Q) At what time in my pregnancy should I begin care with a midwife?
(A) You can make an appointment for a consultation anytime you choose, just give us a call. We want you to have the opportunity to ask your questions without any obligation. We can go over nutrition, exercise and lifestyle changes that can help support a healthy pregnancy. You can choose to have a MicroNutrient Panel done to check the status of your nutritional needs. At BioBirth consultations are completely free.
Once you become pregnant it’s important to make that first appointment to begin prenatal care right away. Some midwives fill their schedules quickly and you may not get in with the midwife you choose.
(Q) I never know what to purchase when I go to the health food store, do you offer prenatal vitamins?
(A) Yes! Here at BioBirth we offer high-quality professional supplements from Designs for Health and Biotics Research. You can pick them up here at our facility or order online and have them drop-shipped directly to your home. (https://biobirth.ehealthpro.com/)
(Q) I am single and have chosen to keep my baby, will you accept patients like me?
(A) YES! We do not discriminate! We welcome everyone regardless of your family structure, culture, ethnicity, religious beliefs, sexuality, or traumatic background. We look forward to getting to know you and your individual needs and desires for your pregnancy and birth.
(Q) Is it safer to have my first baby in a hospital?
(A) Women will have greater success in having a normal birth where they feel comfortable and supported by knowledgeable providers. Where you give birth is your choice. Call and book a tour of our facility to see if this is right for you.
(Q) What kind of records do you keep; paper or electronic?
(A) Since BioBirth Birth Center is a teaching birth center we make sure our intern midwives learn both paper charting and electronic charting. Another reason we keep paper charting is because we live in a hurricane zone. If the internet or power is out we still have access to your records to assure you seamless care. On that note, our building has been able to withstand the wide variations of south Texas weather since 1981 when it was first built.
(Q) Can I get testing done to determine if my baby has Down Syndrome or some other problem?
(A) Yes, we offer NIPT testing through several labs. Once the results are available we review them with you. You can also choose to know the sex of your baby or opt-out of this portion of the test.
(Q) If I have had a previous cesarean can I still have a home birth with a midwife?
(A) Yes, it is possible. BioBirths accepts women desiring a VBAC (vaginal birth after cesarean) on a case by case basis. We will need to obtain a copy of your medical records from your hospital stay including the surgical report. You will also need an ultrasound to determine the placement of placenta and to make sure you are clear of other abnormalities such as placenta previa, placental acreta, percreta or increta. Once you have been thoroughly assessed, a decision will be made.
(Q) Where do I go for prenatal care?
(A) Our facility has 4 spacious exam rooms for prenatal care and postpartum care. Midwives provide excellent prenatal care meeting your prenatal care needs throughout your pregnancy. Check-ups are typically once a month until you reach 28 weeks. Then check-ups will increase to every two weeks. At 36 weeks you will be seen every week until your baby arrives. You will have complete lab work, ultrasounds and thorough prenatal screening throughout your pregnancy. At each visit we will discuss diet, nutrition, and exercise. If a problem should arise you can get a referral to an OB, MFM, Chiropractor, pelvic floor specialist or wherever may be needed to help you have the safest and healthiest pregnancy and birth.
(Q) Do you test for Group B Strep?
(A) We recommend testing for this bacteria for all women in their third trimester per the Center for Disease (CDC) guidelines. Women who test positive are counseled about the current CDC’s recommendations to prevent their newborn from becoming ill. Most patients prefer to test but have the right to refuse the test with written informed refusal if they choose.
(Q) Can I skip all ultrasounds and bloodwork in my pregnancy?
(A) The short answer is no. In Texas, midwives care for low-risk pregnancies. Your midwife can not properly determine whether or not you are low risk without adequate care. This includes ultrasound and labwork. At BioBirth we do not provide inadequate prenatal care.
(Q) Do you believe all women should give birth in a birth center?
(A) Here at BioBirth we believe every woman should have the right to choose where she gives birth. Only women who are essentially healthy carrying a normal pregnancy should give birth outside of a hospital setting. Families who desire out-of-hospital-birth need to be willing to educate themselves and make informed decisions during pregnancy, birth, postpartum, and in caring for a newborn. All patients are carefully screened during their entire pregnancy for potential risks necessary to transfer care. Not everyone can be accepted into care, each prospective patient is thoroughly screened.
