HOMEBIRTH FAQ

1. What is a midwife?

Midwives are health-care professionals who provide expert primary care to pregnant people and their newborns. Through pregnancy, labor, birth, and the first 6 weeks following your birth, you will be cared for by the two midwives in our practice.  We believe this continuity of care leads to a better all-around experience for the birthing individual. Midwives are experts in low-risk pregnancy and birth.

2. What is a CPM?

A Certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care.

• Please see www.narm.org for more info.

3. Are midwives the same as doulas?

A midwife is not a doula.  A doula is a trained labor support person who provides emotional and physical support to those who are giving birth and their families.  Doulas are not medical professionals, but are valuable to the birth experience and we recommend everyone hire a doula!

Your midwives are always available for you.  Ask your team who the “on-call” midwife is. Put her number in your phone and call or text with your questions and concerns.  Someone is always available to you.

4. Do I need to see an OB/GYN if I hire a midwife?

No, your midwife is your primary care during pregnancy, birth, and the postpartum. You would be referred to a hospital-based provider in the event your pregnancy or birth becomes higher risk than what is within the midwife’s scope of practice.

5.How often will I see my midwife in pregnancy?

You will see your midwife on the typical maternity schedule: Once per month until 28 weeks, every 2 weeks until 36 weeks, then weekly from 36 weeks until birth.

6. What is a typical visit like with a midwife?

Prenatal appointment take place in my office, apart from your 34 week visit which is in your home. Appointments last 1 hour, and you’ll typically see your midwife about 12 times before your birth. The first 40-45 minutes are focused on discussing your pregnancy, nutritional counseling, allowing you to ask questions, and getting to know each other. The last 15 minutes will include taking your blood pressure, measuring your fundal height, palpating your abdomen to check your baby’s position, and listening to your baby’s heart rate.  When appropriate, we also check for anemia or run other labs. We encourage family to participate in prenatal visits. Children LOVE helping the midwives! This allows the older children to feel a deeper connection to the pregnancy and their new sibling.

7. How many postpartum visits are provided?

One of the many benefits of midwifery care is the number of postpartum visits!  I see clients and new babies in the family home at 24-48 hours and 3-4 days postpartum.  We also plan a 10-14 day visit in office, and a 6 week visit in office. In contrast, when seeing a hospital-based practice, you’ll be seen in the hospital until 24 hours postpartum, then not again until 6 weeks. I find additional visits and connection greatly helps new families in the delicate and often emotional postpartum period. I am able to continue providing emotional support and make recommendations for herbs, supplements, and beyond if necessary.  I have many resources available for individuals who will benefit from therapy, as well. The postpartum can be a wonderful time, but it can also be extremely challenging. I’m here to help support you!

Midwives provide care for you and your baby in the postpartum.  I recommend you establish care with a pediatrician around the 4th or 5th day post birth, but will also continue to evaluate your baby in the first 6 weeks postpartum, referring for a higher level of care if indicated.  I remain available to you and on call 24 hours/day, 7 days/week. After 6 weeks, clients are discharged from care and will see their family doctors for any additional needs.

Another benefit to having midwives involved in your postpartum care is the wonderful breastfeeding support.  Breastfeeding success is greatly increased by more frequent evaluations and readily-available breastfeeding assistance. These additional skills are highly valuable when supporting the breastfeeding journey!

8. How long will you stay in my home after the birth?

I stay with you for approximately 3 hours following the birth of your baby (at least 2 hours from the birth of the placenta).  I make sure mom and baby are stable, breastfeeding is established (ideally within the first hour), the comprehensive newborn exam is complete, your home is cleaned (we leave everything exactly how it was when we arrived), your birth pool is drained and cleaned (if you had a water labor/birth), your laundry is pre-treated and in the washing machine, and your garbage is outside.  We also make sure you’re fed and tucked in before we leave!

9. Can children attend the birth?

Absolutely!  Children of all ages do very well in the birth environment.  I find children take their emotional cues from the adults in the room.  When a child sees their parent in discomfort, they will look towards the adults in the room for assurance.  When the child sees us quietly smiling and telling their birthing parent that they are SO STRONG (with a smile on our faces), they can confidently believe in the process.  I do encourage you to use your best judgement in regards to children being in attendance. You know your child best - if you feel you won’t be able to relax with your toddler in the room, please feel free to not have them present for the birth.  I do recommend that any child under 10 have an adult support person (grandmother, aunt, family friend, etc) also present. This person can provide care such as food and bathroom assistance, and reassure the child. They can also take the child out of the birth space or home if the birth is particularly long, or the child decides s/he does not want to be present any longer.  If you do not have a support person in your circle who can provide care for your child, we can help you find a sibling doula. I also recommend a sibling prep class for childbirth, and watching birth videos with your children so they know what to expect.

10. Can midwives order labs?

Yes!  Our practice has a lab account with two different labs.  I can draw labs in our office for you and save you a trip to your OB.  

11. Can I access my chart and records with your practice?

Yes!  I use an online charting program called Maternity Neighborhood.  You can access all notes that your midwife takes during your visits and all labs that are drawn.  I also make PDFs of your newborn care following your birth, and fax it to your pediatrician. This way your child’s doctor can follow your child’s care from birth.

12. Do you perform any tests in the first few days for the baby?  Does the baby get any medications, like in the hospital?

Yes.  I will do a congenital heart disease screening for the baby at the 24-36 hour visit.  I also perform the metabolic screen (also called the heel prick or PKU test) for babies at the first postpartum visit.

Babies are given vitamin K following the birth, if the parents choose to have it administered.  We are also able to apply prophylactic eye ointment to your baby’s eyes after the newborn exam, if parents choose.

13. How do we get a birth certificate and social security card for our baby?

Your midwife will fill out the baby’s birth certificate paperwork while at your home during a postpartum visit.  I will file the birth certificate at the appropriate vital statistics office and it will be available to purchase, online or in person.  If you choose to have one issued, a social security card will be mailed to your home 10-14 days from the date the birth certificate is filed.

14. I would like a water birth.  Where do I get a birth tub?

I have professional grade birth tubs available to rent for $100.  This rental fee includes the tub, a tub liner, an air pump, and a sump pump.  You are not responsible for cleaning the tub after birth- the birth team will take care of that for you.

15. Are you CPR and NRP certified providers?

YES!  I maintaing certifcations in CPR and NRP (neonatal resuscitation.)  It is a requirement of licensing and certificate renewal to stay current with these certifications.

16. What do you bring to a birth?

Your midwife bring all equipment needed to handle a low risk birth, and to handle the majority of emergencies we encounter in home birth. This equipment might be considered our “mobile birth center”. Anything available in a freestanding birth center is also available at your home with our supplies.

17. What happens if I am no longer low risk during my birth?

The vast majority of in-labor transports are situations in which the client is no longer low-risk, but are not emergencies. If the situation is non-emergent, such as a need for IV fluids, need for additional monitoring, or additional pain relief, you will be transferred via private vehicle to your preferred hospital.  If the situation is a more time-sensitive emergency, we’ll go to the closest hospital to you. We still typically go by private vehicle, due to the time it takes an emergency squad to arrive. If EMS has something we need, ie: IV fluids or lights and sirens, we will absolutely call. At least one of your midwives will accompany you into the hospital (you will not be left alone to fend for yourselves).

Your midwife will remain with you through your birth in hospital (barring extraordinary circumstances), and also continue care through the postpartum.

18. Can I have an epidural at home?

No. We do not offer any pain medications during your labor.  We do, however, have a range of natural pain relief options! Water, massage, CST, movement, etc. are all things we use at birth to help a birthing person cope with the intensity of labor!