Hallmarks of My Care

DONNA TABAS, C.N.M.,
the "Science and Soul Midwife",
has developed a new model of midwifery care
that enables faster and safer births,
low cesarean section rates,
and wonderful birth experiences

Donna Tabas, CNM, M.S., the Owner and Founder of North Jersey Midwifery Care, L.L.C. that serves the women of Northern New Jersey, New York City, and Rockland County, New York has developed a new five point model of midwifery care for low risk women that has resulted in faster natural labors in both first time and repeat birthing mothers, low Cesarean section rates, wonderful birth experiences and excellent outcomes. Donna and her backup physician, Dr. Charles Haddad is very supportive of women having a VBAC (Vaginal Birth After Cesarean).  Donna is a Columbia University trained Certified Nurse Midwife with 33 years of experience with working with birthing families.  She is a solo “dedicated” midwife who has discovered that this new model of care that simultaneously combines five different components of midwifery practice (of which other midwives may only offer some) provides women birthing experiences and healthy outcomes that are safe, positive, and empowering in the safety of the hospital setting. 

THESE FIVE POINTS OF CARE FOR LOW RISK WOMEN COMBINES:

  1. Extraordinarily personalized, unrushed and extended time home prenatal care visits;
     
  2. Transforming expectations of birthing from that of Fear, Tension, and Pain to that of Power, Relaxation, Confidence, Comfort and even Pleasure through multidisciplinary methods including exposure to hypnobirthing and other relaxation techniques and discussions.
     
  3. Doula Care in labor for all her women
     
  4. Guiding and maintaining the birth as normal using the natural physiological model of birth (as opposed to the medical model of birth).
     
  5. Having a Solo, Dedicated midwife with whom mutual trust has been developed, and the guarantee of Donna being the midwife to attend your birth and her availability of continuous presence during the active stage of labor to diagnose and correct problems that might develop during birth, such as malpositioned babies, so as to return the birth to normal.

Some of these five components are utilized in other midwifery practices, but the combination of all these components together are what enables the excellent, safe, fast, and empowering birthing outcomes that the women under her care experience, with an extremely low Cesarean Section Rate.

This 5 point model of care is informed by her number one priority of a birth culminating in a healthy baby and a healthy mother, which she believes is facilitated by the motto, “Natural facilitates safety, but safety always trumps natural.”

Donna also understands that the birthing experience is one which incorporates all aspects of a woman's life, and likes to refer to herself as the "Science and Soul" midwife.

I would like to highlight some special aspects of the care that I offer and the type of services you can expect to receive if you are under my care.  Please click on each item to learn more:

I am a “dedicated” midwife, meaning that I am the midwife that you will have for all your prenatal care, the birth, and postpartum period barring extraordinary circumstances (death in family, illness, etc.).  This commitment is comforting to women, as some who use busy midwifery practices with multiple midwives may bond more with one midwife than another during the prenatal care period and will not know ahead of time who will be on call during their birth.  During the prenatal period, this solo relationship guarantees continuity of care, the ability to get to know each other in a special way, and the development of mutual trust.  This type of unique relationship is crucial to feeling comfortable and safe with your birthing care provider and decreases stress and increases reassurance and trust during the birth itself.  You will be assured that the person who knows you well and whom you have chosen to be your midwife is the one that will attend your birth.


Home visit option:  My office is in Union City, NJ.  We can have our visits there if you prefer, or, because I have all the “equipment” to complete a thorough prenatal visit at your home, we can choose home visits if you live in Rockland, Bergen, or Hudson Counties and if parking is readily available. The home visits may also include blood draws and laboratory collections if they are indicated during a specific prenatal appointment, so you do not need to make an extra trip to a lab for these services.  This is more convenient for you if you have other children, i.e., no need for childcare.  Moreover, evening and weekend appointments are available, and so if you work during the day or want your partner to be at the visit, this can happen without compromising job responsibilities.  Your partner, your children, family members, doulas, and even pets are welcome to attend!


Limited patient load:  I only take two patients due per month so that I may give the exceptionally high level of personalized, time intensive, holistic, and unrushed care that characterizes my style of midwifery.  It also helps guarantee that I will be the one to deliver your baby, barring extraordinary circumstances.  There are no long waits in the waiting room, and prenatal visit schedules can be flexible and personalized to fit your personal lifestyle.  Exquisite attention is given to your personalized needs so that you will feel that your care provider knows who you are and knows the best way to help you meet your needs and goals for your birth.


