Improved birth experiences through integrated midwifery care at NYU Langone Health

Although midwives have long been associated with home births, roughly 90 percent of midwife-attended births in the U.S. now occur in hospitals. At NYU Langone Health, midwives are fully integrated into obstetric care, giving patients the benefits of personalized guidance in an environment equipped for urgent, advanced treatment.

That approach shaped the experience of Juliette Sardou, who planned to deliver her first child at home until a scan during a third trimester prenatal appointment revealed that her baby had an irregular heartbeat. She was referred to NYU Langone for further testing, where an evaluation by Colin K. Phoon, MD, a pediatric cardiologist in the Pediatric Congenital Heart Center at Hassenfeld Children's Hospital at NYU Langone, revealed a twisted (tortuous) ductus arteriosus—a heart condition that would require ongoing monitoring. The ductus arteriosus is a vessel that helps circulate blood before birth.

To help ensure the safety of both Sardou and her baby, Dr. Phoon advised against having the birth at home, but he wanted to make the transition to hospital-based care more comfortable for Sardou and her partner. Dr. Phoon referred Sardou to NYU Langone's maternal-fetal medicine subspecialists and midwifery team to oversee the rest of her perinatal care.

"We knew Juliette had a strong vision for her birth experience, so our goal was to support that as much as possible while also providing the specialized monitoring her baby needed," said Dr. Phoon. "This is a great example of how we coordinate with multiple specialties to balance patient safety with an experience that feels personal and supportive."

At 37 weeks, Sardou developed high blood pressure and was admitted to the hospital for delivery. Midwives Kathryn Mulholland, CNM, and Karry K. Li, CNM, helped her maintain her preferred birth plan as much as possible, including avoiding an epidural and choosing her labor and birthing positions.

"I felt like every single midwife really had my back," Sardou said. "They handled any stressful moment with a lot of ease. They put my needs first and were also very communicative with my partner."

Sardou's son was born healthy and was cleared to go home without additional care or ongoing monitoring from the cardiology team.

"I feel so grateful for the midwives," Sardou said. "They made an overwhelming situation manageable, supportive, and joyful."

A collaborative model that prioritizes personalized care

At NYU Langone, certified midwives are integrated members of the labor and delivery team, offering patients personalized care during pregnancy, birth, and beyond. In Manhattan, patients are seen at the Mignone Women's Health Collaborative and can deliver with midwives at Tisch Hospital. Midwives also attend births at NYU Langone Hospital—Brooklyn.

"Our midwives focus on education, empowerment, and respecting the natural process of labor," said Eugenia Montesinos, CNM, director of midwifery services. "We take time to understand each person's values and preferences to create birth plans that prioritize mobility, comfort, and minimal intervention when medically appropriate."

The midwifery team works closely with obstetrician-gynecologists and maternal-fetal medicine subspecialists, allowing patients to go through labor as naturally as possible while having access to additional medical support if complications arise. The collaborative approach also means that some high-risk patients can still have midwifery-attended care.

"Patient safety is always our top priority," said Justin Brandt, MD, director of the maternal-fetal medicine division. "Because we work hand in hand with our midwifery colleagues from the start, we can anticipate needs, respond quickly when circumstances change, and make decisions together with the patient. That level of mutual trust and shared decision-making helps us deliver care that's both safe and aligned with each patient's goals."

A supportive experience for first-time parents

When Alison Ferrell became pregnant with her first child, she was relatively new to New York City and didn't yet have an established obstetric provider. She initially sought care at another practice, but each visit left her feeling rushed and unheard.

The experience changed when she transferred her care to NYU Langone's midwifery team. From her first appointment, Ferrell noticed a different approach. Visits seemed unhurried, and the midwives encouraged her to explore her priorities and develop a birth plan focused on mobility and low intervention. When answers to her questions weren't immediately available, she received follow-up phone calls.

"I felt like the care I received was better than any medical care I've ever received in my life," Ferrell said. "I didn't feel like a number. I felt like somebody that was being cared for in a very personalized way."

During labor, unexpected challenges developed, including an infection that required antibiotics. Under Montesinos's care, and with partnership from the generalist obstetrics team, each step was explained clearly, with safety prioritized alongside her goal for mobility and minimal intervention. Ferrell delivered a baby girl, Sydney, and both went home in good health.

Support continued after discharge. Recognizing that postpartum recovery can be overwhelming, Montesinos followed up with a call just to check in.

"That meant a lot to me," Ferrell said. "I felt like I was still being taken care of even though I was out of the hospital setting."

"Every pregnancy is unique," Montesinos said. "Our role is to listen, to guide, and to make sure each person feels heard—whether their journey is straightforward or involves multiple specialists."