Have your baby in your home


Choosing a home birth as an option for your birth depends on many variables. Your medical history and current level of health is of major importance, as is the distance your home is from a hospital providing obstetrical care. We will conduct an interview with you to review these factors in order to determine if you are a candidate for a home birth.

New mom holding twins
Father helping deliver his new baby

Frequently Asked Questions

We have the answers…

No, CPMs & CNMs vary in many ways. A midwife can be either a Certified Nurse-Midwife (a Registered Nurse Practitionerwith additional training and certification by the American College of Nurse-Midwives, www.midwife.org) or a Professional Midwife (not a Registered Nurse, but trained and certified by other CPMs in a home birth atmosphere).

Experience and skill vary with each midwife. CNM’s work in collaborative agreement with physicians, which allows for expanded care if health issues arise. Though all midwives take care of low-risk births, complications will develop at least 10 percent of the time. These mothers may face the need to be transferred. However, if the midwife has expanded skills and options, the mother may reduce the risk of being transferred by having a modified birth experience. This allows the mother to give birth at home, with some intervention to solve the immediate problems to prevent transfer to the hospital.

A Certified Nurse Midwife provides midwifery services after obtaining the highest level of training and experience a midwife can achieve in her education and clinical training. She must first become a Registered Nurse and then attend graduate school to become an Advanced Nurse Practitioner in Obstetrics and Gynecology.  She is licensed by the State by the Board of Nursing and has also achieved national licensure from the American College of Nurse Midwives.  The average time one must attend college to obtain this degree is six years.  She obtains clinical experience in hospitals where she is exposed to all levels of childbirth complications.  While her goal is to work with uncomplicated maternity patients as she provides midwifery services, she will gain invaluable experience in caring for mothers who have developed anticipated or unforeseen complications.

While a CNM’s level of training is not always needed during a normal low risk delivery, her experience can be invaluable if the mother or baby suddenly develops a complication that needs immediate medical intervention.  A CNM can provide emergent care during the time that it takes to transfer the patient to MD care.  Her previous exposure and training in the hospital has allowed her to perfect some of the difficult clinical skills that may be called for.

A CPM received her education with a self-study program and then obtains her clinical experience from another CPM in a home birth environment.  She does not have the skill set that an RN might have obtained before she begins her apprenticeship, and she does not have exposure to high risk situations, as they are handled in a hospital. In the event of an unforeseen emergency she has not obtained the clinical skills a CNM is taught in a hospital.  While providing medical emergent care is not what we desire, it is invaluable in some obstetrical situations that can develop even in low risk maternity patients.

A Certified Nurse Midwife (CNM) is a professional healthcare provider, a Registered Nurse (RN) who has graduated from an advanced education program accredited by the American College of Nurse Midwives (ACNM). In addition, CNMs must pass a national certification examination and must meet strict requirements set by state health agencies. CNMs receive their clinical training in hospitals where they take care of low risk and high-risk mothers. This exposure gives them additional skills and experience to deal with unforeseen problems that may arise in normal childbirth.

We view birth as a natural and healthy experience. Your labor can progress without unnecessary intervention. In fact, it is our lack of intervention that keeps our cesarean deliveries far below the national average. Additionally, a recent Federal study determined that babies delivered by certified nurse-midwives were significantly less likely to die than those delivered by physicians.

While we specialize in the management of low risk women, some clients may develop risk factors, needing more advanced medical treatment. In the event a woman develops a complication during her pregnancy or delivery, we can transition into traditional medical care at a hospital.

Having your baby at home prevents the need for epidurals, pitocin, augmentation and medications. Mothers who abstain from medications deliver their babies much faster with far fewer interventions and complications. Their babies are born free of the drugs that are commonly used in the hospital environment.

Having your baby at home can eliminate hospitalization cosst such as epidurals and or surgery, pain medications and hospital stays.  The cost of care of a low risk normal patient for a home birth is $5,700 whether insured or not.

You pay for all services by 34 weeks gestation. If you are insured, we will file an insurance claim after your birth in order for you to be reimbursed for any amounts insurance may cover.  While some costs may be recognized by the insurance company,be advised that your total cost will not be covered.  Some insurance companies exclude home birth care completely and offer partial coverage.  After you have spoken to us and received clearance that you are a candidate for our care, you may receive a cost estimate of your insurance coverage. Click here to complete the Insurance Request Form on the Fees & Cost page. We will contact your provider and follow up with you to discuss estimated fees for home birth services.

Please note, our fee is based on an uncomplicated pregnancy, labor, delivery and postpartum care. If you develop risk factors demanding extended services, there will be additional charges. We are happy to provide you with a list of extended services and associated costs.

The total fee for maternity care provided by the nurse-midwife is less than half the cost of a doctor and hospital delivery.

