1. What if there's a complication?
This is an important question. Midwives are experts in normal, uncomplicated pregnancy and birth. In order to be a good candidate for homebirth midwifery care, you must have an uncomplicated pregnancy and be in good overall health. Throughout pregnancy, we will be working together to keep you in optimum health and good balance; we will also be vigilantly screening for complications. If, in spite of our best efforts, complications do arise, and the balance required for safe homebirth cannot be restored, an individualized transfer of care plan is in place, and collaborating physicians are available and will warmly accept my clients. Although I am no longer the primary care provider, I will remain with our clients and function as in-hospital labor support. And so that I am well-equipped to handle the very rare unforeseen emergency, I carry emergency medications and equipment, and I am trained and certified in Neonatal Resuscitation and CardioPulmonary Resuscitation as well.
2. Do you accept insurance?
Not directly. I do, however, provide you with a global superbill which you submit to your insurance company for reimbursement. It's important to note that different insurance plans reimburse different amounts for out-of-network providers. Clients with PPO insurance tend to have greater success with reimbursement than clients with HMO insurance. I also employ the services of the fabulous Cole Ynda, insurance ambassador and midwifery accomplice extraordinaire. Cole is a genius when it comes to getting insurance companies to do the right thing where homebirth is concerned. She's been enormously successful in helping our families get great reimbursements, and she understands that every penny counts for any family with a new babe.
Sadly, there is no homebirth midwifery coverage through MediCal at this time. This is offensive and just plain wrong. For folks insured through MediCal, I will happily work out a reduced rate. If we just absolutely can't work something out, then certainly I can refer you to a fantastic group of hospital-based midwives nearby who can help you achieve a lovely, conscious birth in the hospital, totally covered by MediCal.
5. What do your fees look like?
I charge just under $4500 for homebirth midwifery care. This includes all prenatal care, labor and birth in your home with two qualified and licensed midwives, and extended postpartum care. Not included in that figure are visits to a backup physician, lab tests (which are billed directly to insurance) and any ultrasound or other diagnostic work.
4. What do you bring with you?
I bring a doppler for listening to the fetal heartbeat during labor, equipment for monitoring maternal vital signs, herbs, homeopathics, and various other supplies and equipment. In case of emergency, I also carry oxygen and resuscitation equipment, emergency medications to stop bleeding, IV supplies, and suturing equipment with local anesthetic.
5. Do you work with an assistant?
Yes. In fact, my assistant is another midwife. I call a second midwife to your home as labor progresses and birth becomes imminent. She comes to your birth to serve the function of an assistant, allowing you to have the highly skilled hands of two qualified and licensed midwives present for your birth.
6. What do you think about waterbirth?
I love waterbirth! Warm water in labor can make a tremendous difference for many women, and there is some evidence that water can make a smoother transition for baby. I have a list of waterbirth resources that I will happily share.
7. I live in an apartment, and I'm concerned about the noise.
Don't be. It's really not as loud as you might expect. We are conditioned to believe that birth is a loud, dramatic affair. The truth is birth is just another normal human biological process. Beautiful and amazing, yes. But also pretty quiet and kind of boring. Chances are pretty good your neighbors won't know you've had a baby until you make a formal, public announcement.
8. And the MESS???
The mess is a universal question. Everybody wonders what to do about the mess. And it's just not an issue. Because the question is universal, however, Amanda Topping, CPM, a lovely sister midwife in Michigan has put together this sweet little narrative.
9. I want my three year old son to be there for the birth. What do you think?
I think that's lovely. It's vital, though, to have an adult present just for him. Ideally, that adult should be someone who has seen birth before, so that he or she can be completely present and responsive for your son. There are wonderful books and materials for preparing children for the sights and sounds of labor and birth; I can help you find these. Rest assured that children generally do great with birth, especially when they've been adequately prepared.