Alpha Feto Protein
The alpha feto protein test measures markers (hormones) in the maternal blood that could indicate abnormalities your baby may have, specifically-neural tube defects (such as spina bifida and anencephaly) and chromosomal abnormalities (such as Down Syndrome). The test is a simple blood draw from the mother sometime between 15-20 weeks gestation, with 17-18 weeks the ideal time. For those making the decision to have the alpha feto protein test done, it is important to remember is this test is a screening test, it does not make a diagnosis. A positive screen means more tests need to be done, usually an ultrasound or, rarely, an amniocentesis. At the same time, a negative test does not guarantee the baby will avoid such problems.

The alpha feto protein test is far from perfect. The test's biggest problem is its high false-positive result-the test comes back abnormal and the baby really is not abnormal. Factors that can result in a false positive result include incorrect dating-pregnancy is more or less advanced than thought, or it is a twin or triplet pregnancy. Age, race, and weight can also affect results.

A positive or abnormal test result can cause woman or couples much stress and fear, as they will think their baby is at risk. Some question whether these emotions affects pregnancy negatively.

It is important to remember that the alpha feto protein test is optional-one can choose to not have it done. When deciding whether to take the test, you should consider what you will do with the results. Some women/couples choose not to have the test done because they would not chose an abortion and do not want to think of their baby as "abnormal" throughout the pregnancy. Other couples are already planning on having an ultrasound done and do not see the need for an additional test that is so uncertain. Talk with your midwife or doctor, they can provide information to help in the decision making process, and will support the final determination.

Is there a point in my pregnancy that it's too late to transfer care and give birth at the birth center?

It's almost never too late to transfer, but the earlier the better as it allows you and the midwives time to get to know each other. Sometimes women/couples will stumble on information about the birth center and become interested in the options we can provide that are not available at any other facilities. Other times they are actively looking for a change in providers.

They want more options offered to them rather than being told what the routine is and how it will apply to them. The birth center is a safe option, but sometimes the decision to transfer care providers can be tough.

In order to give birth at Bethany Birth Center you must transfer your care to one of the five certified nurse midwives at Bethany Women's Healthcare.

One way to start the transferring process is to make an appointment for a consult to meet with a midwife. You can ask questions about our practice and the birth center. It gives you a chance to talk about what you're looking for in a provider and birth setting and we can help you decide if the birth center is right for you. We will also review your history so bring a copy of your records if you can, if not, we will obtain a copy after you transfer care. The birth center is available to all normal, low risk women. There have guidelines in place to assure that women get the care they need in labor and delivery, either at the birth center or at the hospital. After the consult you will have a good idea which birth setting is best for you and your baby.

You should also talk with your insurance company to find out about your benefits. Many insurance companies cover the birth center, but not all. Some who do not cover it may have an appeal process to try and get coverage.

Some women start the transfer process by attending a birth center orientation. This is an excellent chance for you and any family members to get information. The orientations are held on the first and third Wednesday of every month at 7 pm., anyone considering the birth center is welcome. Barb, a RN on staff, talks about bight centers and midwives and shows a video. There is plenty of time for questions before a tour of the bight center.

Women and their families need to feel safe wherever they decide to give birth, that place is not the same for everyone. The birth center offers a safe alternative to those that decide the hospital or home will not meet their needs., and the birth center is available to you.

The traditional way to compute an estimated due date is to use the date of the woman's last normal menstrual period. By adding seven days to this date and going back three months, we get a basic idea of the expected date of birth. This date, however, is just that, an estimate. Only about five percent of babies are actually born on their due date. Approximately ninety percent will be born between one week before and one week after that date.

This sounds like a good way to guess a baby's birth date, but it is not always accurate. If a woman has irregular or long menstrual cycles or simply cannot remember, it gets a little trickier. The nurse-midwife or physician will also use other signs such as the size of the uterus, whether we can hear the baby's heartbeat at the ten-week point, the time the woman begins to feel the baby's movement, and perhaps an ultrasounds can. These signs coupled with what the woman tells us will help us arrive at the best estimate of baby's birth.

