Want to know more about home birth and midwives?

Women may plan a home birth because they:

  • have had a previous positive birth experience in hospital, and now feel confident about birth at home,
  • want continuity of care, with a midwife they know attending the birth,
  • dislike being in hospital,
  • are worried about the effect of a hospital environment on their labour,
  • want to keep birth normal and avoid interventions,
  • want to reduce the risk of infection,
  • don’t want to be separated from older children,
  • want more than one birth partner,
  • want to avoid an overnight hospital stay without their partner,
  • hope to use a birth pool and cannot be sure that this will be possible in hospital,
  • want privacy,
  • want to feel more in control, or
  • have had a previous negative experience in hospital, and don’t want to repeat this.

Ultimately, the decision to have your baby at home is yours but it always helps to have support and information in making that choice.

Below are some peer-reviewed wide-accepted statistics regarding home birth:

  • 97% of planned home birth babies are carried to full term – versus 87% US National Average
  • 5.2% cesarean rate – versus 31% US National Average
  • 87% VBAC success rate – versus 50% to 80% hospital VBAC success rates
  • 89.1% natural home delivery success rate – about one in ten planned home births switch to a hospital, most often due to “failure to progress”
  • 4.5% intervention rate – less than five percent used pitocin or pain intervention (ie. epidural)
  • 1.5% postpartum maternal transfer rate – it is very rare that moms transfer to a hospital after delivery, most for non-life threatening issues
  • 0.9% newborn transfer rate – it is even more rare that the newborn needed to go to the hospital for postpartum care
  • 97.7% breastfeeding rate at six weeks (86% exclusively)
  • 1.3 deaths per 1000 (0.13%) intrapartum mortality rate – infant mortality rates are similar to hospital data for low-risk pregnancies, and much lower than average hospital births
  • Home birth has grown 54% nationwide in 8 years, from 0.56% in 2004 to 0.89% in 2012 (CDC)
  • Arizona’s out-of-hospital births have grown from 1.23% in 2004 to 1.46% in 2012 (CDC)
  • Six states have grown much faster, now delivering 3-6% out-of-hospital births (the five northwestern states and PA)
  • Maternal deaths are very rare, typically about seven per year in Arizona, and no known deaths at a planned home birth
Most of the statistics above are from this study of 17,000 planned home births:
http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/full
Some are from the Centers for Disease Control:
www.cdc.gov/nchs/data/databriefs/db144.htm
http://www.cdc.gov/nchs/data/databriefs/db144_table.pdf
And some are from the Arizona Department of Health:
http://www.azdhs.gov/phs/owch/pdf/mmr/mmr-annual-report11.pdf
http://www.azdhs.gov/plan/report/ahs/ahs2009/pdf/text1c.pdf

The credential CPM stands for Certified Professional Midwife. It is administered by the North American Registry of Midwives, a certifying agency created to evaluate the knowledge and skills of direct entry midwives. NARM follows the standards set by the National Organization for Competency Assurance. The CPM is the only credential available to maternity care providers which requiresexperience and competency in out-of-hospital birth. The CPM credential is used in the licensure process in most states that license direct entry midwives. CPMs work with healthy women having a healthful pregnancy and planning to birth outside the hospital.  Certified Professional Midwives are experts in normal birth, unmedicated home or birth center birth, and recognizing and acting appropriately to transfer care if pregnancy or birth begins to fall outside the range of normal health.

Yes!  Usually first labors are a bit longer because your body has never given birth before and has to “figure it out.”  It can be very helpful for a first-time mom to remain in her home environment; sometimes labor may stop and start and take time to get going in earnest.  A home birth will provide less pressure and is more relaxing than the hospital environment – this is an experience that need not be rushed or speeded up.