(Q) Can I have a doula at my birth for labor support?
(A) You may absolutely have a doula if you so choose. Doulas can be very helpful in most any birth situation. If you do not already have a doula chosen I will be happy to give you referrals. If you hire an experienced doula from our referral list you actually get a discount.
(If you are a doula and would like to get on our referral list please contact us for an interview. You will need to attend a minimum of 3 births with us to be on our doula referral list and 10 out of hospital births to be listed on the experienced doula list.)
(Q) If I know I will be moving before my baby is born, can I still have prenatal care at BioBirth?
(A) Definitely! That is actually a common question. Some choose prenatal care with a midwife before a big move and others just choose prenatal care and transfer towards the end of pregnancy for a planned cesarean. We will support you in your prenatal needs even if you can’t birth with us.
(Q) Even though every labor and birth is different, is it ok to have a birth plan written in advance?
(A) Absolutely! Keeping an open mind about how your labor and birth will unfold is very important when compiling a birth plan. But putting your thoughts and wishes on paper lets everyone know what they are and leaves you free to concentrate on your labor. Writing a Birth Plan allows you to explore options that you may not have known were available. We can go over your birth plan at one of your prenatal appointments.
(Q) If I don’t go into labor until after 42 weeks is that okay?
(A) Texas Midwifery law allows for out-of-hospital birth with midwives between 37 and 42 weeks. If you go into labor prematurely or go beyond 42 weeks we will need to transfer care to keep you and baby safe.
(Q) I have read about the benefits of waterbirth, does BioBirth offer waterbirth?
(A) YES! Two of our three birth suites have large built-in birthtubs. You can choose to just labor in the tub, stay in and birth your baby or not use the birthtub at all. All three birth suites have a walk in shower in your private restroom.
(Q) Will I be confined to a bed during labor?
(A) Absolutely not! We encourage you to walk around and change positions. Freedom to move around actually helps with your comfort level and improves the labor progress. Being confined to a bed is extremely painful for most women during labor.
(Q) Will you allow for delayed cord clamping after the birth?
(A) YES! Babies get about 30-40% of their blood, which has been circulating through their body and the placenta after the birth. Delaying clamping the cord post-birth, which allows more time for blood to move from the placenta to your baby, may actually improve iron stores and hemoglobin levels in the newborn. Improved iron could help reduce the risk of learning deficiencies and cognitive delay in children, which have been linked to iron-deficiency anemia in school-age children. We do not have a time limit for allowing the cord to pulse after birth.
(Q) I have read much about birth stools, do you have one available?
(A) Yes! A birth stool is available for all births. Some moms choose to use it during labor, some for the actual birth and others for the delivery of the placenta.
(Q) What happens if I am transported to a hospital during labor?
(A) If you are transported to a hospital during your labor or after birth your doula or one of our intern midwives can go with you. (Depending on hospital policy due to Covid-19.) There are TWO hospitals within a couple of blocks of our facility.
IMPORTANT: If you should have to transfer to a hospital for any reason it doesn’t mean that you failed or your birth team failed. If you were planning your birth at a hospital and it was determined your baby needed to transfer to Texas Children’s Hospital after birth that does not mean your hospital failed you. Your hospital recognized your baby needed extra care and rightfully sought out the care your baby needed. The same goes for your midwife and birth center, they are here to make sure you and your baby get the care you need, not guarantee an out-of-hospital birth.
(Q) What about any medications during my labor or birth?
(A) There is no routine use of medications in our facility. While most midwives have medications available for emergency situations or your specific health needs, there is no routine use of medication at BioBirth.
(Q)What happens after the birth?
(A) Immediately following the birth, your baby will remain with you. You will never be separated from your baby without your consent; like to take a shower. We will monitor you and your baby for 2-4 hours after the birth. More time may be needed for first time mothers or a difficult birth/postpartum event. We will see you again between 24-48 hours after the birth. You may also make an appointment for a 2 week, 4 week and 6 week visit to make sure you are healing well and breastfeeding is getting off to a good start.
(Q) What happens to the placenta/afterbirth?