Why do some babies come early and others late? Many factors and variables affect early or pre-term birth. These may include maternal infection, cervical problems, baby infection, or a history of a previous premature baby. A provider will encourage rest, treat infections, and sometimes prescribe medications in an effort to delay a very early birth. The closer to thirty-six weeks we can get, the less risk for the baby.

How about the "late" babies? Normal pregnancy, by definition, goes to forty-two weeks. This means about two weeks past the estimated date of delivery. For an expectant woman, this can feel like an eternity. It becomes even more trying when well-meaning family and friends phone the woman daily to ask, "Are you still pregnant?" Combined with the discomforts of late pregnancy, this pressure may cause the woman to believe that there is something abnormal about going past that estimated date. Some providers will begin to talk about inducing labor at the due date, but we will prefer to allow each woman adequate time to begin labor on her own. Allowing this normal time frame reduces the risk of prolonged induction, increased cesarean section rate and possible fetal distress due to the induced labor. Early induction assumes the baby is ready. What about the baby who is really not due yet, but now we have forced the issue. These babies are also at greater risk.

It is true that some babies are at risk when the due date passes. For this reason the provider will instruct each woman in baby kick counts. The mother is the best person to tell us if there is a change in her baby's behavior. We may also do tests like the non-stress test or biophysical profile to assess the health of the baby. Like ultrasound, these tests are limited in their accuracy, but they can helpful. Of course, if a baby shows any sign of not tolerating pregnancy labor will be induced in a timely fashion.

How labor is induced is determined by the estimated weeks of gestation, the softness and effacement of the woman's cervix, the descent of the baby, and whether there is any dilation of the cervix. We may use prostaglandin gel intra-vaginally to soften the cervix, pitocin in an IV solution or we may do artificial rupture of the membranes. It is important to speak to the provider regarding the risks and benefits of each method of induction. It is often the advice of the provider to choose the method of induction that will allow the most freedom of mobility to the woman and the least risk to the baby. Sometimes the quickest method is the most uncomfortable and bears more general risk. We may also recommend more natural or physiological forms of labor stimulation.

Because labor and birth are very "unscientific" processes, women today still give birth both before and after their due dates. It is important to remember that we do not always have control over birth. Be sure to speak to your individual provider about your concerns and thoughts about your pregnancy and birth plan.

Another contraction, I told myself "Don't look at the clock Julie, don't look." Ten minutes passed, I stayed in bed and waited. Another contraction came and I told myself again, "Don't look at the….." This time eight minutes passed since the last one and I thought to myself, "this must be the real thing."

I decided to get out of bed and wait for my husband to return from work. I was anxious to tell him today was the day, and I was determined that today would be the day.

Time went on, and by 10:00am I hadn't felt a contraction for the past30 minutes. I was so disappointed! How could I get my hopes up so soon? I thought to myself, "Maybe the contractions will return. I'll just rest a while." After a couple more hours passed by, there were still no contractions, but I was just sure they would return. I made myself some soup and finished the laundry, the house had to be in tip-top shape for my little one.

3:00pm rolled around…..what was that I felt? A contraction! But, this one is much more intense that the others, "This is it; I know it!" Sure enough, the contractions started coming every five minutes now and with more intensity each time. Since my husband, Nick, works evenings and sleeps during the day, I decided to wake him up. He helped me into the tub and timed my contractions; they were now three minutes apart. It was time to call the Birth Center.

So, off we went! I was excited and relieved it was finally underway, yet I was over-whelmed by the pain. Did I really think I could do this thing without drugs?

By the time I checked into the Birth Center I was four centimeters. "Four centimeters? Is that it!" I thought for sure I was at least six centimeters .I was determined to have this baby in record time.

After spending an hour or more in the whirlpool, I was checked again .I thought I would be pretty far along by now… so I thought. "What? Five centimeters!" I was in for a lot more pain than I anticipated.