For insured patients, our insurance specialist will verify the coverage with your insurance company and will work toward maximizing the benefits provided by your plan. Insurance companies will honor your care at Birth and Women’s Center unless it is a specific exclusion in your plan. After you have spoken tous and received a clearance that you are a candidate for our care you may receive a cost estimate with your insurance coverage, click here to complete the Insurance Request Form on the Fees & Cost page. We will contact your provider and follow up with you to discuss estimated fees for home birth services.
For non-insured patients, the fee for uncomplicated pregnancy, labor, delivery and postpartum care is $5,700. If you develop risk factors demanding extended services, there will be additional charges. We are happy to provide you with a list of extended services and associated costs.

Sometimes during the prenatal period or during labor your pregnancy may become high risk and medical intervention may be needed.  It may be necessary for you to see a physician or be transferred to the hospital.  Out of 4,100 births our transfer rate is about 10% and C-Section rate is about 5%.  This means you have a 90% chance of having the birth you planned.  It is always our desire for every mother to experience natural childbirth without intervention, but intervention may become necessary for the safety and health of the mother or baby.  While disappointment will arise that things did not happen as planned, it is most important to understand that a safe delivery is the most important aspect of having a baby.

Birth is a highly individual experience, and we encourage women to do whatever will make them most comfortable during labor and birth. This may include walking around, relaxing in our tub, sitting in a chair, resting in bed, sitting on the birth ball, or doing anything else that will help you maintain a maximum level of relaxation.

During early stages of labor, we will encourage you to drink ample liquids and eat a light meal. Instead of using electro-fetal monitors that must be strapped onto your abdomen and keep a mother in the bed, we monitor your progress with a special electronic stethoscope in order for you to remain active and out of bed.

Our laboring mothers rarely request to lie down in labor and often never do. We will encourage you to find the position most comfortable for you. You can lie on your side, kneel, squat, sit upright, or float in the Jacuzzi. We will advise you on positions to optimize an efficient delivery of your baby.

In a supportive environment we work with mothers to achieve their goal of natural childbirth.  Being active in labor, using freedom of movement to assist the baby to come quickly and deal with discomfort.  The more you learn about birthing, removing your fears and attending Bradley Childbirth classes, you learn how to relax and lessen the pain.  We can discuss the use of Nitrous Oxide in a home environment.

A low risk mother can develop unexpected complications during her birth. A midwife with extensive medical training and experience may be able to handle the situation and prevent a transfer to the hospital. If the complication necessitates transfer, she will stabilize the patient and plan the transfer for specialized medical care. Not all mothers desiring natural out of hospital care will be able to have their intended birth. We are most thankful for traditional medical services when complications arise. A safe healthy mother and baby is always the main goal of each birth.

Having a baby is a highly personal experience and we feel you should be able to share it with anyone you choose.  We recommend you only invite friends and family that are supportive of your choices and whom you truly want to be with you.

Most fathers deliver their babies and they can decide how much they want to participate.  Our goal is for your spouse to be the best coach possible and we will assist them to support you and bond with you and the baby due this life changing experience.

Choosing to deliver you baby without drugs in your home decreases the risk of complications developing from hospital interventions and drugs commonly used even in normal childbirth.  With the elimination of epidurals and c/sections our bodies can birth naturally as we were created.

Mothers experience an incredible sense of accomplishment and euphoria when their infants are born without the use of drugs.  Their sense of power and strength often sustains them for the remainder of their lives.  When a mother gives birth totally numb from an epidural, she enters motherhood without this strong sense of accomplishment and feels as if birth was done to them. When she bears her baby without pain medication, she knows she is giving her baby the opportunity to begin its life drug free.

I offer circumcision to families who choose this procedure.  We wait until the baby is eight days old for the baby to adjust to life. Breastfeeding should be established, the baby should be gaining weight, and blood clotting factors are peaking.  Most fathers attend the procedure and local pain anesthetic is used as well as sweet ease.  The comfort of touch and talk is freely given, and the mother can breastfeed the baby immediately after the procedure.

We offer Standard of Care to our patients, but do not insist on all routine labs and sonograms. We value your ability to make choices and decisions in your pregnancy. We work together as a team and help educate you about the Standards of Health Care and assist you in your decision about the treatments you may choose to avoid.

Mothers receive all prenatal, labor and delivery, and postpartum care from her midwife as long as she has a low risk pregnancy.  If she develops a medical complication during her care, she may need to see a physician or have additional testing.  If the pregnancy becomes high risk and the baby needs to be born in the hospital, we will assist in changing your plans and provider.

We believe that the services of a doula can be very helpful, particularly in a hospital setting.  In the home birth setting the husband plays the role of a doula and becomes your main support during your birth.  While a doula could be very helpful in the management of your home at this time, we will offer your husband all the tools and support for him to be the person who you truly depend on.  We want you two to bond deeply as you enter parenthood and take on the task of becoming great parents.

