What is the difference between a midwife and a doula?
A midwife is a primary health care provider who is trained and educated to provide comprehensive, clinical care for low-risk women throughout their childbearing years.
A doula is a trained labor support person. She is specially trained to inform parents of birth options, give emotional support, and provide physical and emotional comfort measures and assistance during labor, birth and postpartum. A doula does not perform clinical care.
Postpartum doulas provide support in the home during the postpartum period. They help with emotional and physical support, including meal preparation, light housekeeping, some childcare, breastfeeding support, and newborn care.
Is homebirth safe?
Yes! Homebirth is safe for low-risk individuals and when planned with skilled professional midwives who work within their scope of practice and expertise. Midwives are trained in emergencies and carry medical equipment and medications to help manage complications if they arise. Midwives are also trained and certified in Neonatal Resuscitation and can assist a newborn after the delivery if needed.
Here are some studies and facts on the safety of planned homebirth:
2004-2009 Midwives Alliance of North America (MANA) statistics project: Home birth outcomes in the United States
For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.
In countries such as the Netherlands, where 1/3 of the births occur at home, the infant mortality rate is one of the lowest in the world. In comparison, the United States rates 27th in the world. We also have a maternal mortality rate, at 15th in the world, that has not improved in over 20 years.
Many major research studies have documented the safety of planned homebirth with a trained attendant. One study done in Washington state and sponsored by the Washington State Department of Health compares 2,054 women who gave birth at home and in the hospital. The authors concluded that their results are consistent with other literature documenting the safety of homebirths for low-risk women with a trained provider.
What happens if something goes wrong? What does a transfer look like?
The most common transfer we encounter is not an emergency. In this situation, the hospital is called ahead, and the clients are accompanied to the hospital by a midwife. Of those 10% of babies that are born in the hospital, outcomes are mainly positive. Real medical emergencies are rare during homebirths.
Complications are something many families have concerns about. If a problem develops during labor, and we feel you or your baby would be safer in the hospital, we call ahead and then take you there. We do not want to risk an emergency transport situation, so we go to the hospital before we have an emergency on our hands when possible.
Some complications we see are things that can be dealt with safely in your home, such as postpartum hemorrhage or a baby that needs help to start breathing.
The number one reason we go to the hospital is for failure-to-progress. This situation is not an emergency; we just need to go to the hospital and get more help. Usually the baby is not in a good position and is not fitting in the pelvis properly. In this case a cesarean delivery might be necessary. Pitocin and an epidural can often relax the pelvis enough for the baby to rotate into a better position allowing for a vaginal delivery in the hospital.
What if you are at another birth?
It is extremely rare that we would miss a birth, but we always have other midwives to help us out if needed. You will get to know us throughout your care so that if we needed to call upon another midwife, there would be at least one midwife at our birth who you know well.
How much does it cost?
We offer a sliding scale for homebirth service between $3,800-$5,500. This includes prenatal care, attendance at the birth, and postpartum care. This fee does not include a birth kit, supplies, or rental of a birth tub.
Does insurance cover midwifery care?
Often, PPO insurance companies will reimburse for our services at the out-of-network rate. We have a billing service that can assist you with this for a fee, or we can provide a receipt for you to submit to your insurance company.