Our prenatal visits are unrushed with no time limits:  A typical visit can last up to 3 or 4 hours if desired.  It, of course, does not need to be that long!  I can and will do the typical obligatory “weigh, dipstick, measure, blood pressure, heartbeat” components of the prenatal visit, and if time is an issue, I can make our visit as brief as it needs to be.  But my 33 years of experience working with birthing families has revealed to me that women like the time to be fully informed, unrushed, and have all their questions answered fully.  We will have ample time and opportunity to discuss your personal needs and concerns, previous birth experiences, as well as the emotional and psychological aspects of being pregnant, such as potential fears and expectations for the pregnancy.   Private and soulful issues have an opportunity to reveal themselves as our discussion unfolds, which often does not happen during the typical 15-minute office visits that charcterize busy practices.  Most importantly, we have the time to develop the kind of trusting relationship that is so crucial to a pregnant woman and her midwife and so important for her birth process.


Preparation for childbirth without fear.  Over the course of our time together, I slowly help you take any negative, preconceived notions about childbirth that may be based on fear and negativity, and transform your expectations of the natural birthing process to one of sensuality, tranquility, relaxation, confidence, empowerment, and for some, even pleasure.  Many women I have cared for have described their birthing journey as one of self-discovery, self-respect and empowerment.  Giving birth as a low risk woman is a normal, powerful, natural bodily function.  Thus we try to disassociate fear from the birthing experience, which helps make it much easier for the birthing process to unfold without the need for unnecessary medical intervention. My goal is that each woman leaves each appointment feeling listened to, having her questions answered, and feeling informed about what is happening at each phase of pregnancy.  My hope is that as each woman approaches her Birthing Day, she feels confident, prepared, relaxed, and ready to fully experience all of the sensations of labor and birth without fear.


I give holistic care and fully inform my ladies about every aspect of their pregnancy and birth: Each visit will not only include the obligatory standard of care measurements and lab tests, but I will:

  • fully inform you of what each test means, why it is done, what your choices are regarding the array of prenatal testing options and their implications.
  • talk about normal discomforts of pregnancy and how to cope with them.
  • teach you about nutrition—the most important thing that you can do to have a healthy pregnancy—and review with you how you can best reach your nutrition goals in pregnancy.
  • discuss with you health promoting behaviors to help you be in the healthiest state possible when your birthing day comes.
  • give you anticipatory guidance about what to expect over the next time period until we see each other again.
  • not only feel what position your baby is in, but teach you how to know yourself so you become an empowered pregnant woman
  • show you how to get your baby into the best possible position to facilitate an easy birth.
  • help you plan for your birth, and talk about what your goals are and how I can help you reach them.
  • talk about Childbirth Education Classes, the different methods available, and which would resonate the most for you.
  • talk about the importance of doula care.
  • talk about preconceived notions of childbirth you may have and transform any negative expectations into ways to labor joyously, with power and pleasure rather than fear and dread.
  • discuss the actual birth itself and what to expect.
  • talk about the care your baby will receive in the hospital.
  • talk about anything and everything that you want to discuss -- physical, emotional, spiritual, historical, familial, and perhaps feelings inaccessible—that may possibly impact how you birth.  The more you feel comfortable sharing with me about you and what is important to you, the more I can incorporate that information into taking better care of you during your pregnancy and birth.

     
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You are welcome to contact me in between office visits with questions, concerns, etc. I want you to feel informed, empowered and knowledgeable about your pregnancy and birth. That means that I want you to feel welcome to ask any questions you may have about anything. I am very accessible, and do not want you to wonder, worry, or forget to ask about something important just because our next visit is not until three weeks ahead.


I have produced an extensive, hand-written Pregnancy Orientation Booklet specifically made for my practice that each one of my clients receive. This booklet covers everything one might need to know about being pregnant, and we use this information at each visit to guide various discussions. It is a living document, because it is updated continually as new evidence-based recommendations come out. This resource book will be yours to keep and refer to for each and every subsequent pregnancy.

 The chapters are:

  • When and How to Contact Us
  • What is a Certified Nurse Midwife?
  • Your Prenatal Visits
  • Genetic Screening
  • Blood and Laboratory Testing During Pregnancy
  • Laboratory Locations and Contact Information
  • Nutrition and Weight Gain During Pregnancy
  • Things to Avoid During Pregnancy
  • Common Discomforts of Pregnancy
  • Warning Signs During Pregnancy]
  • Safety/Self-Care During Pregnancy: Seatbelts, Sunscreen, Insect Repellent, Hair Dye, Dental Care, Immunizations and Vaccinations, Travel
  • Sex During Pregnancy
  • Working During Pregnancy
  • Medications During Pregnancy
  • Exercise During Pregnancy
  • Planning for an Unmedicated Birth / Childbirth Education
  • True Informed Consent For Epidurals & Risks of Epidurals
  • Affirmations for Easy and Comfortable Birthing
  • If You Think You Are In Labor
  • Umbilical Cord Blood Stem Cell Collections
  • Preparations For Your Birth and Hospital Experience
  • Choosing Your Pediatrician
  • Hospital Newborn Procedures
  • Postpartum Instructions
  • Resources: Book and CD list, Labor Support Doulas, Childbirth Educators, Postpartum Doulas, Lactation Support, Perinatal Nutrition, Yoga, Exercise, Physical Therapy, Counseling, Chiropractic Care, Perinatal and Infant Massage, Acupuncture, Reiki, Aromatherapy

     
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I have my own birthing tub available for rent at a minimal cost so that those women who choose to labor in the tub may do so, easily and conveniently, without conflicts of whether the tub will be available. In order to utilize the tub in labor, having a doula present is required.


