Collaborative care: what you need to know!

Cara Wolf Patient Education

Understanding the particulars of how an ob/gyn practice works can be confusing! You probably have some questions:

Who will I see for my visits?

Where will I have my baby?

Who will be there when I have my baby?

Can I pick my midwife?

Will I know the person who attends my birth?

Will students or residents be involved?

Who do I call when I’m in labor?


Here is what you can expect from Regional Midwifery:

Regional Midwifery is a 6 midwife practice that is shared between Durham Women’s Clinic and Chapel Hill OB/Gyn. We see patients in all 4 office locations (Durham, Brier Creek, Chapel Hill and Southpoint), so you have the opportunity to receive care in the office most convenient for you.

Our team delivers exclusively at Duke Regional Hospital (DRH). While we share the Duke name, it’s a smaller community hospital with experienced nurses and personalized care. The nurses at (DRH) are well trained in low intervention birth, the work with you toward your birthing goals. The nurses also have extensive training and experience with epidurals and other interventions that may become necessary. Since the health and safety of mother and baby is our number one goal, the entire team is well trained to handle emergencies with 24/7 in-house anesthesia and neonatology.

Our team ALWAYS has a CNM and a physician (from Chapel Hill Ob/Gyn or Durham Women’s Clinic) on-call at DRH 24/7/365. We rotate 24 hour call-shifts from 7:30am to 7:30am. We do 1-2 call shifts/week, and we’re all used to it!  This means you can have the extra support and attention you need through labor and birth from your midwife, but know that a physician is present on the unit and immediately available if needed. We work together, and we all really like each other! We respect each other’s areas of expertise, and are always learning from one another. If you plan midwifery care, the on-call physician may pop in to say a quick hello, or you might not even see them! Be assured that your midwife communicates regularly whether things are progressing normally, or if complications develop.

What to expect at time of birth:

We are a private practice. Patients are cared for by either the on-call midwife from Regional Midwifery or the on call attending physician from either Durham Women’s Clinic, or Chapel Hill Ob/Gyn. Your L&D nurse will be present, and a nurse assigned to care for your baby. If risk factors are present, other staff will be involved to provide extra support as needed. Sometimes DRH has student nurses working with the L&D staff. This means extra support for mom, but it’s always your choice to work with students.

For cesarean births, the physician on call for our team will be performing the procedure, they will utilize either your CNM or if she is unavailable, may elect to use the Duke Ob/Gyn resident to assist. We offer family-centered Cesarean births, with skin-to-skin in the OR, the option of a clear drape, and continued rooming in for mom/baby.


What to expect with CNM care:

If you plan midwifery care, we encourage you to meet all the CNM’s during your prenatal course, that way you’ll have had the chance to meet all of us before the big day! Your baby will pick which one of us is attends your birth. We like to think you get the midwife you need… which may not necessarily be the one you thought you wanted! We hear this over and over from our patients. “Cara, or Sue, or Leigh Ann, etc. was just what I needed!” Our personalities may be different, but our practice styles are all the same.  Our practice is dictated by clear evidence-based protocols. A list of our standard practices is on the first page of our Birth Plan Template.


When to call:

Like we said, a CNM is on call 24/7, so if you experience an emergency or you are in labor: call Duke Regional Hospital and ask for the midwife on-call at 919-470-4000. The operator sends us a text page (yes, we still wear a pager!!) with your name and phone number. It is routine to get a prompt call back, if you don’t receive a return call within 20 minutes, please call back. It is our duty to discuss your concerns and come up with a plan best suited for you and your needs.


What makes Regional Midwifery special:

We are proud of the care we provide to families in our community. Having a cohesive team means we can share responsibility for work we love as well as have with our own families.

Our team has a low cesarean section rate and a high VBAC (vaginal birth after cesarean) rate; this is in part due to the environment we have created with our MD colleagues. Our collaborative care model and community hospital setting provides safe care and a personalized positive experience for one of life’s most important events.

We love what we do, and we love being a part of your care! See you soon!