available for pain control. Nurse-midwives order both if needed. We work with mothers to honor your birth plan and your decisions about using medication to relieve pain.
Yes, you can walk, eat, and shower as long as your pregnancy is low risk, and a fetal monitor strip (used to monitor your baby's heart rate) demonstrates that we have a happy baby. No, you do not have to have an IV in labor. However, we want everyone to have rapid access to an IV if complications develop - so everyone will need a Hep-Lock. A Hep-lock, short for Heparin Lock, is a small tube inserted into a catheter and taped in place to the arm. Hep-Locks keep a vein open for quick access in case medication is needed.
During your third trimester, you can take a Maternity Tour through California Hospital Medical Center (CHMC). This gives you an opportunity to learn the routine, see where you and your baby will be, and get many of your questions answered. You can schedule the tour through EPFMC's prenatal classes or CHMC.
Yes. California Hospital Medical Center, where our patients deliver, offers private birth suites. Each room includes a TV, private bathroom, and a sleeping chair for your labor partner.
Yes, CHMC features the Keith P. Russell Birthing Center and a childbirth team dedicated to taking care of you and your baby.
Yes, your family, doula, and others you invite are welcome.
This varies. Factors that can affect the time include whether you deliver naturally or by c-section and whether you had any complications. One to two days after birth is typical for vaginal births with no complications. For cesarean births, two to three days after delivery is typical. Cesarean sections are surgery and require longer hospital stays and recuperation.
Yes, EPFMC and California Hospital Medical Center both offer breastfeeding classes. EPFMC offers a breastfeeding class as part of our prenatal education classes. After your baby is born, you'll want to sit down with our certified lactation specialist, Magdalena Estrada, one on one, and learn how to breastfeed and use a breast pump.
Our postpartum support includes:
- Postpartum Care class (to be taken during your third trimester)
- Breastfeeding consultation with a Certified Lactation Specialist
- Postpartum checkups for you
- Immediate Medi-Cal coverage for your newborn (if needed) and first well-baby checkup within two weeks
The Medi-Cal coverage for your baby is started while you are still at California Hospital Medical Center. EPFMC offers a Postpartum Care class, as part of our prenatal classes. It's essential that you learn how to care for yourself after the baby is born. This class focuses on concerns such as proper rest, eating a good diet, and keeping up with your hygiene needs postpartum. We'll also teach you how to recognize signs of postpartum depression. After the birth, you'll have a breastfeeding consultation, lasting about 30 minutes, in which our certified lactation specialist will teach you how to breastfeed properly.
Your nurse-midwife will want to see you about 4 to 6 weeks after the birth. This is to see how you and the baby are progressing, to address any concerns about postpartum depression, and to answer your questions.
Resources for Patients: