Why midwifery care?
Childbirth is a miracle and for the majority of us, it’s a normal, straightforward life process. For this normal miracle, it’s midwives who offer the most experienced care. Midwives are trained professionals with expertise in supporting individuals to have healthy and confident pregnancy, birth and postpartum experiences.
I offer personalized care, education, counseling and support throughout the childbearing cycle. I work with each family to identify their unique physical, social, psychological and emotional needs. I recognize if things are not progressing normally and offer essential response and guidance.
From Midwives Alliance of North America (MANA):
The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:
- monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
- providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- minimizing technological interventions and
- identifying and referring women who require obstetrical attention
Is Homebirth Safe?
The best evidence available shows that a healthy person, giving birth at home with a qualified midwife, is as safe as giving birth in hospital. What is also known is that, in low risk situations, along with homebirth being as safe as hospital birth, there arefewer interventions with homebirth and the incidence of birth injury, physical & emotional trauma, infection and cesarean section are reduced.
It is also known that when an individual is treated with dignity and their self knowing and body’s innate intelligence are respected the personal fulfillment and empowerment experienced is tremendous. A positive pregnancy and birth experience can make a significant difference with the transition into parenthood.
"Birth is not only about making babies; birth is about making parents – strong, competent parents who trust themselves and know their inner strength." - Barbara Katz Rothman
Women choose homebirth because:
- Pregnancy and birth are a normal body process; not an illness or medical event that automatically requires hospitalization and medical interference.
- You get to choose what is right for you and your baby.
- You have the comfort and familiarity of your own private home environment.
- You are surrounded by those you love - you can choose who you would like to have at your birth.
- No strangers come in and out of the room and there are no shift changes.
- There is continuity of care with a trusted midwife who you get to know during prenatal visits and who attends your labor and birth and provides postpartum and newborn care.
- You are not "on the clock" with time limits.
- You are free to birth instinctively by listening and responding to your body's natural signals.
- You are encouraged to move, eat, drink, labor and birth as you want.
- There are no routine, unnecessary interventions, monitoring, checks and IVs.
- You are never separated from your baby. The newborn exam is done in your bed.
- The majority of complications of childbirth are due to medical interventions. By lowering interventions in birth, there are fewer opportunities for complications to be created.
- There is a much lower chance of having a surgical cesarean birth.
- There is a much lower chance of infection.
- With uncomplicated pregnancies, birth is as safe at home as it is in a hospital.
Am I a good homebirth candidate?
You don't have to be super human or exceptionally brave, you just have to want this!
Consider the following questions:
- Are you committed to being healthy?
- Are you interested in learning more about your body and birth?
- Do you want to be a part of the decision making process for your care and your baby’s care, with knowledgeable, supportive guidance?
- Do you trust yourself or do you want to develop a deeper trust in yourself.
- Do you want your mind-body-heart-spiritual connection to be honored in your birthing process?
- Do you want to birth your baby in your way?
- Do you want uninterrupted time with your newborn?
- Are you ready to know wild and unbreakable aspects of yourself?
If you answered yes, then homebirth with a midwife is likely ideal for you
Hospital based medical care may recommended if you are working with certain conditions. We can discuss your personal situation at your consultation visit.
What happens during prenatal appointments?
Appointments are scheduled to allow plenty of time to answer questions and discuss all aspects of your pregnancy. We spend time talking about questions, concerns, the decisions you face and the benefits, risks and alternatives of the options you have. At every appointment I check your blood pressure, measure your uterus and test your urine. I listen to and feel your baby, checking baby's position, growth and heart rate. We take time to talk and get to know each other, so that I can best understand your strengths and challenges in order to support you well.
When do I begin care?
You can begin you care as soon as we agree to work together! The baby’s heartbeat can first be heard, with a doppler, at about 10 weeks. Statistics show that women who start early prenatal care have fewer complications and better outcomes.
Do I need to see an OB as well as a midwife for my prenatal care?
Concurrent care is not necessary. I provide complete prenatal care and offer all the standard testing options and discuss a full range of treatment options. If you have been seen by an OB already, to transfer your care, make a firstappointment with me and then get a copy of your medical records from your previous provider.
If a high risk situation arises, I will refer you to an appropriate physician or you may visit a doctor of your choice.
What if something goes wrong in pregnancy?
I check on you and your baby's wellbeing at every prenatal visit. I am trained to recognize signs of complications as they arise. If something comes up that is a cause for concern I recommend testing to rule out issues necessitating medical care. If complications develop during your pregnancy that are outside of my scope I refer you to an appropriate medical provider. Examples of this include developing pre eclampsia, pre term labor and gestational diabetes that can not be regulated with dietary changes.
How will I manage the pain?
Having a birth is an intense and challenging life event. While it can definitely be painful, most people’s relationship to pain can be greatly affected by the environment, their relationship with their care provider and by how safe they feel. Evidence shows that unnecessary interventions, foreign environments, being surrounded by strangers, restricted in movement and being hungry & thirsty all contribute to increased pain. By choosing midwifery care and homebirth you are avoiding many of the situations that cause the intensity of childbirth to be overwhelming & unmanageable. I encourage the use of non-pharmaceutical methods to support labor:
- Doula care
- Continuous physical and emotional support
- Showers and birthing tubs
- Freedom to be in any position
- Birthing stool, yoga ball and other tools/props
- Herbs and homeopathic remedies
- Acupressure & acupuncture
- Food and drink
- Mindfulness practice - cultivating compassion, acceptance, curiosity, investigation
- Breathing techniques
- Privacy in your own home environment
Can I have a waterbirth?
