It’s the end of a busy day at Coastal Ob Gyn & Midwifery, but the staff isn’t in a hurry to leave. They’re all circling new parents Laura and Brian Racicot, waiting to hold their 6-week-old son, William Kent Racicot. In for a post-natal visit, both parents and newborn are doing well.
“Two nights ago, he slept from 8 o’clock until 6 in the morning,” says Brian, clearly grateful for a full night’s rest.
Laura and Brian are both elementary school teachers, so they know the importance of doing their homework. When Laura became pregnant, the couple researched maternity options near their North Stonington home.
“I decided I wanted a midwife for the birth of our first child, so I could have more control over my pregnancy,” Laura says. But having access to doctors and a hospital with a NICU unit was an important consideration, in the event that she or the baby developed complications. They were thrilled to find a practice that could deliver it all.
Coastal Ob Gyn & Midwifery is a unique collaboration of providers. It is the first and only full-service midwifery practice in Southeastern Connecticut that is working with an Ob Gyn group and delivering in a hospital. As their patient, Laura was able to choose a midwife-assisted pregnancy, labor and delivery, and give birth at New London’s Lawrence + Memorial Hospital.
“It’s the best of all possible worlds,” says Joann Donnel, a certified nurse-midwife with 30 years of experience in obstetrics. “You can have non-intervention if you want it, but I have everything at my fingertips if you need it, and you don’t have to move anywhere to get it.” At 41 weeks, Laura had to be induced. She chose a balloon catheter (a natural alternative to labor inducing medications) and an epidural to manage her labor pain; the midwives easily provided her with both in the hospital’s birthing room.
Joann Donnel, Leigh-Anne Sastre, Kathalina Fabian-Fontenot and Virginie (Vivi) Eklund are at the forefront of women’s health care in Southeastern Connecticut, and the only midwives delivering at Lawrence + Memorial Hospital. All four women are certified nurse-midwives, trained and licensed in both nursing and midwifery. This is a critical distinction from other midwives who provide homebirths, but are neither licensed nor regulated by the State of Connecticut.
“Connecticut does not regulate any midwives except nurse-midwives,” explains Leigh-Anne Sastre. “It’s important to distinguish that for patients so they know that who they’re going to has been board-certified, proven, educated and is being overseen by other people.” Vivi Eklund adds, “Connecticut is actually one of the few states where midwives can work independently. We choose to work collaboratively.”
Collaboration between the nurse-midwives and board-certified physicians is at the heart of Coastal Ob Gyn & Midwifery’s state-of-the-art care.
“Our goal is to always provide the highest level of care in the most patient centered manner,” says Steven Fleischman, MD and Managing Partner of the practice. “Our true collaborative model of care with nurse-midwives and physicians working together helps achieve that goal. In order to move health care in the right direction we want all members of the team - midwives, nurses and physicians - to work together to help women achieve the care and experience they desire.”
To that end, the midwives routinely consult with one another and the doctors on all patient cases. Prenatal visits are shared between midwives so patients get to know all of the providers and are ensured continuity of care.
“We’ve all had eyes on them,” says Sastre. “We have clinical meetings where we discuss anybody who’s up and coming, and any problems that we have.” Twice a month the midwives also meet with one of the practice’s obstetricians-gynecologists to review the patients who are due to deliver during the next four weeks. And with every midwife birth, an attending physician is either in the delivery room or on the hospital floor should an emergency occur.
It’s a common misconception that midwives only deliver babies. In practice, midwifery is so much more. “Midwifery is women’s health care, from puberty through menopause and everything in-between,” explains Sastre. The nurse-midwives at Coastal Ob Gyn & Midwifery are also experts in providing women of all ages with routine and specialized gynecological care, from annual exams to family planning to menopause management. These patients also benefit from the midwives’ close working partnership with the doctors. Any woman in the care of the midwives who has unique health concerns is brought to the immediate attention of one of the physicians for consultation and/or referral.
With offices in New London, Connecticut, and Westerly, Rhode Island, Coastal Ob Gyn & Midwifery is improving the health outcomes of women throughout the region. For Eklund, this includes women who may not otherwise have access to quality health care.
“Historically, midwives in the United States have taken care of vulnerable populations,” she says. For many people, their first entry into the hospital system is with the birth of a child. Because of midwifery’s focus on education and supporting the physical, emotional and social well-being of a woman, families who have a positive experience with midwifery care are more likely to return to the medical system for future health care needs.
“The amazing thing,” says Sastre “is that if you improve the health of the mother and you educate the mother, you improve the health and well-being of the entire family.”
Midwifery is relationship-based care. When you schedule your first appointment with Coastal Ob Gyn & Midwifery, plan on spending over an hour with one of the midwives.
“A big part of our practice is really listening to the women,” says Kathalina Fabian-Fontenot. “Midwife means with woman, so we really listen to them and we try to be their advocate.” Sastre agrees. “We sit down with each of our patients before their appointments and we have an actual conversation with them, getting to know them and their history and their life,” she explains. “It’s really the relationship and the extra time spent with them that makes midwifery care truly unique.” Laura Racicot adds that the relationship between patient and provider is a special one. “I knew they would be there for me when I needed them, ” she says.
As the Racicots prepare to leave, the midwives draw them into warm embraces. But everybody knows that this isn’t really goodbye. These midwives will be with this woman for many years to come.
For more information or to schedule an appointment, visit http://coastalobgynmidwifery.com/.