Rupture of the Membranes is an excellent sign that baby is on the way. One usually starts labor immediately or if already in labor the labor will increase which is what causes the birth of your baby.

Premature rupture of membranes means the water broke and labor does not begin. The body is not ready for labor and therefore it does not get the clues to put itself in labor. This can happen many weeks before your due date or even around your due date yet labor does not begin.

If labor does not start, most likely the mother will need some means of induction. The baby is exposed to bacteria entering the uterus which can cause an infection in the uterus or the baby itself. The longer the time from rupture of membranes to the delivery increases the exposure of infection and therefore puts mom and baby at a higher risk for complications.

Standard hospital procedure includes intravenous antibiotics starting at 18 hours and continuing until the baby is born, and blood cultures being taken on the baby to watch for infection. Your baby needs extra observation if 24 hours has lapsed and may need NICU admission if the baby is symptomatic.

Knowing that these added risk occurs, we start giving all Moms advice and assistance to get her into labor once the water breaks. We are pushing the clock knowing that the sooner the baby delivers the less chance of needing antibiotics or hospitalization. While some patients want to just wait for labor, we know that some Moms will not start labor until we intervene. Waiting too long has resulted in mothers and babies having to be hospitalized.

Why would a mother not go into labor? Cervical ripeness and the application of the baby’s head on the cervix is the key factor for the body to be stimulated to go into labor. If the baby has not engaged or the cervix is firm and not ripe for labor, the body will not be stimulated. Labor does ensue if your cervix is ripe and the baby is moving into the birth canal, hence most women go into labor once the water breaks.

What can I do if my water breaks and labor does not begin? Call your health care provider so we can confirm that your water broke. If confirmed we usually start with things such as walking, nipple stimulation, assistance with the baby’s head applying to the cervix. During your exam we determine if your cervix if not ready and decide the best plan of management to ripen the cervix and to get contractions to begin.

If a mother gets a fever or the baby is born with one, hospitalization is critical to prevent severe infection. Our goal is to prevent prolonged rupture of membranes and a fever or infection starting.

We wish that PROM was never a problem, yet if it is we will work with you to go into labor so your baby does not become exposed to an infection or need hospitalization. CALL US IF YOU ARE LEAKING WATER EVEN IF YOU ARE NOT SURE.

Babies will come before or after the due date. Babies after 42 week, and before 36 weeks have to be born in the hospital where they can receive specialized care if needed. Babies born after 41 weeks are considered post mature and are at increased risk of complications during labor or delivery. Our babies home the uterus is programmed to perform well until the 40 week mark, and slowly declines in its efficiency every day after 40 weeks. Therefore we will give you advice and homework to encourage your baby to come close to the 40 to 41 week point.

How do I know if my baby is okay? We will have your baby checked by a sonogram to determine if there is sufficient water around the baby, the placenta is working, and the baby has good body tone and breathing movements. We will watch your baby closely every 3 to 4 days thru sonography.

We are also checking your cervix to be sure it is ripening and getting ready for labor. We will give you advice as to things you can do to encourage labor.

Once a mother passes the 40 week point the cord of the baby begins to lose it curls and firmness. By 41 weeks it is thinner and less curled, and by 42 weeks it will be thin like a pencil with no curls. The lack of cord health and thickness means the cord can be compressed before or during labor and cut off the blood supply to the baby. This is the reason mothers are not allowed to go past 42 weeks and the need for extra surveillance to be sure all is well.

The cervix prepares itself by getting soft and open so labor will begin. If the cervix remains, high, thick, closed it is not being signaled to go into labor. Cervical ripeness is one of the key factors in a mother going into labor. What ripens the cervix? The baby dropping down into the pelvis stimulates the cervix to prepare itself. Why do some babies not drop down on the cervix? If the baby is not in the optimum position it often does not engage. Lack of engagement, stimulation, or poor abdominal tone of the mother can prevent the cervix from being ready and labor does not begin on its own.

We will work with any mother who goes post dates with daily suggestions and help to support your body going into labor. We will try to avoid you getting to 42 weeks and needing a hospital induction.

Our goal is a happy mother and baby close to its due date.

“We have been so pleased with our two births at BWC. The midwives are incredibly personable and have gone above and beyond to make sure we have the birth that we wanted. I feel like BWC is the perfect balance of a natural birthing environment and providing medical knowledge. I would recommend them to anyone.”
“The serenity of the birthing room at Birth and Women’s Center allowed me to focus. She reminded me of my strength whenever I started to forget.”
“My body was telling me to push but somehow I didn’t know how. The midwives were very understanding and coached me on how to push effectively. To me pushing hard and long was discouraging, but they would not let me give up.”

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