Many individuals choose to labor in a tub and some also give birth in water. There are pros and cons to birthing in water that we discuss during prenatal visits.
What supplies do I need to have a homebirth?
I give you a list of items to purchase and assemble. These include a birth kit, that you order online, and things that are readily found in your home like a bowl, towels and plastic bags.
What do you bring to a birth?
I carry instruments and supplies for the birth which include the standard equipment for monitoring a woman and her baby's wellbeing, medications to stop hemorrhages, IV equipment, suture material and local anesthetic. I am trained in resuscitation and life support and carry oxygen and resuscitation equipment. I also bring herbs and homeopathic remedies.
What if I have to go to the hospital in labor?
In almost all cases there are warning signs which occur before a problem develops allowing for non-urgent transfer to a hospital in your own car. Examples of why a non-urgent transport could be necessary include maternal exhaustion and the baby’s heartbeat indicating fatigue. In these situations a transfer is relatively seamless; Icall the hospital to let them know we are coming and provide a copy of your chart to the staff. I stay with you, until after your baby is born, and help you to understand what your options are, supporting you within the hospital setting. Upon discharge your postpartum care will continue as planned.
What if there is an emergency during the birth?
In the case of an emergency a call to 911 is needed for urgent transport by ambulance. Very rarely a problem occurs without warning. I am skilled, experienced and prepared for all complications, and have the equipment to handle emergencies. I carry oxygen and suction equipment, can provide intravenous infusion (IV) and have emergency medications readily available. I plan for a second licensed practitioner to be present at your birth who is also trained in infant resuscitation. A transport plan is made prenatally, should a complication arise that cannot be managed at home.
If something comes up in your pregnancy, labor, birth, or postpartum that indicates it would be safer to be in a hospital setting, we don’t hesitate to go.
Who may come to my birth? Are children allowed? Pets?
You may have whomever you choose at your birth. My suggestion is that you invite others to attend who trust the birth process and with whom you feel safe and can open up.
I welcome children of all ages at your birth! I recommend that your child have an adult present who is responsible only for them. We discuss having siblings present at the birth during the course of your prenatal care.
If you think your pet may need special attention while you're in labor than arranging for a pet sitter is a good idea.
Is homebirth messy?
Birth is usually not very messy. Fluids are caught with underpads or in the water (in the event of waterbirth) and all will be cleaned by the time we leave your home.
What happens after the baby is born?
You get to be with your baby! I discretely monitor you and your baby to make sure the transitions are going smoothly and that both of you are thriving. During this time breast feeding begins, I do a newborn exam, give you stitches if necessary, clean up, get laundry started and catch up on paperwork. After you have peed, showered, eaten and been tucked back into bed with your nursing baby I go home. I leave all the necessary instructions and paperwork you'll need to register your baby's birth.
Do I need to take my baby to a doctor after birth?
Midwives specialize in normal, healthy newborns and provide regular care for the first few weeks of your baby's life. I encourage you to choose a care provider (family practice, pediatrician, naturopathic doctor) ahead of time in case your baby needs additional assessment or care in the first few weeks after birth.
How many birthing families do you take each month?
I take 2 clients a month, which allows time for unhurried care as well as time for other passions in my life!
What about cost, does insurance cover homebirth?
A deposit is due upon agreeing to work together and the fee is paid in full by 36 weeks. Payment plans are available. Many PPO’s will cover a significant portion of the fee. HMO’s will not cover homebirth. I am contracted with a billing service who will verify your insurance benefits, obtain any necessary referrals or authorizations, and request an in-network exception for out-of-network providers. If the exception is granted, the services will be reimbursed at the in-network rate, regardless of whether the midwife is contracted with your insurance company.
What is included in the fee? Are there extras/hidden costs?
Everything that I do is included in the fee. Lab processing, ultra sound fees may be covered by your insurance provider or may be out of pocket expenses. Birth tub and homebirth supply kit are rented and purchased by you.
How will I get a birth certificate for my baby?
After birth I will provide you with all the required paperwork and instructions to register your baby. You make an appointment with the Office of Vital Records and Statistics. All you need to bring is your baby, a witness (your partner), the paperwork and a valid photo ID.
What's the difference between an LM, CPM and a CNM?
Licensed midwifes (LM) are trained in homebirth and/or birth center settings andlicensed by the California Medical Board. They complete a three-year postsecondary midwifery educational program accredited by an organization recognized by the United States Department of Education and complete a comprehensive Licensing Board Examination.
Certified Professional Midwifes (CPM) are trained in homebirth and/or birth center settings and have met the requirements for certification set by the North American Registry of Midwives (NARM). CPM is an international credential that requires skill, experience and knowledge in out-of-hospital birth and practices within the Midwives’ Model of Care.
Certified Nurse Midwives (CNM) are trained in hospitals. They are registered nurses who have graduated from a nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) and have passed a national certification examination.
How far will you travel?
I attend births all over the Bay Area in California.
Can I meet in person to ask questions?