Frequently Asked Questions

1. Where are my appointments?
Most appointments are in my office.  Home appointments are an option for certain women depending on location. All women will have one prenatal and at least one postpartum appointment in their home. 

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2. How often will I have appointments?   
You will have monthly appointments until 32 weeks, every 2 weeks until 36 weeks then weekly until you deliver. There are an average of 12 prenatal visits, the birth, and three post partum.

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3. How long are my appointments?
Most of your appointments will be one hour in length. I carter to the needs of my clients and their specific needs, so some appointments may be longer or shorter.

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4. Do you offer water birth as an option?
Yes, we have a birth pool that you can borrow or buy your own. You must also provide a liner, adapter, and water hose. Or you can birth in your tub.

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5. Can I have a home birth if I have had a previous c-section?        
Yes. You will have a separate class about the risks and benefits to opt out of a repeat C/S and attempt a HBAC (Home Birth After Cesarean). You will also need to fill out an informed consent.

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6. When do you come to my home during labor?
We will come to your home when you feel the need for support, usually in Active Labor (Contractions 3-5 min apart lasting 1 min for one hour). We will labor with you and help you deliver your baby. We will stay 2-3 hours after delivery when both mom and baby are stable and breastfeeding is established.

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7. What about post-partum care?
We will return to your home at 36 hours, have a 5 day phone call, and a 2 & 6 week check up on both mom and baby. These appointments will happen in your home and in my office. 

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8. How many clients do you have that will deliver each month?
We only take 6-8 clients per month.

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9. Do you offer GYN Care?
Yes, the cost is $60.00 per visit, your insurance may pay for any lab fees.

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10. How much does a home birth cost?       
The out of pocket cost for a home birth is $3,800. A $500 (registration) nonrefundable deposit is due once you decide to home birth with us and is part of the $3,800. This holds your date as we only take 6-8 clients per month. Then $1,500 (covering total prenatal care, classes, and postpartum care to 6wks) is due prior to 34 weeks. The remainder $1,200 (birth fee) is due by 36 weeks. This is when we go on call for you. If for medical reasons you transfer out of care before 36 weeks any portion, that you have already paid, towards the birth fee, of the $1,000 is refunded. the Last $600 is paid to an assistant if one comes or to me if I serve you alone with out the help of an official Midwife assistant not including a student which may also be present.

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11. The fee for home birth midwifery care seems expensive. Can you explain the cost?
When compared to the cost of a normal, vaginal hospital birth, a home birth is a small fraction of that. It is inexpensive for the amount and quality of care received. Here’s a rough estimate of our average time spent with a client:

• 12-14 hours/prenatal visits

• 6-48 hours/ labor and birth

• 3-4 hours/ immediate postpartum

• 4-6 hours/ 4 individual postpartum visits

• In addition to that, we include the cost of on-call status of the midwife and assistants, access to a midwife by phone 24 hours a day. 

• The cost of ware and tare on our cars

• Maintaining up to date equipment.

• You are also assured that we maintain our certifications in CPR, Neonatal Resuscitation, up to date education (CEU) and certificates, memberships. and licenses

• Electronic charting systems

• Referal to MDs and Ultrasounds

• Websites & advertisements

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Each birth is a once-in-a-lifetime event. Most people budget and plan for things they really want, because it is worth it to them. Birthing a child the way you want to is as important as the special things we expect to pay out of pocket for, like weddings, cars, engagement rings, and vacations.

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12. Is home birth safe?         
Medical researchers and statisticians have studied the safety of home birth for almost 35 years. It is thoroughly documented in studies conducted throughout the United States, Great Britain and the Netherlands that home birth is safe for well-screened, carefully attended women. Home births result in lower rates of surgical intervention, fewer complications in both mother and baby, and lower morbidity (birth injuries) and mortality (death) rates.

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13. What are the benefits of home birth?

• Familiar surroundings help the mother feel comfortable and safe during labor and birth

• The mother determines the birth atmosphere, minimizing stress and fear.

• Birth attendants are considered invited guests.

• No encounters with strangers or unfamiliar places

• Less chance of illness due to exposure to hospital-borne infection.

• No awkward moves from room to room

• Few or no routine interventions.

• No separations from the people and setting that empower her.

• No arbitrary separations of mother and baby

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14. What will I need to get ready for the birth?
Your main responsibility is to have a clean place to birth. I will provide a list of supplies which you will need to obtain for your birth, I provide the birth kit, and if you are using the birth pool you will need to purchase a liner or painter's plastic.

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15. What about special equipment and sterile supplies?
We will bring all the medical equipment such as oxygen and medications used in case of a hemorrhage to the birth, as well as sterile instruments. 

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16. What about the mess? 
We will do everything to keep the mess to a minimum. Plastic drop cloths or shower curtains are placed on the bed and floor around the birthing area. You are not required to clean up after yourself. We will clean up everything. Your home will be just as clean, if not cleaner, than when we arrived. See this short story by Amanda Topping for the Birth Project III. Home Birth? What about the Mess?

