Is Homebirth Safe?
Studies consistently show that planned homebirth with a skilled attendant is safe for low-risk clients. Up until recently the only studies available were studies using birth certificate data which included many births that were not planned to be at home and for which the client did not have adequate prenatal care. The Midwives Alliance of North America (MANA) has been collecting high-quality data on planned homebirth as part of the MANA stats project. Studies using this data are just emerging, but are demonstrating that planned homebirth is safe. The results of two of the biggest and most recent studies can be seen by clicking here.
Numerous healthcare organizations in the UK recently came to the conclusion that planned homebirth is safer for low-risk clients than hospital birth. To read an article by the BBC on these new recommendations click here.
Is Homebirth Right for Me?
It can be hard to figure out what kind of care is right for your pregnancy and birth. I'd love to try to answer some of your questions. I offer free in-person consultations (even before you're pregnant if you'd like) and love meeting people who are interested in exploring their options.
What Does "CPM, LM" After Your Name Mean?
Vermont is a state that requires a license in order to practice as a midwife.
I am a Certified Professional Midwife (CPM) and Licensed Midwife (LM).
The CPM is a national credential awarded by NARM (The North American Registry of Midwives.) The CPM requires 2-3 years of study and clinical apprenticeship and students must meet detailed requirements and domonstrate evidence of didactic and clinical learning through knowledge and skill sign-offs either with a structured school program or with an approved preceptor and portfolio evaluation. NARM administers a test that CPM candidates must pass before earning the credential. In order to maintain the credential CPMs must meet yearly continuing education and peer review requirements. To see more about the process of becoming a CPM and what the credential means you can click here.
Vermont grants the LM based on the CPM. If a midwife earns the National CPM credential she is eligible for the Vermont credential, Licensed Midwife.
Neither NARM nor VT require an advanced degree as part of the certification/licensing process, but I hold a BA in Motherhood and Sustainable Living, and an MA in Radical Alternative Education.
What Kind of House do I Have to Live in to Have a Homebirth?
I'm surprised by the number of people who think they can't have a homebirth because they live in an apartment/live in a cabin/don't own their house, etc. Your home is your home! As long as it's accessible and safe, and it's a place YOU feel comfortable, it's a great option for a place to give birth! If you're concerned that your living space would disqualify you from having a homebirth, talk to me--I bet you'd be suprised at the diversity in great places I've attended births.
What Kinds of People Have Homebirths?
All kinds! People with big families and first-timers...single people, younger and older...straight people, gay people, cis gendered, gender queer, surrogates, people who have utilized reproductive technology...people with light skin and dark skin, with long hair and short, people from all over the world...crunchy families, republicans, people with all income levels, all types of professions, insured and uninsured...There is no one "kind" of person who has a homebirth. If you think it sounds interesting or appealing to have your baby at home, then you just might be the "kind".
What Happens in an Emergency?
Emergencies that require immediate medical attention at a homebirth are extremely rare, but they do happen. Proper screening, risk-assessment during pregnancy and birth, appropriate monitoring, and close personal care reduce the risk of encountering an emergency at home. I carry medications and equipment to stabilize client and/or baby while waiting for more advanced medical care to arrive or while in transit to a medical facility. I carry oxygen for client and/or baby, medications to help control postpartum bleeding, IV fluids, and other life-saving equipment. I maintain certifications in Cadiopulmonary Resuscitation (CPR) and Neonatal Resuscitation Protocol (NRP) which I can administer while waiting for more advanced medical personnel/equipment. Some emergencies require a call to 911 for medical transport. In some emergencies we travel by personal car to the nearest hospital. To reiterate, true immediate medical emergencies at homebirths where there has been adequate prenatal care and with a skilled midwife in attendance are extremely rare. (See studies cited above.)
Most hospital transports from homebirths involve a non-emergent need for more advanced medical assitance such as: exhaustion during labor and the need for medications to relieve pain in order to get adequate rest, need for medications to augment a slow labor after trying everything we're comfortable trying at home, meconium in the amniotic fluid (when the baby empties his/her bowels before birth it can be an indication of stress to the baby) when birth is not imminent, or early indications in vital signs that client or baby could need more advanced care at birth.
In the case of an emergency or non-emergency transfer to the hospital I will remain with you and/or your baby as long as necessary to provide support and help you navigate the situation.
Won't a Birth at Home Leave my House a Mess?
No! I ask each family to purchase supplies for a birth kit that will contain all the materials we will need to protect your home from messes. Midwives tend to be very good at using these materials to protect your furniture and furnishings. When I leave your home after your birth I leave it looking like nothing ever happened--this work will not be left for you or your family! We might create a bit of laundry, so if possible I will start the machine on my way out.
Do you Accept Insurance and/or Medicaid
Yes. I accept Medicaid and many private insurance plans. Before we begin care I will contact your insurance company to verify benefits and will be able to tell you what they will commit to paying in your specific situation, and we can work from there. I am very interested in exploring the ways we can work together within your unique set of circumstances.
What is Your Fee and What Does it Include?
My fee is $4200. This is in alignment with the fee charged by most other CPMs in Central Vermont. This includes: all of your prenatal office visits with me throughout the whole pregnancy, on-call availability 24/7 for emergencies and labor for the duration of your pregnancy, my attendance at your birth, the use of my equipment and medications at your birth, newborn care and examination, newborn screenings that you choose: hearing, metabolic, and soon CCHD, newborn eye prophylaxis and vitamin k administration if you choose, postpartum visits for you and baby on days 1 and 3, at 1 week, 2-3 weeks, and 6 weeks, and includes my fee for lab services including prenatal and postpartum bloodwork and pap tests. My fee does not include: your birth supplies ($50-$100), any vitamins and herbs I may recommend, birth tub rental if you desire ($150), or the fees from the lab to run your bloodwork or pap. My fee does not include any additional medical testing you elect or are recommended to have during your pregnancy like genetic screening or ultrasounds. Full details will be covered as part of a financial agreement that we will sign before we start care.
For clients with Medicaid: The services that are not covered by, nor billed to, Medicaid that you will be billed for total $1400. Again this fee is in line with most other CPMs in Central Vermont. A detailed list of what these services encompass will be given to you at the start of care.
If you have private insurance they may cover the entirety of my fee or they may cover only part. They may not cover my services at all. You may have a deductible. We will discuss the details of your particular insurance plan and what it will pay before we start care.
My fee IS negotiable, I offer flexibility in payment plans, and I will even consider barter/trades when you have goods and/or services that would be valuable to my family. It is my hope that every family who wants a homebirth can find a way to have one. I also need to honor the fact that my time is valuable. Caring for you takes me away from my own family. I strive to find balance and am open to creative solutions.
What Are Some of the Benefits of Homebirth Care?
Care with a homebirth midwife is personalized care. I spend time with my clients, listening, so that I can know you well enough to provide just the right kind of care to support you physically and emotionally throughout the gigantic transitions involved in having a baby. You have choices during the care for your pregnancy and birth. I educate my clients, sharing what I know, so that they can make informed choices for their families that they can feel good about. Birth at home can be a transformative experience. I honor whatever that will look like for you personally and support you through the hard and amazing parts. Clients who give birth at home rave about not having to leave their comfortable surroundings during labor, being able to tuck in to bed and sleep afterwards, not having to travel with their new baby immediately after birth, having the people they want to have in their space to support them, and having nourshing food and other familiar comforts of home during labor and the postpartum period.