Frequently Asked Questions


If you have a specific question that is not listed below, feel free to contact us!
 

What’s a Certified Professional Midwife (CPM)?

A Certified Professional Midwife (CPM) is a professionally trained midwife who is certified by the North American Registry of Midwives (NARM), the official credentialing body.  CPMs are the only professionals who are required to and are specially trained in managing out-of-hospital births.  They provide personalized care for expectant mothers and newborns up to 6 weeks postpartum
 

How do you deal with pain management at home?

The advantage of being at home is that you are in a loving, supportive, and comfortable environment which greatly increases a woman's  ability to cope with the intensity of labor. Stress hormones are shown to increase pain and slow labor so a great part of what our birth team does is to help reduce stress in the environment.  Free movement helps to cope with contractions and encourage descent of the baby so I encourage moms to move as much as they would like during labor. You are also able to drink and eat as much as you would like! Even if you are not planning a water birth, laboring in water is also very soothing and eases the labor process.  We have found that hands on-support, eye contact, and reassuring words are tremendously helpful as well. I also bring homeopathic and herbal remedies that can help manage the intensity when appropriate.
 

What if there is an emergency?

Home birth is statistically safe but is not without occasional complications.  Should a problem arise during the course of your pregnancy that is outside my scope of practice, our first step is to refer you to a physician to determine the severity, and in some cases your care may be transferred to an obstetrician.  complications arise during pregnancy, you may need to consult with and possibly transfer care to an obstetrician. The midwives who attend your birth are trained to manage immediate emergences including the need for newborn resuscitation and controlling severe bleeding.  Because we only care for low-risk, healthy women the incidence of true emergencies are low and in most cases the process unfolds without the need for much intervention.  In fact, most hospital transports are for non-emergency issues such as a long labor with no progress. In case of any hospital transport, I stay with you for continued support but your birth will be then clinically managed by an obstetrician.

 

Do I have to get an ultrasound?

Ultrasounds also known as sonograms can be useful tools for getting an accurate date or ruling out certain issues but they are not mandatory during an otherwise healthy pregnancy.  In cases where there is abnormal pain, bleeding, a previous C-Section, the chance of multiples, or lessened fetal movement then an ultrasound is recommendable.  We offer referrals for ultrasounds or you may have one done with your physician

I don't have a large home, do I have enough space to have a home birth?

Absolutely! As long as you are comfortable, can move freely, and your home is clean and warm--then there is no reason why you would not have enough space.
 

I am over 35 years old--is home birth safe for me?

Yes!  If you are healthy and are willing to play an active role in your care, then you are likely a good candidate for a home birth.
 

I’ve had a cesarean before. Can I have a home birth?

Probably. Any surgery to the uterus can leave scar tissue on the uterus that weakens the surrounding the tissue, thereby making women who have had previous c-sections at a slightly higher risk for uterine rupture.  This risk is lowest if you have only had one previous uterine surgery, had a low transverse incision, eat a healthy diet, do not smoke, allow at least a year after surgery before becoming pregnant, and labor is not induced. If the reason for surgery does not require another surgery (for example, you had a breech baby or your labor stalled), you may consider having a home birth after cesarean (HBAC). We can discuss this further during a free consultation.

Who is not a good candidate for home birth?

Women who are more likely to have problems in pregnancy or during birth are usually safest with obstetrical, hospital-based care. I cannot accept clients with epilepsy, diabetes, high blood pressure, significant heart disease, kidney disease, liver disease, alcoholism, or significant mental illness. Also, women who currently smoke, use drugs (other than occasional marijuana), or do not take responsibility for their health are not good candidates for home birth. I offer care for women who have no major medical or obstetrical problems, who seek an active role in their pregnancies and birth, and desire minimal intervention. By maintaining healthy lifestyles – eating a variety of whole foods, being active, and avoiding harmful substances (such as tobacco, alcohol, and pesticides) – most of my clients remain low-risk and are expected to have a good, normal outcome for both mother and baby.

What do I need to do to get ready for a home birth?

Less than you might think! You’ll need to gather a few common supplies, clean sheets, towels, and receiving blankets, and have food and beverages on hand for your labor and postpartum. You’ll also need to purchase a birth kit (approx. $60), which contains disposable clean and sterile supplies for birth and postpartum. I’ll provide you with a complete list of what you will need. Your midwives will bring all the medical equipment needed at the birth.

Isn’t home birth messy?

Birth is usually not very messy. Midwives are very good at containing any mess (after all, we’re the ones to clean it up afterwards!). You can expect to have a garbage bag full of trash and one full of laundry when the birth is over.

Who can be at my birth?

Anyone you like! You can have a doula, your mother, your best friend, anyone who can provide good support for you during birth and who accepts your decision to give birth at home. Children are welcome, as long as you have a support person for young children. I encourage family-centered birthing and have books and videos to help you prepare your children for the birth.

There will be two midwives at your birth – myself and another midwife to assist. We can be as involved or as hands-off as you’d like. We can be by your side, or quietly sit in another room, ready and available. This is your birth experience! You decide who will be present, and how each person will support you.

