​No Ifs Ands or Buts—Midwifery Care Leads to Better Outcomes

Having a baby or thinking about growing your family? Research has shown that adding midwifery care to the birth team improves outcomes for pregnant people and their babies by reducing race-based disparities and decreasing NICU admissions, low birthweight, and C-sections, while increasing breastfeeding rates. And now Sutter East Bay Medical Foundation’s Midwifery Services has welcomed two new Certified Nurse Midwives (CNM) to expand access to this vital care model for East Bay families.

Ellie Griffinger, CNM, and Gwen Haynes, CNM, the co-founders of Oakland’s Golden Oak Midwives, have recently joined Midwifery Services at SEBMF’s Berkeley and Orinda locations to help bolster seamless, comprehensive pregnancy care, and their longstanding history with the community has been a welcome addition to the group, according to Martina Chwascinska-Szarek, CNM, WHNP-BP, the group’s Certified Nurse Midwife Site Lead.

“The East Bay, and Alta Bates Hospital, has a rich history of midwifery. Midwives have been catching babies at Alta Bates since the 1970s,” Chwascinska-Szarek said. “It’s really ingrained in the culture, and Gwen and Ellie have been pillars in the East Bay birth community for a long time as Golden Oak Midwives. They understand how important protecting normal physiological pregnancy and birth is for our patients.”

Tenets of midwifery include:

· Compassionate, whole-person care

· Informed consent and shared decision-making

· Unbiased support

· Kindness, diversity, equity and inclusion

“Midwives are the experts in normal physiological pregnancy, birth and postpartum care,” says Chwascinska-Szarek. “For normal, low-risk pregnancies, every health organization now recommends incorporating midwifery care into prenatal, birth and postpartum care, and Sutter East Bay Medical Foundation has recognized that having midwives as part of the care team is integral to providing the best possible care.”

Medical director of Women’s Health for Sutter East Bay Medical Group Dr. Onouwem (Ono) Nseyo, M.D., FACOG agrees that Griffinger and Haynes joining the practice has been significant advantage for East Bay patients.

“We’ve gained Gwen and Ellie’s longstanding commitment to our East Bay patients, and the expertise they bring is helping complete the team we need to provide the 24/7 midwifery coverage that our patients deserve.” Dr. Nseyo added that 24/7 coverage has been a longstanding goal of the Midwifery Services teams in Sutter’s East Bay Market, including Milvia, Hilltop, Orinda, and Alta Bates.

One outstanding advantage of SEBMF’s midwifery model is the breadth of care available to patients, according to Dr. Nseyo, who points to the team’s ability to provide access to group prenatal care, or CenteringPregnancy, which allows patients to have extended visits in a relaxed group setting with a clinician guiding them.

“Centering is a different way to receive prenatal care,” Dr. Nseyo explained. “Women can develop a network of people giving birth at the same time who can help provide vital emotional and physical support. Not all OB practices can offer that. Expecting parents can ask themselves, ‘Do I want one-on-one appointments with my clinician, or do I want to build a network, be involved in my own care and learn all the aspects of labor and birth in a way that ends up being more enriching with a larger community?’ Centering is offered by SEBMF at our Berkeley office, and patients from our Orinda and Richmond clinics are welcome to attend these Centering sessions as well.”

There are projected plans to offer Centering sessions to patients at SEBMF’s Castro Valley location starting in 2025.

For Chwascinska-Szarek, one of most significant aspect that sets the group’s care apart is that the CNMs at SEBMF have the ability to provide full-scope gynecological and maternity care—from puberty to post-menopause. “The same person you see for your annual Well Woman visit is the same one you see for your prenatal care and for the rest of your life.” In fact, one of her “awesome” patients is 89 years old.

Another unique aspect of care available through SEBMF’s Midwifery Services is the collaboration between the Certified Nurse Midwives and the physicians. Under this model of care, even medium or high-risk patients can continue to see midwives, and if the patient’s care ever requires co-management by a physician partner, they don’t need to transfer to a different group during their pregnancy journey.

“For people who want midwifery care, very few patients risk out of our care completely,” according to Chwascinska-Szarek. “In the vast majority of cases, you can continue to access midwifery care with additional physician appointments, maintaining that continuity of care. It’s incredibly rare that patients must switch exclusively to physician care.”

She has, however, seen unfortunate cases where patients from other practices have had their continuity of care interrupted midway through their pregnancy due to risking out of midwifery care, ultimately switching between as many as four practices, because there wasn’t a collaborative care model between the CNMs and physicians. Notably, Sutter East Bay Medical group is the largest—and one of the few non-Kaiser OB practices—to offer collaborative care between CNMs and obstetricians in the Bay Area.

Another significant advantage, according to Chwascinska-Szarek, is that all patients seen by the midwives at SEBMF give birth at Alta Bates Summit Medical Center’s Berkeley campus, which offers a host of benefits, including:

• A dedication to a low C/S rate and reducing interventions
• A volunteer doula program
• Labor tubs
• Nitrous oxide for pain relief
• Commitment to protecting the Golden Hour, including skin-to-skin contact and delayed cord clamping
• Family-centered cesarean birth

“These are all standard of care at Alta Bates and SEBMF,” said Chwascinska-Szarek. “The majority of priorities that people I see people highlight when they develop their birth plans are something we offer. We also have 24/7 midwifery care at Alta Bates Hospital for labor, birth and postpartum, as well as 24/7 backup in-house M.D. care.”

To make an appointment with any of the CNMs at SEBMF, call (510) 204-5600. Click here for more information.