Frequently Asked Questions


are these services covered by insurance?

For homebirth clients with out-of-network benefits or a PPO insurance plan, we work with an insurance biller to ensure reimbursement at your out-of-network rate on what you have paid upfront for our services as well as lab work.

  • We accept PayPal, Venmo, cash, check, and HSA/FSA. HMO, EPO, & Kaiser insurance do not cover our services.

  • HMO & EPO will only cover specific lab work.

  • We don’t bill MediCal for birth services at this time but we do offer payment plans and a few sliding scales slots each year.

We believe our services should be accessible, and will work with you to make it happen.


Tell me about waterbirth?

Water can be a very effective tool for integrating sensations in labor. We have several inflatable birth tubs that can be borrowed for your due window and we give you instructions on set up. Following your birth, we will drain, clean, and remove it from your home.

Benefits of water birth include:

  • Relief of back pain, pressure and labor sensation

  • Warm water calms the nervous system, lowers stress hormones, and facilitates physiological labor.

  • The buoyancy of water enables your body to comfortably maintain positions for extended periods and transition between different positions more easily.

  • Inflatable tubs are gentle on the knees, and many people rest or even sleep in between surges.

  • The transition from warm amniotic fluid into warm water is gentle on the baby.

  • Birthing in water makes it easy for you or your partner to gently receive the baby into your own hands.


What do midwives bring to births?

We bring a large EMT bag to births with the same equipment available at birth centers. Homebirth clients will need to purchase a birth kit from Cascade Health.

Vitals equipment: fetal monitoring equipment, stethoscope, blood pressure cuff, neonatal scale, thermometers, neonatal / adult pulse oximeter

Medications & Herbs: Emergency anti-hemorrhage medications to stop bleeding, IV supplies, suturing equipment and medication to numb for suturing, newborn meds, Rhogam, antibiotics, herbal tinctures for labor, birth, and postpartum

Resuscitation Equipment: Oxygen tank and cannula/mask, newborn resuscitation equipment, including laryngeal mask, bag valve mask

Instruments, cord clamp, gloves, flashlight, a birth stool, blood typing kit, urinary catheterization supplies, bed pan, and more.

We seldom need to utilize most of our equipment, but we are fully equipped to handle situations that necessitate interventions when they arise. We have a hospital transport plan arranged before birth.


What happens if I need to go to the hospital?

We are trained to support a wide spectrum of labor and birth progression, as well as identify when something appears to be falling outside of our scope. If this happens, we may recommend you or your baby transfer to a hospital. If a client wants pain relief or labor augmentation - interventions that aren’t accessible in a community setting, we may go in as well. The majority of home-to-hospital transfers are non-urgent in which case we will go via personal car. If emergency services are needed, we initiate by calling for an ambulance and facilitating transfer of care upon their arrival. Whenever possible, one midwife will accompany you to the hospital, to transfer your clinical management and ease your transition. We may visit you in the hospital after the birth, and continue our normal postpartum care schedule once you are home.


When do I call/when do you come in labor?

We ask that you let us know when you are early labor but will not usually arrive until your labor is active. This enables us to organize our schedule and gives you the opportunity to rest and establish a contraction rhythm. Feeling "watched" during labor can sometimes hinder progress. Via phone support, we'll assess your labor phase based on the frequency, intensity and duration of contractions. If you utilize a contraction timer app (we recommend Full Term), you or your partner can easily relay this information to us as labor progresses. Typically, we join you during active labor, around 6 cm dilation or when contractions are 3 minutes apart, lasting over a minute, for at least an hour (sooner for subsequent pregnancies).

It’s best to ‘let labor find you’. Taking time to rest, stay hydrated, engage in gentle movement, and consume nutrient-rich foods during early labor is crucial. These actions will greatly benefit you as labor progresses, much like preparing for a marathon. Prior to our arrival, we'll stay in touch, recommend labor positions, coping strategies, and rest techniques.


 

IS MY HOME TOO SMALl? Is birth too messy, or loud for home?

We've served families in residences of all sizes, and it's interesting to note that even in spacious houses, folks in labor often gravitate towards the quieter, darker corners of their homes, seeking privacy and a sense of mammalian safety. When you consider the size of a hospital room, most homes are more than sufficient. In apartment complexes with neighboring units, some families leave a note on the door during labor or inform their neighbors in the weeks leading up to the birth. However, in reality, birth is a relatively quiet event.