Your midwife is well trained in avoiding and handling complications – remember normal births are her “specialty”.  Her intuition and instinct are consciously developed and their use is a priority in the kind of care she gives.  Problems in labor usually develop slowly, allowing enough time to be transferred if needed.  A good midwife always comes prepared with an excellent emergency plan created specifically for you and where you live.  She has the proper tools with which to control hemorrhage if the need arises.  If the problem lies with the infant, your midwife is competent at neonatal resuscitation.  Because your midwife has come to know you on an intimate level during all your prenatals, she is also equipped to help you handle emotional issues that might arise during birth.

When compared to the cost of a normal, vaginal hospital birth, a home birth is a small fraction of that and is inexpensive for the amount and quality of care received. Here’s a rough estimate of our average time spent with a client:

  • 12-14 hours/prenatal visits
  • 6-48 hours/ labor and birth
  • 3-4 hours/ immediate postpartum
  • 4-6 hours/ 4 individual postpartum visits

In addition to that, we include the cost of on-call status of the midwife and assistants, access to a midwife by phone 24 hours a day, and the cost of driving to our client’s homes.

Each birth is a once-in-a-lifetime event. Most people budget and plan for things they really want, because it is worth it to them. Birthing a child the way you want to is as important as the special things we expect to pay out of pocket for, like weddings, cars, engagement rings, and vacations.

Maybe. Since a large majority of women have their babies in a hospital setting, most insurance companies don’t know how to process the rare home birth claim. If you call your insurance company with regards to midwifery care, most will tell you they won’t cover a home birth. However, some send reimbursement checks anyway. We can provide you with a receipt after 6 weeks postpartum for all services received (all prenatal care, birth, and postpartum).  You may submit your receipt to your insurance company if you wish.  Your insurance company may reimburse none, some, or all of the fee. Some clients have pursued their insurance company for explanation of refusal, and received reimbursement.

One of the best things about having a home birth is being in control of your environment. You are welcome to invite whomever you would like to attend your birth.   We will talk with you during prenatals about how to plan for child care at the birth, or other people attending.  Most often, women want their homebirth to a fairly quiet and private event with their partner, but many women are comforted by the presence of another nurturing, supportive family member, or their older children.

Ideally care should begin with preconception planning–discussing history and lifestyle choices that could affect the pregnancy outcome. Included would be recommendations for diet, exercise, supplements, lab work and more. Education on general health is important in pregnancy and questions on a variety of subjects can be addressed.

If already pregnant, I believe it is best to find the right care provider for you to begin care as early as possible. Establishing a trusting and comfortable relationship is important and it can be helpful to have someone to call for questions or situations that may arise. As with most midwives, there is no charge for an initial consultation.

 

Yes! Waterbirth is an excellent choice for women seeking to birth at home.

Treat yourself and your baby to warm, luxurious water to cradle you and give you complete freedom of movement during labor and birth if you choose.  This is an excellent way to take charge of your birth experience and help facilitate a gentle birth.

I can help assist you with the rental of a birth pool for your home birth.

 

 

Water immersion is defined as providing a depth of water which enables the mother to sit in water that covers her belly completely and comes up to her breast level or kneel in water on her haunches which comes up to just below her breast level.  Any amount of water less than this does not constitute true immersion and will not create the buoyancy effect and produce the chemical and hormonal changes which enhance a more rapid labor.  The chemical and hormonal effects of immersion take effect after no less than twenty minutes and peak around ninety minutes.

 

 

 

Waterbirth is wonderfully safe option for many mothers and provides many benefits to laboring moms and babies.

  • Buoyancy facilitates mobility and enables the mother freedom to assume any comfortable position
  • Water is soothing, comforting, relaxing
  • Provides significant pain relief
  • Conserves a mothers energy
  • Reduces the need for drugs and other medical interventions
  • Offers perineal support, decreasing the risk of tearing and reduces the use of an episiotomy
  • Buoyancy promotes more efficient uterine contractions and improved blood circulation resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby

You can read more about the safety and effectiveness of waterbirth here: Evidence Based Birth.

 

There actually a lot of great articles from Evidence Based Birth that are worth looking at.