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17. What position will I be in for the birth?                               
The choice is up to you. You may prefer to sit on the bed or on the floor, to stand up or squat down, to kneel or lay on your side. You can get in and out of the tub, or sit on the birthing stool. You can adopt the position of your choice. Of course we will suggest different positions to help enhance the delivery if necessary. 

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18. What about medical backup?
If we need to transport to the hospital we will go to the hospital of your choice and I will go with you as a support person. in most cases I will not leave until the baby has delivered and you have breastfed.

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19. What about newborn care?       
We do follow up for 6 weeks postpartum. We will give you numbers for the hearing screening, we do the PKU or metabolic screen in your home at the 36 hour visit.

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20. What do we do about a Birth Certificate Social Security Card?                            
We fill out the online forms for both so you don't have to worry about it. They should both arrive in

2-6 weeks. 

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21. What happens if there are two women in labor at the same time?         
We serve on average of 4-6 women per month, so two births at the same time is an unlikely scenario. However, we are prepared in the event that it does happen. Throughout your prenatal care you will also get to know my assistants; if two women need us at once, we will split up and call in another team of midwives from the area to assist at each birth.

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22. What happens if there is an emergency?
True birth emergencies are rare. Many urgent situations can be anticipated with careful monitoring of the infant and mother during labor. We have the same neonatal emergency resuscitation certifications as hospital personnel. We are CPR, BEST, BLS and NRP certified.

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23. What does “CPM” mean?
The credential CPM stands for Certified Professional Midwife. It is administered by the North American Registry of Midwives, a certifying agency created to evaluate the knowledge and skills of direct entry midwives. NARM follows the standards set by the National Organization for Competency Assurance. The CPM is the only credential available to maternity care providers which requires experience and competency in out-of-hospital birth. The CPM credential is used in the licensure process in most states that license direct entry midwives. CPMs work with healthy women having a healthful pregnancy and planning to birth outside of the hospital. Certified Professional Midwives are experts in normal birth, un-medicated, home or birth center birth, and recognizing and acting appropriately to transfer care if pregnancy or birth begins to fall outside the range of normal health. We follow recommendations  by Citizens for Midwifery – the only national consumer-based group
promoting the Midwives Model of Care!

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24. Will my insurance company pay for a home birth with a Certified Professional Midwife?
Maybe. Since a large majority of women have their babies in a hospital setting, most insurance companies don’t know how to process the rare home birth claim. If you call your insurance company with regards to midwifery care, most will tell you they won’t cover a home birth. However, some send reimbursement checks anyway. We can provide you with a receipt after 6 weeks postpartum for all services received (all prenatal care, birth, and postpartum).  You may submit your receipt to your insurance company if you wish.  Your insurance company may reimburse none, some, or all of the fee. Some clients have pursued their insurance company for explanation of refusal, and received reimbursement.

 

25. I know I can’t have any pain relief medication at home. How will you help me cope during labor and birth? What happens if I decide I want an epidural?
Because we practice midwifery and not medicine, we do not offer pain relief medication. Medications for labor pain carry risks that require hospital care. With a little self-education, childbirth preparation, and supportive encouragement, most women feel able to cope well during labor and birth at home.  We have years of experience supporting women in labor, offering words of encouragement, physical support, massage, and positioning ideas. Keeping mom and baby healthy and comfortable is our primary concern.

Being in your own familiar home provides a tremendous comfort to labor. Heat, cold, privacy, tub and shower, nourishment, closeness of loved ones, and ability to move around as you wish are the tools women use to successfully cope with labor. Being in a normal environment helps keep labor and birth normal! If for whatever reason, a client decides she wants pain relief at the hospital, we will transfer care to the hospital and accompany you, serving as a doula, in the hospital setting.

 

26. I’m thinking of having my older daughter and mom at the birth. Do many women invite people to their births?
One of the best things about having a home birth is being in control of your environment. You are welcome to invite whomever you would like to attend your birth. We will talk with you during prenatal appointments about how to plan for child care at the birth, or other people attending. Most often, women want their home birth to a fairly quiet and private event with their partner, but some women are comforted by the presence of another nurturing, supportive family member, or their older children. 

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27. Do you have childbirth education classes or do you recommend someone else?

Yes, I do give some prenatal education during your prenatal appointments. We do spread them out a little bit. We have one during the first trimester (0-12 weeks) teaching you about what are normal changes of pregnancy and what may not be normal. We also discuss diet and exercise during the first trimester. There will be one class during the second trimester (13-27 weeks) when we discuss lab tests, more pregnancy changes, and early signs and prevention of premature labor. During the last trimester (28-40 weeks) we fit in four more classes regarding signs and symptoms of labor, stages of labor, pain management during labor, the labor environment and much more. We also encourage you to do some study on your own. The more you read the more prepared and confident you will be going in to your labor. Childbirth Connection is a good start. Read books get my recommend list here. Birth Videos 1, 2, 3. Listen to Podcasts of birth stories and pregnancy health 1, 2, 3, 4. Local Classes 1, 2, 3, 4,. Victoria is our Childbrith Educator for first time moms, she does excellent classes via Zoom. 

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