(A) The choice is yours. Your placenta does not become the property of BioBirth immediately after it is birthed, it remains yours until you state otherwise. The placenta is truly a biological engineering feat that helped create and support your baby until birth. Some mothers choose to encapsulate their placenta for consumption. Some parents bury their placenta with a tree to grow as the baby grows. Choosing a tree that produces nuts, flowers or fruit the month of the child’s birthday to enjoy year after year will be a reminder of the very special day that your child came into this world. You may also choose not to keep your placenta and allow it to be used for educational purposes at our workshops for intern midwives. www.BioBirthAcademy.com
(Q) What if you are out of town, on vacation or sick when I go into labor?
(A) I usually plan vacations when no one is due. It would have to be a very serious illness for me not to be able to attend your birth. If I could plan illnesses around birth I would! In an emergency I would call another midwife to assist you. When I commit to being your midwife I plan to be available for approximately three weeks before and two weeks after your due date.
(Q) I had an episiotomy with my hospital births, do you give every mother an episiotomy?
(A) Once episiotomies were considered to be a beneficial procedure that would make birth easier for the baby and protect the mother from trauma to the birth canal. Episiotomy has been found, in study after study, to be more harmful than beneficial except in a few cases. Even so, it continues to be practiced routinely in many hospitals in the U.S. and around the world. At BioBirth an episiotomy is rarely necessary.
(Q) Do I need to take my baby to a doctor after the birth?
(A) Yes, we always recommend getting established with a pediatrician, osteopath or family doctor in the first week or so after birth. However, your baby will continue to have excellent care with the midwife for the first six weeks after birth. A thorough newborn exam is done at mom’s side in the first few hours after the baby is born, then again at 24-72 hours after birth. Our postpartum care schedule is then at 2 weeks, 4 weeks and 6 weeks.
(Q) Will my baby have a birth certificate if I have a baby with a midwife instead of a doctor?
(A) Yes. A birth certificate will be filed through the state’s TxEver birth certificate filing platform with The Department of State Health Services within the first five days after your baby is born. You can obtain a copy of the birth certificate by going to your local county clerk’s office and requesting one or by going to the DSHS website. https://www.dshs.texas.gov/vs/order/online.aspx Frequently asked questions https://www.dshs.texas.gov/vs/faqs/
(Q) How will my baby get a social security number?
(A) When filling out the information worksheet for your baby’s birth certificate there is a box you can check if you want a social security number for your baby. A card will automatically be sent to you in the next couple of weeks.
Ok I’m ready for an appointment…
(Q) I have maternity coverage on my insurance plan, will insurance cover midwifery care?
(A) Due to the variability in insurance reimbursement BioBirth is currently a self-pay practice. As a separate service we will provide you with a referral to SLB Billing who can help you with insurance reimbursement. Please note that there is a commission fee that is assessed by this billing service based on the insurance final allowable amount. This fee is collected when the insurance payout occurs. You will need to complete a verification of benefits through this biller to pre-authorize charges and attempt to estimate your insurance plan’s reimbursement for charges. You may go to their website for benefits, verification and enrollment to bill your insurance. A global maternity receipt for BioBirth’s services will be given to you after your six-week postpartum exam so you can file for reimbursement. Please be patient many insurance companies may not work in the quickest fashion. Please note that if you choose to self-bill your insurance company BioBirth will provide you with an itemized receipt but will not be participating in the billing process. (phone calls to the insurance company, etc) ICD-10 codes are now public access and it will be your responsibility to research them if requested by the insurance company.
Insurance companies are not accustomed to the midwifery model of care. They pay according to the industrialized healthcare system which emphasizes quick, efficiency and productivity, not the development of respectful, trusting and invested time-consuming relationships with a midwife. The codes billed to insurance can not and do not translate to appropriate payment that BioBirth provides to each and every client. Because of this it is necessary to understand that BioBirth operates on a self-pay out-of-pocket fee for service at an agreed-upon payment plan. Negotiating back and forth with each and every insurance company is just not something we are staffed to handle. We serve YOU, the client, not the health insurance industry.
(Q) I don’t have insurance can I still have my baby at BioBirth?
(A) Absolutely! If you do not have insurance that will cover your pregnancy we can work on a payment plan that works for you. Payments can be made at each prenatal visit, through Cardx. All fees will need to be collected by 36 weeks of the pregnancy. We do offer an early-pay discount for those who pay in full by 32 weeks.