(Q) What supplies will I need for a homebirth?
(A) You will need to purchase a birth kit that will supply your birth with all of the disposable consumables used during the labor and birth process. You can order it online here www.InHisHands.com just enter the name BioBirth to find the birth kit specially put together for our practice. You also need to have available other necessities that will probably be found in your home.
I will bring all necessary medical birth equipment to your home for your birth. Included are items such as a Doppler, blood pressure monitor, oxygen and resuscitation supplies, emergency medications and herbs along with other important supplies.
(Q) Is it safer to have my first baby in a hospital?
(A) Women will have greater success in having a normal birth giving birth where they feel comfortable with equipped and knowledgeable attendants. Where you give birth is your choice.
It is well-known that women having their first child in a hospital suffer the most unnecessary interventions and have an excessively high rate of preventable Cesarean sections. It is also well known that first time pregnancies tend to go to 41 to 42 weeks gestation compared to 40 weeks for woman with subsequent pregnancies. This factor isn’t calculated into most doctor’s decision regarding inductions of first time labors. Artificial inductions and having labor sped up are disturbingly frequent. Inductions, since they are more painful and stressful, lead to more use of narcotics and anesthesia. All this contributes to higher cesarean rates. Most first time moms will leave the hospital with a scar, either on their perineum (episiotomy) or on their abdomen (c/section).
(Q) At what time in my pregnancy should I begin care with a midwife?
(A) As soon as you are trying to get pregnant you can make an appointment for a consultation. 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 all your nutritional needs.
Once you become pregnant it’s important to make that first appointment to begin prenatal care right away. Some midwives fill their schedule and you may not get in with the midwife you choose.
(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 the placenta, after the birth. Delaying clamping post-birth, which allows more time for blood to move from the placenta, 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.
(Q) If I have had a previous cesarean can I still have a home birth with a midwife?
(A) Yes, it is possible. I accept 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 cesarean 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 anomalies such as placenta acreta. Once you have been thoroughly assessed, a decision will be made.
(Q) Do you believe all women should give birth at home?
(A) I do believe every woman has the right to have a choice in where she gives birth. Only women who are essentially healthy carrying a normal pregnancy should give birth at home. These women ideally should not smoke, and should consume a healthy diet, with regular exercise. Families who desire homebirth need to be willing to educate themselves and make the informed decisions that need to be made during pregnancy, birth, postpartum, and in caring for a newborn. All patients are screened during their entire pregnancy for potential risks necessary to transfer care. I do not accept everyone into my care, each prospective patient is carefully screened.
(Q) Can I have a doula at my birth for labor support if I choose a homebirth?
(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 make a recommendation.
(Q) Where do I go for prenatal care if I want to have a homebirth?
(A) Midwives provide excellent prenatal care meeting all 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, 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 a doctor to determine if homebirth is still a safe option for you.
(Q) Do you test for Group B Strep?
(A) We recommend testing for this bacteria for all women closer to the end of the pregnancy 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) 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. I also have no problem with moms compiling both a Homebirth Birth Plan as well as an Emergency Hospital Birth Plan so you can relax and know that your wishes are already expressed in the event of a hospital transport. Writing a Birth Plan allows you to explore options that you may not have known were available.
(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) I have read much about birth stools, do you have one available?
(A) Yes! I bring a birth stool with me to 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, I will transfer your care to the physician on call. Some hospitals will allow me to remain with you, others will not. I can help guide you through the decisions but I can’t make decisions for you at the hospital. Even though a hospital transport requires much more work on my behalf than a homebirth, there is no additional charge to you.
(Q) Can I have homebirth in an apartment?
(A) An apartment is usually more than an adequate place to give birth. Hot water, heat and electricity are usually basic necessities for homebirth but we have done births without all the basics.
(Q) What about any medications during my labor or birth?
(A) There is no routine use of medications in homebirth. While most midwives have available medications for emergency situations, there is no routine use of medication at home births.
(Q) Is it okay to see a doctor through my pregnancy then hire a midwife in the last month to save on costs?
(A) It will be very difficult to find a midwife who will agree to this arrangement. Asking a midwife to be totally responsible for your birth without the benefit of getting to know you and your prenatal history for a reduced fee is tough for a midwife and tough for you as an expecting mother. Most midwives will not agree to this arrangement.
(Q) Will I be left with a large mess to clean up after the birth?
(A) No, upon leaving your home there will be very little evidence that a birth took place in your home, except for the little bundle of joy left in your arms. Usually birth at home has less blood loss than hospital births since episiotomies (vaginal surgical incisions) are rarely done; episiotomies tend to lead to extra blood loss. The birth place and your bed are specially prepared and protected. Linens are laundered quickly to remove any soiling. We rarely get blood on the carpeting but hydrogen peroxide removes most blood spots out of carpeting or linens, if needed.
(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. 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 then 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. The placenta was made, just like your baby, from the union of the mother’s egg and the father’s sperm. 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 to help with increasing breast milk supply, and decreasing postpartum hemorrhage. Some parents bury their child’s 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
(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. I just don’t accept someone in my care and then plan a vacation when they are due. That is very disrespectful of the expecting mother and her family.
(Q) I had an episiotomy with my hospital births, do you give every mom 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. I may have to give sutures for a small tear about once a year or less. It is very rare that I have to do a necessary episiotomy.
(Q) Do I need to take my baby to a doctor after the birth?
(A) Yes, with in the first week after the birth. However your baby will have a complete newborn exam at the birth. A thorough newborn exam is done at mom’s side in the first couple hours after the baby is born. Your baby will be weighed, measured and checked over from head to toe. Prior to the newborn exam, baby’s lungs and heart rate are assessed while mom is holding the baby. I am certified in CPR and Neonatal Resuscitation and have EMT training as well.
(Q) Will my baby have a birth certificate if I have a homebirth?
(A) Yes. A birth certificate will be filed with the local county clerk’s office 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 their website.www.texasonline.state.tx.us/tolapp/ovra/
(Q) Is homebirth legal?
(A) Homebirth is legal in most states, although the details vary from state to state. Homebirth is legal and growing fast in the state of Texas!
Ok I’m ready for an appointment…
(Q) I have maternity coverage on my insurance plan, will insurance cover midwifery care?
(A) In most situations the answer is yes. More and more companies are recognizing homebirth as a reasonable and cost effective option. I will send your insurance information to my medical billing service to determine your coverage and what percent you will need to cover out-of-pocket.
(Q) I don’t have insurance can I still have a homebirth?
(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 PayPal, or by mail. If you are transferring into care late in your pregnancy ask for special arrangements. Typically all fees will be collected by 36 weeks of the pregnancy. If you are past 36 weeks then full fee may be expected at your first prenatal visit as you could go into labor anytime after that date.