The vast majority of pregnancies and births can proceed beautifully without intervention and surgery. Even more can proceed normally with the attendance of a well trained midwife. Women who are cared for by the appropriate care provider (midwives for lowest risk women, nurse midwives for slightly higher risk and obstetricians for the highest risk woman) diminish their chances of unnecessary interventions and allow themselves to grow in health and vitality throughout their childbearing year. One of the largest studies done to date to determine the outcomes and safety of home birth concluded that care by a certified professional midwife as compared to hospital based care produced the same outcomes for mothers and babies. Furthermore, the home birth group had far less interventions and surgical deliveries. Check out the study for your own research: www.bmj.com/content/330/7505/1416. Furthermore, visit Citizens For Midwifery.
The top four benefits are:
The health and well-being of Mother and baby: As a diligent, expert provider for low-risk women and babies, my outcomes are consistently exceptional with regards to patient satisfaction, minimal interventions and healthy outcomes while remaining at home.
Your care is highly individualized: The mother and her family hold the focus of power. You, based on evidence, informed consent, experience and intuition, make decisions about your health.
Your environment: You are in charge of where you birth, how you birth and with who you birth. You choose what your wearing, eating, and hearing. You choose the positions that work best for you, and if you want to be in the water tub, shower, bed, birth stool, standing, squatting or kneeling. Through the control over your environment you can decrease fear, increase endorphins and oxytocin (pain relieving and pleasure hormones) and proceed with normalcy and health. By providing your care outside of an institutional setting, obstacles to individualized care are extinguished. You can trust that your uniqueness and individuality will be nurtured and honored.
Optimal bonding: When you give birth at home you can trust that you will be the first to receive your baby and remain skin to skin for as long as you choose. This promotes a quicker initiation of breastfeeding, decreases hemorrhages, and postpartum depression. It also promotes the long-term emotional and physical health of the mother-child dyad. There is no single better place for your bonding to occur other than your home!
I have attended over 500 births. I offer a rare expertise in normal, non-interventive prenatal, intra-partum and postpartum care. I have worked as a midwife, delivering babies in the four corners for over a decade. I have also worked in high volume clinics throughout Jamaica and Haiti. Because most women choose to deliver in the hospital and become subject to routine interventions, the hospital based care providers have little or no experience in normal, non-interventive birth.
I encourage you to start care as soon as possible. I see you once a month until 28 weeks, twice a month until 35 weeks and once a week until delivery. I return to your home 24 hours after the birth, 3 days after the birth and again at day 5 if you desire. You return to my office at 2 weeks and 6 weeks. I encourage you to visit at 6 months and 1 year so I get the chance to see how your family is growing! Another benefit of my care is the great flexibility and availability I offer in the event of concerns and complications.
No. Before establishing care, you are screened and determined to be low-risk and appropriate for midwifery care. As your pregnancy progresses, my care includes recognizing clinical situations that require the attention of an obstetrician or pediatrician and referring you to one if necessary.
I draw all labs at my office. I don't promote routine ultrasounds but order them if medically indicated or requested by the mother. There are no tests available in obstetric care that I cannot provide you or help you access.
I attend all of your prenatal care, birth and postpartum visits. I believe in the apprenticeship model and often have a student present. All of my students are qualified to provide skilled assistance to me as well as supportive care to the laboring mother. Depending on the availability, I prefer two skilled midwives and a student at each birth. I value and respect your desire to know who will be at your birth and strive to make sure the entire birth team has had many chances to get to know one another over the course of your care.
Yes! I support the presence of loved ones who bring positivity and their love for you into your birthing space. I also support mothers in setting boundaries when you desire privacy.
I am trained to handle certain complications at home, and to recognize complications that mean a hospital birth is advisable and to transport in those circumstances. One of the more common complications I handle at home is excessive bleeding immediately after the baby is born, and I carry medications to stop this bleeding similar to the hospital. The other, which is rare but still one of the more common complications, is a baby who needs some help to take his or her first breaths. I am certified in neonatal resuscitation and have experienced this scenario. Most babies in this scenario receive a couple breaths from me and then start breathing on their own very quickly. Again, in this scenario, I follow the same standards as the hospital. My most common transport to hospital happens for a first-time labor that lasts a long time and the mother nears clinical exhaustion; we can go to the hospital for pain relief or further appropriate interventions. I also listen to the baby with a doppler during labor so that the baby can let us know that he or she is doing well; babies usually give us plenty of advance warning with a change in their heart rate if they need us to go to the hospital for their birth.
I aim to leave the house as clean as it was when I arrived! During your prenatal care we will give you a link to a website where you will order a "birth kit" which includes all the disposable supplies for your birth. Many of these supplies are meant to keep your house clean during the birth. While you have family bonding time with your new baby, we quietly tidy up.
Yes! Waterbirth is a lovely option for those mothers who desire it. Many families choose to have birth tubs for comfort in labor, regardless of whether the family plans to have the baby in or out of the water.
I assess and stabilize your baby as needed immediately following the birth, determine APGAR scores, etc. At about 1-2 hours postpartum we will do a full newborn exam, including weight and measurements. If you approve, vitamin K and antibiotic eye ointment will be administered at that time. I provide well baby care for 6 weeks postpartum including well mother/baby care, weight checks, breastfeeding support, and the newborn screen (PKU) which is typically done at 24 hours and 2 weeks.
Over the following 4 hours (plus or minus) my priorities are mother/baby health and wellness. I am well trained to observe and address any complications that come up at this time. More commonly I work to promote a healthy mother/child bond and encourage breastfeeding. I keep a close eye on your bleeding and assist with the delivery of the placenta. After the placenta is born and the baby's cord is done pulsing, you can request the cord be clamped and cut. I give you some space for family bonding time, while staying attuned to your needs and checking on you periodically. When you are comfortable and ready for a nap with your baby, and I'm satisfied that you and baby are healthy and stable, I tidy up and prepare to leave. I return in about 24 hours for your first postpartum visit.
My services are covered by most insurance plans, that cover out-of-network providers. I use Larsenbilling.com for my insurance billing. They help you figure out what your deductible and copay are, and will give you a printed estimate of what you can expect for reimbursement. You will be responsible for paying the total amount, by no later than 36 weeks. I will (at no additional cost) file your insurance claims in a timely manner, to help you get the highest possible reimbursement. All insurance payments will be reimbursed directly to you. HSA and Flex accounts cover midwifery care as well. Colorado Health Plan offers full coverage for home birth, with an approved provider, but Colorado Medicaid does not. New Mexico Medicaid does however cover my services. To help Colorado based families who are medicaid eligible, I offer a sliding scale through the Colorado Cares Program.