How do you monitor the baby during birth?

We typically use a handheld Doppler to periodically listen to your baby’s heart during labor. Doppler is a form of ultrasound that allows us to hear the baby’s heart beat through your abdomen. It can be used under water and with you in almost any position. If you prefer, we can use a fetoscope (a type of stethoscope) instead, but you may have to move into a position that allows us to hear the baby’s heart.

What if my labor needs to be induced?

A cornerstone of my birth philosophy is that babies’ know how to pick their own birthdays. Your labor will begin at the time that is right for both your body and your baby. The average length of gestation is 41 and a half weeks for first-time mothers and slightly less than 41 weeks for women who have previously given birth. This means that about half of women have their babies before this time, and about half of women have their babies after this time. If your pregnancy nears 42 weeks, we will monitor baby more frequently and discuss your available options at that time. Induction with medications is risky and must be done in a hospital.

Can my partner/husband catch the baby? Can I catch the baby?

Yes, parents are encouraged to receive their own baby! A midwife may help check for a loop of cord or a hand by the baby’s face, and if you wish, will help guide the baby into your hands.

Doesn’t a doctor need to see the baby right away?

Midwives are trained to provide care for moms and babies-both during the pregnancy and after the birth! I provide a complete newborn exam within a few hours after birth. If anything is not normal, I will let you know and we will discuss whether your baby needs to be seen by a pediatric care provider right away. I ask that all families select a pediatric care provider by 36 weeks gestation, and that you know how to reach that provider urgently. Most babies do not need to be seen immediately, and you are encouraged to get the rest you need following birth.

Can my baby be born in water? 

(Note: Waterbirth FAQ questions are largely taken from Waterbirth International’s website. Please visit www.waterbirth.org for even more info!)

es! We welcome and encourage birthing mothers to utilize the comfort and relaxation of water to help move through labor and often for the actual birth of the baby. Almost every laboring woman will find time in a birthing pool, shower or her own tub to be a useful tool in the birthing process. We encourage our clients to keep an open mind as to whether or not they will actually give birth in the tub as one never knows what one (or baby!) will need at the time, but we are very happy to offer waterbirth as an option for our clients. Please ask your midwife about options for tub rental (AquaDoula) or borrowing an inflatable birth pool (Birth Pool in a Box) for your labor and birth.

What prevents baby from breathing under water?

There are four main factors that prevent the baby from inhaling water at the time of birth:

1.  Prostaglandin E2 levels from the placenta which cause a slowing down or stopping of the fetal breathing movements. When the baby is born and the Prostaglandin level is still high, the baby’s muscles for breathing simply don’t work, thus engaging the first inhibitory response.

2.  Babies are born experiencing mild hypoxia or lack of oxygen. Hypoxia causes apnea and swallowing, not breathing or gasping.

3.  Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. So, even if water were to travel in past the larynx, they could not pass into the lungs based on the fact that hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence.

4.  The last important inhibitory factor is the Dive Reflex and revolves around the larynx. The larynx is covered all over with chemoreceptors or taste buds. The larynx has five times as many as taste buds as the whole surface of the tongue. So, when a solution hits the back of the throat, passing the larynx, the taste buds interprets what substance it is and the glottis automatically closes and the solution is then swallowed, not inhaled.

For a more complete description, please read Barbara Harper’s Waterbirth Basics

What is the temperature of the water?

Water should be monitored at a temperature that is comfortable for the mother, usually between 95-100 degrees Fahrenheit. Water temperature should not exceed 101 degrees Fahrenheit as it could lead to an increase in the mother’s body temperature which could cause the baby’s heart rate to increase. It is a good idea to have plenty of water to drink and cold cloths for the mother’s face and neck. A cool facial mist from a spray bottle is a welcome relief for some mothers as well.

How long is baby in the water after the birth?

Here in the US, practitioners usually bring the baby out of the water within the first ten seconds after birth. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth videos that depict leaving the baby under the water for several moments after birth and the babies are just fine.

Physiologically, the placenta is supporting the baby with oxygen during this time though it can never be predicted when the placenta will begin to separate causing the flow of oxygen to baby to stop. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him into his mother’s arms.

When should I get into the water?

A woman should be encouraged to use the labor pool whenever she wants. However, if a mother chooses to get into the water in early labor, before her contractions are strong and close together, the water may relax her enough to slow or stop labor altogether.  That is why some practitioners limit the use of the pool until labor patterns are established and the cervix is dilated to at least 5 centimeters.

There is some physiological data that supports this rule, but each and every situation must be evaluated on its own.

Some mothers find a bath in early labor useful for its calming effect and to determine if labor has actually started. If contractions are strong and regular, no matter how dilated the cervix is, a bath might be in order to help the mother to relax enough to facilitate dilation.

Therefore, it has been suggested that the bath be used in a “trial of water” for at least one hour and allow the mother to judge its effectiveness. The first hour of relaxation in the pool is usually the best. We’ve seen that being in the tub during transition can be especially helpful and often help a woman achieve complete dilation quickly.