I tried to concentrate with every contraction. I imagined the feel of the Ocean's sand on my toes. I visualized my arms around my dog, his soft fur coat touching my face. I tried not to look at the clock, but I remember seeing the hours pass by and wondering, "Will I be in labor forever?"

I tried different positions to ease the pain…on the bed, on the toilet, on my knees…anything to make me more comfortable. My husband tried all he could to help me relax. He would say to me, "Breath deep honey, breath deep." And it worked, for a while. Eventually the contractions stopped, but what followed was like no paid I had ever known or imagined. It was one long contraction that had me believing I would surely die. My midwife said that I must be in transition, and I thought to myself, "Transition? More like Hell." She checked me again, and this time she informed us I was at seven centimeters, FINALLY.

At this point my water still had not broke, so my midwife broke it for me. Transition continued, and the thing I swore I wouldn't do in labor I did. I started to scream, "God, this hurts! Help me! I'm dying!"

Finally, I felt the urge to push so I told my midwife and she said, "Go ahead." I got on all fours and pushed. At first it was a relief, but eventually it felt like my bottom was on fire. The nurse suggested I lie on my side. She helped me to bear down, and I pushed, and pushed, and pushed!

I kept hearing "I see the head, you're almost there." I told them, "You've been saying that for hours," I yelled, "How much longer?" The nurse offered me a mirror to see the head, but all I could think was "God, no, I just want him out!"

I continued to push. My midwife told me I needed an episiotomy, and at that point I just didn't care. I told her, "Go ahead, just get him out."

Snip, snip, I didn't feel a thing. I pushed again, then one more time and…"Whaa!" My son was born! They placed him on my chest and I felt a great sense of relief. It was finally over and even though my baby was crying I felt a sense of calmness. My husband was in tears. I knew what he was thinking, that his parents sent an angel to us from above. It was a moment I will never forget.

A few hours later I dressed my son, and myself, and we left the Birth Center. I was a mom. It was weird, yet strangely familiar and I wasn't nervous. I didn't feel awkward, it all seemed natural, and looking back I guess I should have known that, after all, some things in life should come naturally.

The segments featuring Bethany Birth Center were taped this past winter. They include two deliveries, one at Bethany Birth Center and a second at a Phoenix hospital. Both deliveries were normal, uncomplicated births that were attended by a Certified Nurse Midwife (CNM). The Bethany Birth Center story features a water birth in which a CNM guided the mother through one of the most unique experiences in childbirth.

While a water birth may not be for everyone, the staff of Certified Nurse Midwives and OB-GYN physicians at Bethany Women's Healthcare work daily to create individual plans of care designed to empower parents with the knowledge and skills they need to manage childbirth.

"Discovery Health Channel viewers will see the birth experience as real teamwork that brings family members, midwives and nurses together in an experience that is truly spiritual," said Lylaine Gavette, a CNM who is one of the founders of the birth center.

"Free standing" birth centers are delivery settings that are either unattached from or located outside a hospital. The Commission for the Accreditation of Birth Centers accredits all birth centers. Birth center care is covered by most major health insurance plans including AHCCCS. Birth centers are becoming more popular with pregnant women and their families because they offer the opportunity to create a plan of care that gives the mother more involvement and control in decision-making about their birth. Care is individualized to each woman's needs and plans. Since opening 8 years ago, Bethany Birth Center has been home to nearly1000 deliveries. Even more were completed at the Center's associated hospitals.

"We've seen the value of the birth center experience play out over and over the past eight years," explained Dr. Alan Schapker, founder of Bethany Birth Center. "It's exciting to share that experience with a television audience here in the Valley and around the world. We feel honored that Discovery Health Channel chose us to showcase the birth center experience."

Birth Day is seen on The Discovery Health Channel, and sets the standard for health -related, high-quality, reality-based television. Stories and medical information are shared with viewer through the voices of the parents, midwife, and or doula throughout labor and delivery. Valley viewers will have five opportunities this summer and fall to see the program, including twice on the June 13th premier:

June 13 8:00AM & 1:00PM
June 16 8:30AM
August 30 1:30PM
September 25 8:00AM