Homebirth FAQ

Is homebirth safe?
Homebirth has been shown to be a safe option for healthy women and healthy babies whose normal pregnancies are full-term at the start of labor, and who are monitored and attended by professional midwives. You can get more informationhere, and check out these studies on homebirth safety: Outcomes of planned homebirth with CPMs in North America, andOutcomes of planned homebirth after regulation in British Columbia.

What are the benefits of homebirth?
There are many benefits of having a homebirth. Some of the ones most commonly reported by families are:

• Individualized care: All decisions about your care are made together with you, in detailed discussions of your needs and desires, your individual health, and the evidence regarding the options available to you. We respect you as your own - and your baby's - primary care provider.
• Evidence-based care: We stay current on the research around pregnancy, birth, postpartum, and breastfeeding, so that we can provide the best evidence possible for your decision-making and our skills and knowledge.
• Your own environment: You choose who attends your birth and who cares for you. You choose what to eat and drink. Walk, dance or sleep uninterrupted if you want to!
• Bonding with your baby: We hold the space for the mother-baby connection as it makes the transition from the womb to the mama's arms, to the breast, and beyond.

Do I need to see a doctor for my prenatal care?
Most midwives offer comprehensive care during pregnancy, birth and the first weeks after the baby is born. Prenatal care in the midwifery model includes all the same clinical components as obstetric care, such as listening to the baby with a doppler or fetoscope and taking your blood pressure, and also includes time getting to know you and your health, and addressing all your questions. Postpartum care includes two to six hour-long visits depending on your midwife. Midwives also provide weight and color checks for your newborn for the first two weeks, and most families see the pediatrician at two to four weeks of age. There are some instances when mothers may need to see a physician, such as antibiotic treatment of a UTI. Our care includes recognizing clinical situations requiring the attention of an obstetrician or pediatrician and referring you to one if necessary.

What about ultrasounds and lab work?
Most midwives offer referrals to medical imaging professionals in order to obtain ultrasounds as needed or desired. Many midwives are skilled in drawing blood, have a lab account and will order the blood and urine tests that you choose as part of your care. We are also able to refer you to other professionals for additional testing if it becomes necessary. There are no tests available in obstetric care that we cannot provide you or help you access.

Who will attend my birth?
Most midwives bring at least one other qualified birth attendant, sometimes an advanced student or another licensed midwife to each birth.  We 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.

Can I have friends and family at my birth?
Yes! We truly appreciate the presence of loved ones who bring positivity and their love for you into your birthing space. We also offer support for setting boundaries when you desire privacy.

What happens if something goes wrong?
Midwives are trained to handle certain complications at home, and to recognize complications that meana hospital birth is advisable and to transport in those circumstances. One of the most common complicationswe handle at home is excessive bleeding immediately after the baby is born, and we carry medications to stop this bleeding and use them the same way they are used in 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. All Bay Area Homebirth Collective midwives are certified in neonatal resuscitation and have experienced this scenario. Most babies in this scenario receive a couple breaths from us and then start breathing on their own very quickly. Again, in this scenario, we follow the same standards as the hospital. Our most common transport to hospital happens for a first-time labor that lasts a long time and mom nears clinical exhaustion; we go to the hospital for an epidural so that mom can have several hours of sleep and get her uterus the rest it needs - often she wakes up pushing her baby out! We 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.

What equipment do you bring with you to births?
Midwives in California are legally licensed to carry equipment and medications to safely manage normal deliveries at home. Some of the equipment we bring includes:

• Resuscitation equipment for baby and mother: a bag and mask resuscitator and oxygen.
• Antihemorrhagic drugs to stop excessive postpartum bleeding.
• Monitoring equipment for you and your baby, including a doppler, blood pressure cuff and stethoscope, and infant stethoscope.
• Supplies for the newborn exam and any newborn procedures that you choose, including a scale, measuring tape, erythromycin ointment, and vitamin K.
• Suturing equipment to do repairs if any tearing occurred, and lidocaine to numb for suturing.

What about the mess?
We aim to leave the house as clean as it was when we 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.

Can I have a water birth?
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.

What do you do after the baby is born?
Every midwife has a little different approach but at a typical birth we put the baby up on mama's belly, and for about the first fifteen minutes we keep an eye on your bleeding and your baby's adjustment to life outside the womb. After the placenta is born and the baby's cord is done pulsing, we ask you if you are ready to cut the cord and who is going to be the one to do it, and we help clamp and cut the cord. Then we give you some space for family time, staying close by with an ear out for your needs and checking on you periodically. Whenever your baby is interested in nursing, we offer help with positioning and latch if you would like it. When you are comfortable and ready for a nap with your baby, and we are satisfied that you and baby are healthy and stable, we leave. We then return in about 24 hours for your first postpartum visit.

How much does it cost?
Generally the fee for service is between $4,000- 6,500 and usually includes prenatal care, attendance at the birth and postpartum care. This fee does not include your birth kit, lab work or ultrasounds, or a birth tub.

Does insurance cover midwifery care?
Often, PPO insurance companies will reimburse for our services at the out-of-network or sometimes the in-network rate.   Each midwifery practice approaches insurance billing a bit differently so make sure to ask your midwife.

Is it worth the money?
The average cost of a wedding is $24,000, and like birth is a very important and emotional day. We often get to hear grandmas-to-be and sometimes even great-grandmas-to-be talk about their birth experiences, and it is very clear that birth creates a lasting impression on women that is greater than their wedding day. Women remember their births with deep feelings for their entire lives, and most clearly remember how their care providers treated them. Having been present with women when they tell us with awe how their birth changed them, we can say confidently that it is worth even the full amount out of pocket.