I appreciate the style and sass of the Bay Area Midwives. I have used their FAQs as a template for getting these questions answered for you:
Is your space bigger than a hospital room? If so, then you are golden. Midwives have caught babies in tiny studio apartments, house boats, in-laws, attics, and mansions, too. The truth is that laboring women act like the mammals they are and tend to seek out the smallest space in the home anyway.
The noises of birth are more comparable to a good romp in the sack, unlike the birth portrayals in the movies and on TV. No matter where you plan to birth, you will probably be doing some laboring at home, and labor moans are similar to birth noises. Likely, your neighbors will be hearing your baby more than your labor.
No, birth doesn’t require the full Dexter. You will have all the absorbent materials necessary to help us protect your mattress, couch, carpets, and papasan chair. It’s a point of honor for homebirth midwives to leave your home as clean or cleaner than we found it. By the time we head out after the birth you will only be left with one bag of garbage and your placenta in the fridge for encapsulation – if you choose. We even start your laundry! The only evidence that you had a homebirth will be your baby tucked up in bed with you, and all the warm fuzzies that you get when you accomplish something incredible.
Homebirth is universal. Birth moved into the hospital in the 1940s, but midwifery has existed since women have been having babies. In 1950 50% of births occurred at home, while today only 1% of births are homebirths. Today doctors, lawyers, taxi drivers, artists, software developers, electricians, teachers, celebrities, and sometimes even hippies give birth at home. Birthing rights are human rights, and we support a woman’s choice in childbirth.
Absolutely, and Auntie Moonbeam and Uncle Rainbow too! You can invite anyone to your homebirth that you wish. It would be super rad if we could meet them before your delivery to answer any questions they have.
Sure thing! You can do it to the soothing sounds of humpback whales should you desire. Whether or not you choose to actually birth in the tub, most women consider the provision of a birth tub to be one of their best decisions. Water can be very relaxing in labor and we jokingly call the birth tub “the midwives’ epidural.” Fun fact – we provide a tub as a part of our service package!
What about safety? At the birth do you just bring your rain stick, a shaman and a drummer, and hope for the best?
Just like any other birth provider a healthy mother/baby is our primary goal. Besides their education, knowledge, skills, and intuition your homebirth midwife will come to your birth with a ton of gear to help keep the labor, birth, and postpartum time as safe as possible. I carry oxygen for mom and baby, IV solutions, medications to treat hemorrhage, resuscitation equipment to help little ones transition (if necessary), suture material (including numbing medication), and urinary catheters, to name a few. And yes, if you wish, we will burn some incense and bring the rain stick, too. Homebirth has been shown to be a safe option for healthy women and healthy babies whose low-risk pregnancies are full-term (37 weeks) at the start of labor, and who are monitored and attended by professional midwives. Check out these studies on homebirth safety: Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009 https://onlinelibrary.wiley.com/doi/abs/10.1111/jmwh.12172 Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study https://www.bmj.com/content/346/bmj.f3263 Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician, Canadian Medical Association Journal, 2009 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/
Yikes. No. Actually the worst bugs live in the hospital (MRSA, staph, etc.). Birth is never meant to be sterile unless it’s a surgical birth and then it should absolutely be sterile - in which case, please don’t attempt this at home. The germs in your home are familiar to your immune system and thus pose a much smaller risk to you and your baby.
Without the added environmental challenges of being in a hospital (bright lights, cold recirculated air, restricted freedom of movement, constant interruptions, strangers, uncharted territory, and machines that go “ping”) women tend to be much more relaxed and confident. The security of the home turf optimizes a woman’s capacity to cope with the work of labor. Also, not to be underestimated are the supportive benefits of comforting massage, freedom of movement, hot water, and your midwife’s reassurance. But, of course, feel free to bite down on whatever you like, just not your midwife. In short, medication for discomfort may only be administered in a hospital setting by a physician’s orders.
If I choose a homebirth, am I banned from the hospital, or can I still get some hospital services like ultrasounds and genetic testing if I want them?
Fortunately, I have built and maintained professional relationships with a few facilities and providers. I may facilitate any necessary utilization of hospital-based services including ultrasounds, genetic testing, and labor transfers if needed or requested. Most lab services can be drawn and ordered by me, in my office at a very low cost for you.
The current homebirth package starts at $5500 and may go up based on lab work required, birth supplies needed, medicines like RhoGAM shot for Rh- pregnant persons, or the newborn metabolic screen. A typical Homebirth care package includes all prenatal care (either in your home or an office), all basic labs (special labs not included), the birth (no matter how epic), usually a second midwife at the birth (my lovely assistant), and multiple postpartum visits for 6 weeks or more. The postpartum period is where homebirth midwifery really shines. Whereas in the hospital mothers and babies get 24-72 hours of monitoring and then no visits at all until the six week visit for mom with a single pediatric check-up for baby; I will provide full care for both mother and baby typically in the comfort of your own home. Additionally, when you hire a homebirth midwife, you are getting the benefit of continuity of care, a provider who knows you and is readily available for questions and concerns.