Concerning potential mess, your birth kit includes a mattress protector, hydrogen peroxide for stain removal and many underpads. We take care to cover your carpeting and furniture, and leave your home tidy, allowing you to focus on bonding with your new baby. Homebirth contributes to a smaller ecological footprint, and we typically leave with only one or two small bags of trash.


Do I need to work with a doctor if i have a midwife?

Licensed Midwives are primary care providers trained to support a normal pregnancy, birth, and postpartum including the first 6 weeks of newborn care. If your pregnancy is ‘low-risk’, then it is not necessary to work concurrently with an obstetrician. If you are choosing our integrative option, you may work with one concurrently (co-care).


IS HOMEBIRTH A SAFE OPTION for my family?

 A number of studies affirm that homebirth is both a gratifying and safe choice for healthy, low risk pregnancies. “Low-Risk” refers to pregnancies without specific complications for the pregnant person or the fetus that may pose a risk to either during a spontaneous birth. In California, this category also covers term pregnancies (37-42 weeks) with a head-down baby.

Our midwives are equipped to manage rare instances where interventions may be needed in community settings. We undergo training in both neonatal resuscitation and adult CPR, and carry oxygen, resuscitation equipment, neonatal meds, anti hemorrhagic medications, and suturing supplies. While birth inherently involves some level of risk regardless of location (hospital, home, birth center, etc.) the decision of where to birth is deeply personal. We have have worked with people of all backgrounds from doctors and lawyers to musicians and farmers. Here are some resources to explore if you are considering homebirth. 

This large scale study (11,000+ home births) showed home birth with registered midwives just as safe (if not safer) than hospital birth: “Compared with those who planned to birth in hospital, those who planned to birth at home underwent fewer obstetrical interventions, were more likely to have a spontaneous vaginal birth and were more likely to be exclusively breastfeeding at three to 10 days after delivery."​ 2015 Canada Study:

“83% of all maternal deaths, stillbirth and newborn deaths could be averted with quality midwifery care… Beyond preventing maternal and newborn deaths, quality midwifery care improves over 50 other health-related outcomes, including in sexual and reproductive health, immunization, breastfeeding, tobacco cessation in pregnancy, malaria, TB, HIV and obesity in pregnancy, early childhood development and postpartum depression. 62% within the scope of midwifery show the importance of optimizing the normal processes of childbirth.” WHO: The Case for Midwifery.

“A large international study led by McMaster University shows that low risk pregnant women who intend to give birth at home have no increased chance of the baby's perinatal or neonatal death compared to other low risk women who intend to give birth in a hospital…This research clearly demonstrates the risk is no different when the birth is intended to be at home or in hospital.” McMaster University. "Home births as safe as hospital births: International study suggests." McMaster University. (2019, August 7). “Home births as safe as hospital births”

More Studies: Study on Perinatal mortality and morbidity, Outcomes of planned home births with midwives versus physicians, Outcomes of home births with CPMs in North America, Study by The Lancet, MANA study

Films:  Why Not Home, These are My Hours, The Business of Being Born, Freedom for Birth

Article: Why Choose Homebirth

Podcasts: Birthing Instincts, Evidence Based Birth, Happy Homebirth, Midwives Cauldron, Midwifery Wisdom, Birth Hour, The Great Birth Rebellion, The Homebirth Midwife, Doing it at Home, Down to Birth, On Health: Aviva Romm


Do you recommend an additional labor support person if I’m planning a homebirth? (Doula, Labor coach, etc.)

Many families hire an additional labor companion while planning a homebirth with a midwife. Labor companions (doula, labor coaches) provide educational, emotional, and physical support - their job is to guide you through the stages of labor using comfort measures, affirming language, position changes, and so forth. They will typically head to your home before the midwife arrives and leave soon after the birth. Alternatively, while there is some overlap, ultimately the midwife’s role and responsibility is primarily clinical. We arrive when you are in active labor, and stay for a number of hours after the birth.
Midwives truly value the additional assistance that labor companions/doulas offer - our roles complement each other, and we collaborate easily and effectively to give our clients well rounded clinical, emotional, informational and physical support. We especially recommend first time pregnant people hire a labor companion if it is financially feasible.