I have hospital privileges to deliver babies at Hackensack UMC at Pascack Valley in Westwood, NJ, which is very familiar with the midwifery model of care for low risk births, i.e. intermittent fetal monitoring, ambulation in labor, eating and drinking in labor, labor support instead of encouraging pain medications, doula care, and physiologic birth.  They have a birthing tub for labor and remote Continuous Fetal Monitoring if that becomes necessary for labors at increased risk, allowing for full ambulation.  The staff is very accommodating regarding no separation of mother and baby postpartum, rooming in, delaying routine newborn procedures until after the first hour after birth, and waiving of certain newborn procedures if that is what the parents have chosen after having been given full informed consent.  They are very supportive of breastfeeding and have a lactation consultant on staff.  The women I have served have been very satisfied and happy with the care they have received by the hospital staff.


Labor and delivery:  As an expert in normal childbearing with a focus on promoting the natural progression of labor and delivery, I look after the mother and baby's health and provide individualized emotional and physical support to guide you to achieve your birthing goals in a warm and positive environment.  During your care I will continually and vigilantly monitor the birthing process to ensure safety, while actively helping your labor to progress naturally.  I will support the mother’s wishes and birth plan throughout labor and delivery within the realm of safety.  I will be present with you from the time you are admitted in active labor, during the delivery of your baby, and during the first 2 hours post-partum.  The same environment in which babies are made is the same environment in which normal, physiological labor can unfold most naturally, without the need for unnecessary intervention.  Therefore, I become the guardian of your birthing space, maintaining an environment in which you will feel safe, trusting, private, and intimate to optimize your state of relaxation and decrease your stress. 

There are no routine "preps," shaves, or enemas. For low risk births I encourage freedom of movement and walking during labor, unless it is contraindicated. Low risk women should be allowed to eat lightly and drink during labor. If you are low risk, there is no need for continuous fetal monitoring (being hooked up to a machine); I use the standards set by ACOG for intermittent monitoring of the baby, which facilitates free movement, unless the baby needs closer surveillance.  Because I am present throughout your labor, I can diagnose and reposition a baby in the wrong position by using specialized midwifery maneuvers.  I will assist your baby to descend more easily and naturally by suggesting alternative laboring and birthing positions and with the help of birthing balls, stools, rebozzo techniques, and squatting bars. I often encourage the use of water in the bathtub or shower to assist with coping and comfort during labor.  I utilize massage, visualizations and aromatherapy to help promote relaxation during labor. You may deliver in any position that feels right for you, as long as it is safe . I help integrate your supportive family members if you have invited them into your birthing space and/or doulas into the support given if that is what you desire.  I am also willing to be the “bad guy” and “escort” someone out of your birthing space on your behalf if that is what you want.  I am attuned to how much privacy you want versus how much support you need as you labor.

In addition to supporting your choices for your pregnancy and birth as long as it is safe for mother and baby, I may need to use medical intervention, even if it was not originally desired, to assure a safe outcome for mother and baby.  These interventions may include the use of pharmacological agents, augmentation or induction of labor, continuous fetal monitoring if indicated, and delivering a woman if she either chooses or needs to have an epidural.  All interventions that are necessary and/or recommended are fully explained so that the decisions made for intervention are based on a team approach between you and me.  I support physiological pushing instead of directive pushing.  I am trained to help keep your perineal tissues as intact as possible during birth.  Although I can perform and repair episiotomies if they are medically necessary, my episiotomy rate is extremely low.

I am expertly trained to recognize the signs of problems during pregnancy, labor, birth, and postpartum, and will consult with the physician if necessary at any point if a problem develops.  If a cesarean section becomes necessary, it would be performed by an obstetrician with whom I have consulted during the labor.  I would accompany you and your partner into the operating room and continue to advocate for you to bond, touch and be with your baby as much as is clinically safe and appropriate during the surgery.  I would accompany you through your recovery period to preserve the parts of your birth that can still be normal, like breastfeeding and bonding and taking care of your baby.

I, as your midwife, would continue my care for you through the birth, the in-hospital post-partum period, and through the six week post-partum period that follows, as I would for any birth.