Though, I will accept a certain amount of trade for midwifery services (given that the product or service is needed), most families are going to pay some amount out of pocket. If you are struggling with the financial piece, I may work with you on extended payment plans or hardship discounts, or a sliding scale. Also, get creative! Ask your friends and family for a loan, put your homebirth on your birth registry, or crowd source.
If I choose a homebirth, will my child ever be documented and have a passport, or are they off the grid forever?
No, your midwife will provide with the paperwork, file it with the state electronically, and walk you through the process of getting your baby’s birth certificate. From there you can get your baby’s SSN, passport and ACLU membership.
There are many benefits of having a homebirth. Some of the ones most commonly reported by families are: Individualized care: All decisions about your care are made together with you, in detailed discussions of your needs and desires, your individual health, and the evidence regarding the options available to you. I respect you as your own - and your baby's - primary care provider. Evidence-based care: I stay current on the research around pregnancy, birth, postpartum, and breastfeeding, so that I can provide the best evidence possible for your decision-making and our skills and knowledge. Your own environment: You choose who attends your birth and who cares for you. You choose what to eat and drink. Walk, dance or sleep uninterrupted if you want to! Bonding with your baby: I hold the space for the mother-baby connection as it makes the transition from the womb to the mama's arms, to the breast, and beyond.
Most midwives offer comprehensive care during pregnancy, birth and the first weeks after the baby is born. Prenatal care in the midwifery model includes all the same clinical components as obstetric care, such as listening to the baby with a doppler or fetoscope, ordering lab work, and taking your blood pressure, and also includes time getting to know you and your health, and addressing all your questions. Postpartum care includes two to six hour-long visits depending on your midwife. Midwives also provide weight and jaundice checks for your newborn for the first 6 weeks, and most families see the pediatrician at two to four weeks of age. There are some instances when mothers may need to see a physician, such as antibiotic treatment of a UTI. My care includes recognizing clinical situations requiring the attention of an obstetrician or pediatrician and referring you to one if necessary.
Most midwives bring at least one other qualified birth attendant, sometimes an advanced student or another licensed midwife to each birth. I value and respect your desire to know who will be at your birth and strive to make sure the entire birth team has had many chances to get to know one another over the course of your care.
Midwives are trained to handle certain complications at home, and to recognize complications that mean a hospital birth is advisable and to transport in those circumstances. One of the most common complications I handle at home is excessive bleeding immediately after the baby is born, and I carry medications to stop this bleeding and use them the same way they are used in the hospital. The other, which is rare but still one of the more common complications, is a baby who needs some help to take his or her first breaths. I and my assistants are certified in neonatal resuscitation, and have experienced this scenario. Most babies in this scenario receive a couple breaths from us and then start breathing on their own very quickly. Again, in this scenario, we follow the same standards as the hospital. Our most common transport to hospital happens for a first-time labor that lasts a long time and mom nears clinical exhaustion; we go to the hospital for an epidural so that mom can have several hours of sleep and get her uterus the rest it needs - often she wakes up pushing her baby out! We also listen to the baby with a doppler during labor so that the baby can let us know that he or she is doing well; babies usually give us plenty of advance warning with a change in their heart rate if they need us to go to the hospital for their birth.
Often, health sharing accounts will reimburse for our services, and PPOs may reimburse at the out-of-network, or sometimes the in-network rate. My insurance biller will provide you a verification of benefits for a small fee when you begin care so that you may have an idea, but not a guarantee, of what may be covered. As a courtesy, I cover the cost of billing, should you choose to pursue it.
The average cost of a wedding is $24,000, and just like birth, it is a very important and emotional day. I often get to hear grandmas-to-be and sometimes even great-grandmas-to-be talk about their birth experiences, and it is very clear that birth creates a lasting impression on women that is greater than their wedding day. Mothers remember their births with deep feelings for their entire lives, and most clearly remember how their care providers treated them. Having been present with pregnant people when they tell me with awe how their birth changed them, I can say confidently that it is worth even the full amount out of pocket.
Yes. Certified Professional Midwives (CPMs) and Certified Nurse Midwives (CNMs) may practice legally in the state of Missouri since 2008. For more information on the law, you may visit http://www.missourimidwivesassociation.org/legislative.html
It is my standard of care to encourage immediate skin-to-skin for the baby and the family, delayed cord clamping, breastfeeding assistance and trouble-shooting, and a full physical exam – including weight and measurements. I also provide newborn metabolic screen, vitamin K shot, erythromycin eye ointment, critical congenital heart defect screening, blood typing, and gentle circumcision referral for families that choose or require any or all of these. I am qualified to care for and monitor your baby for their first 6 weeks of life.
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