APM has wonderful collaborative care arrangements with two different obstetricians and three different hospitals. We believe strongly that women choosing out-of-hospital birth should have easy access to medical care when the need arises or if she opts for pain relief during labor. Fortunately our obstetricians and hospitals feel the same way. One of our OB's says, "I don't care where the baby is born as long as Mother and baby are safe. And if at any time that means coming in to the hospital to give birth, we will do all we can to ensure her a good experience." We have seen first-hand that these OB's live this out and are supportive and kind to our clients.
At APM we acknowledge that sometimes normal, low-risk women need additional care either during their pregnancy or during their labor and births. In our 20 years of experience we've found that having good relations with the local EMS personnel, obstetricians, labor & delivery nurses and staff goes a long ways in making a change of birth location go more smoothly. Talking about it ahead of time, making a plan and prepping our clients also helps them transition better and have a more positive experience.
During the third trimester we encourage all our clients to consult with one of our two obstetricians and establish care. Before your visit we will send your records so they are ready to discuss your care with you. Occasionally women will need to see the OB earlier and do co-care to manage things like Gestational Diabetes, or if other complications arise. We all work together to keep you as low risk as possible so you maintain your options.
APM works closely with Chino Community Hospital (right across the parking lot), Montclair Hospital Medical Center (4.7 miles) and San Dimas Community Hospital (12 miles). All three hospitals are part of the Prime Healthcare system.
In the very rare acute emergency situations a mother and/or baby would be send directly to Chino Community Hospital Emergency Department and either treated and released or treated and transferred to another facility such as Montclair Hospital Medical Center or to the NICU at Pomona Valley Hospital.
Most transfers are not 'emergencies' and can go easily and safely to Montclair or San Dimas. We've developed relations with Labor & Delivery at both of these hospitals and have the practice to call ahead and fax the records before we even leave the birth center. Then you drive in your car, we go in ours but we arrive together and the midwives accompany you in to Labor & Delivery and remain with you until you are settled and remain with you depending on the circumstances. We always try to explain what to expect before we leave so you can mentally prepare. We're very thankful for the amazing nursing staff at both hospitals who welcome and care for our families so graciously. You won't shock them with your birth choices and they won't treat you unkindly. It's the ideal of what Midwifery care should be like!
APM has low transfer rates and even lower cesarean rates with good outcomes.
Women who transfer most often are those who have had a prior cesarean section. Our VBAC rate is 72%.
The second highest rate of transfer occurs in first-time mothers either during pregnancy when they develop complications that don't meet the low-risk criteria, or during labor. When birthing with one of our back-up OB's our cesarean rate for first-time mothers is only 9% which is incredibly low compared to national and state averages. California has averaged about 35% for many years now. We can achieve this low rate because of the wonderful collaboration we have with OB's and hospitals. When midwifery clients have good access to medical care when indicated, a few more women may transfer in to the hospital but fewer women will need drastic interventions. To put it simply, we don't wait for your birth to become a 'trainwreck' before going in and doing a c-section is the only remaining option. Overall first-time mothers have a 16% chance of transferring either prenatally or during labor/birth.
For women who have given birth vaginally before, the transfer rate is very low at 8% and the cesarean rate is 3%. The risk of a baby being transferred to the hospital is less than 3% of all births.
Some other fun stats are that we've had 58% of all our babies be boys vs 42% of boys. The average infant weight is 7.9 pounds (3586 grams), 64% of all our births have been water births and 97.3% of all our mothers and babies are breastfeeding at 6 weeks postpartum.
These figures are based on APM's MANA Stats.