How do I know if home birth is for me?
You know yourself better than any else does, so only you can answer this question. One way to ﬁnd out what you want for this pregnancy and birth is to talk to women that have given birth, both in home and hospital settings, interview a few midwives and some doctors and ask all your questions – especially the difficult and vulnerable ones. After doing this, it is very likely that you will know what you want.
What is the role of midwife?
The midwife-client relationship begins during early pregnancy. We provide continuous care and support to women throughout pregnancy, labor, birth and postpartum. Prenatal care involves a combination of overseeing the physical well being of the mother and baby, building a mutually trusting relationship, providing information and linking her with community resources. Emotional and physical safety is our priority and we are skilled at diagnosing factors that may adversely affect mom or baby. We work collaboratively with women to reduce the risk for complications during pregnancy, childbirth and postpartum and when necessary, refer the family for appropriate medical care. As midwives we honor the needs and preferences of the family, and respect the cultural, social and spiritual values of the women in our care. We support women in making fully informed, empowered and safe choices.
Do I need to have a doctor too?
We provide complete prenatal care and are able to order any testing that could be ordered by a doctor, including ultrasounds. Many of our clients see no other provider for their maternity care.
Can I have a water birth?
We love water birth – it’s such a gentle way for a new baby to emerge from the womb. Most of our moms use water in labor, though for some it doesn’t feel right to actually give birth in the tub. In certain circumstances, we may ask a laboring woman to get out of the water for birth if we feel there are extra risks to the baby.
How can I best prepare for a successful birth?
Our deﬁnition of a successful birth is one where you and your baby are healthy, safe and well cared for and that you feel empowered by your experience. It is so important that you are guiding (or being guided by) the process of your own birth – both by being supported in following your body and by being a part of any decisions that need to be made on behalf of you and your baby. Informed choice is at the center of this, as is collaboration and trust built with your care provider. Prioritizing your health during pregnancy is also essential. If ever there is a time, this is it. Treat yourself and your baby to excellent nutrition, regular exercise and physical activity, childbirth preparation class, lots of rest, spending time with other pregnant women & new mothers and including a daily practice of simply ‘being’ instead of ‘doing’- whether that is walks in the woods, meditation, breathing, prayer, yoga, dance or art making.
What about the mess?
Birth isn’t as messy as many people believe it to be! We give instructions prenatally on how to make up a bed so that the mattress stays protected from amniotic ﬂuid and blood. We also take precautions so that the ﬂoors, carpets and pillows stay clean. We use disposable underpads to help catch ﬂuids during the birth process. We clean up during and after the birth, wash all soiled sheets and towels and remove the trash.
What equipment and supplies do you bring to the birth?
In addition to our knowledge and experience, we bring appropriate medical equipment and supplies to every birth, including oxygen and resuscitation equipment, drugs to control bleeding, IV therapy and suturing materials. In many of the births we attend, we never need to use these items. We also bring a doppler to listen to your baby’s heart rate, our skilled hands and labor support tools including homeopathic remedies. We carry a scale and other items for the newborn exam and have vitamin K and eye ointment available if you choose to have us administer them to your baby.
What if there is a problem during labor or birth?
If there is a problem during labor requiring medical attention we transfer to the hospital. Hospital choices are discussed prenatally. The majority of transfers are not emergencies. By far, the most common reason is a fatigued mother due to a long labor. There are also times when we transport for issues with the baby – again, most commonly it is not an emergency, but a situation where we feel safer being in the hospital so that your baby can be continuously monitored. Typically, these births turn out perfectly ﬁne with healthy moms and healthy babies. We call in ahead of time, drive to the hospital in our own cars and are received by people who are expecting us. We can admit you to the hospital,stay right with you, help you make decisions and support you emotionally until your baby is safely born and you are both stable. Postpartum appointments then continue, as well as breastfeeding and parenting support.
How many births do you attend in a month and what if you have two people in labor at the same time?
We have about 6 moms due each month. Overlapping labors are rare, but one of the benefits of a group practice is that if two women are in labor at the same time, we can split up and at least one of your midwives is available to come to you, bringing in another midwife or nurse from the community if necessary to assist when the baby is ready to be born.
How does payment work? Will my insurance cover the services of a midwife?
Clients pay any deductibles or co-fee directly to us in advance of the birth. If you have PPO insurance, we will bill the insurance claim for reimbursement after the baby is born. We offer helpful suggestions in how to work with your insurance company to get proper reimbursement. If you have no health insurance we have reasonable rates.
What midwifery credentials do you possess?
Our practice is comprised of one Certified Nurse Midwife (CNM), a Certified Professional Midwife (CPM), a Registered Nurse (RN) and Certified Doula (CD) who together have over 40 years of experience and have attended over 2,500 births.
Do you offer a free initial consultation?
Yes, we are happy to meet with you and discuss everything you would like to talk about.
What is the schedule for prenatal care and what happens during visits?
At a prenatal visit we make sure that you and your baby are doing well. We take blood pressure, test your urine, listen to the baby’s heartbeat, palpate your uterus and attend to any necessary lab work. We get to know each other and talk about how you are doing and how the pregnancy is going. It is a time to get any of your questions answered and to share any emotional issues that arise. It is important to us that our clients understand what the beneﬁts and risks of any given procedure or test and we offer our clients full informed choice in all aspects of their prenatal care and birth.
We meet once a month through 28 weeks of pregnancy, then every 2 weeks up to 36 weeks. At 36 weeks we begin to see each other every week until your baby is born. After the baby is born we come to your home a couple of times during the ﬁrst week. Then, typically we see you again at 2 weeks and 6 weeks postpartum. This schedule can be adapted to ﬁt your individual needs and situations. During the entire relationship, we are available 24/7 for any questions, concerns or support you may need.
Should my partner come to the prenatal visits? How do you view his/her role at the birth?
Partners are invited and encouraged to be a part of care at every stage. After all, this is their baby too! Partners are welcome at prenatal visits, as it is important that their questions, concerns, and hopes for the birth are discussed during pregnancy. As midwives we are skilled at supporting partners in participating during the birth in a way that feels right for them. Some partners prefer to be directly involved while others provide background support. We view childbirth as the birth of a family and respect your partner’s unique and essential presence.
What if I can’t handle the pain?
It has been our experience that most women birthing outside a hospital setting do not ask for pain relief in labor. Rather, they look to their birth attendants for encouragement when labor takes them to the edge of what they feel they can endure. In addition to supporting thousands of women through their unmedicated births, each of us has given birth naturally without pain medication, so we know first hand what women are capable of. From the perspective of this deep trust in women’s bodies, we offer caring physical and emotional support, encourage optimal fetal positioning (to reduce back pain and shorten labor), and suggest the use of warm water (tub or shower). And of course, we honor and respect every woman’s choices throughout the course of pregnancy and birth, including the choice to use pain medications.
What happens after the birth?
After the birth we closely monitor vitals signs of both mom and baby as they recover, check for perineal tears and repair if necessary, perform a newborn exam and provide breastfeeding support. We clean up and stay for about 2-3 hours until both mother and baby are stable, fed, cozy and ready to sleep. We will see you 2 or more times in the first two weeks and then again at six weeks postpartum. We are available in person and by phone around the clock for all of your questions and concerns.