Michele “Misha” James-Parham, BSW
midwife, chaplain, social worker, & educator

 

PCP CO-CARE

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While it is not a requirement for care, we HIGHLY recommend all of our clients have a co-care arrangement for themselves and their newborn as soon as possible during their pregnancy. This ensures clients have access to a primary care provider (PCP) who can order lab work and ultrasounds if necessary and have them covered by their private insurance and/or Medicaid. Having a PCP also means that there is a doctor you already have a relationship with, which makes co-care, physician consults, and possible transfer of care in the case of hospital transport much easier. 

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Having a family practice physician or pediatrician picked out and consulted with BEFORE your baby is born will help make postpartum check-ups, newborn co-care, and physician consults for your baby much easier. While it is not a requirement for care, most clients have their newborns seen by their doctor by 2 weeks postpartum, unless there is a concern warranting seeing them sooner. Making appointments and getting seen in a timely manner are more likely when clients have already chosen and met with their baby's doctor before their birth.

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We are big fans of Family Practice Medicine and practices/clinics where the whole family can be seen from birth until death. It facilitates a better relationship with your physician, as they get to know your entire family and its unique needs as a whole, complete unit. Having a family practice physician also affords you more face time with your provider, because you will be in their office more since the entire family is under their care. Family practice physicians are *typically* more accepting of alternative family structures, parenting choices, and homebirth.

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We currently recommend the following practices for clients who need a PCP or would like to switch their PCP:

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Metro Community Health Center (formerly Metro Family Practice)
1789 South Braddock Avenue #410
Pittsburgh, PA 15218
412-247-2310
Services provided: Primary Care, Family Practice, Integrated Medicine, Psychiatry, Psychology, Geriatrics, Women’s Health, LGBTQ Health, and Neurology

Payments/Insurance: accepts most insurance & medical assistance and is an FQHC offering a sliding fee scale

Comments: MCHC is well known for its competent care for queer and gender-diverse patients and is our recommended provider for our clients who need affirming care

Hospital Affiliations: Forbes Regional Hospital and UPMC Shadyside

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East Liberty Family Health Care Center

7171 Churchland Street
Pittsburgh PA 15206

(multiple locations available)

412-661-2802

Services provided: Primary Care, Behavioural Health, Dental, Medical Health, Pediatrics, Prenatal/OB/GYN, and Lab Work

Payments/Insurance: accepts most insurance & medical assistance and is an FQHC offering a sliding fee scale

Comments: ELFHCC is a Christian Ministry clinic, but they do not discriminate and patients are not required to be Christian or to participate in prayer at appointments (though prayer will be offered).

Hospital Affiliations: UPMC Shadyside, UPMC St. Margaret, Children's Hospital of Pittsburgh of UPMC, West Penn Hospital, and Magee-Women's Hospital of UPMC

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Squirrel Hill Health Center

4516 Browns Hill Road
Pittsburgh, PA 15217

(there is a location in Brentwood too)

412-422-7442

Services provided: Primary Care, Dental, Behavioural, Internal Medicine, Family Medicine, Geriatric Care, Pediatric Care, OB/GYN Services, Prenatal and Postnatal Care, Family Planning Services, Immunizations, and Lab Work

Payments/Insurance: accepts most insurance & medical assistance and is an FQHC offering a sliding fee scale & payment plans

Comments: SHHC has an amazing refugee program and will see undocumented patients

Hospital Affiliations: UPMC Shadyside, UPMC Presbyterian, Magee-Women's Hospital of UPMC, and Children’s Hospital of Pittsburgh of UPMC

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LABOUR COMPANION (“doula”)?

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While midwives have the skill set to offer the same physical and emotional support that a labour companion can provide, our first priority is the safety of you and your baby. While we do everything we can to provide you with both emotional support and physical comfort during your labour and birth, we are often tasked with needing to focus on other aspects of your care, charting, or in the case of long labours, sleeping to ensure we are well rested for the actual birth and immediate postpartum period when our expert decision-making may be most needed.

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We HIGHLY recommend ALL of our clients hire a labour companion, or at least employ the support of a close and supportive friend or relative to help tend to their emotional and physical comfort needs during labour. Early labour can be especially difficult for first-time parents who lack the experience of having given birth before and might be unsure of exactly when they should have their midwife come to check on them or come set up & be ready for the actual birth. The midwife is happy to come and check up on their clients at any point in labour if requested or there are concerns (and may return home in some cases), but otherwise, they do not typically show up for the birth until active labour is well established (in the case of distance or client history of precipitous births, they may arrive earlier than typical).

 

Our practice defines Active Labour as two or more of the following:

• contractions lasting 45–90 seconds

• contractions being 3–4 minutes apart for an hour or longer

• complete concentration & breathing or vocal toning through contractions is *necessary*

• “bloody show” with or without loss of mucus plug (having spots or streaks of blood from cervical dilation)

• cervical dilation of 6 cm or more