Frequently Asked Questions

 

What type of midwives are you? What is your certification & licensure exactly?

We are Certified Professional Midwife (CPM), through the North American Registry of Midwives (NARM) and licensed by the VA Board of Medicine (BOM) to practice midwifery. We are not a nurses; all of our training is specific to midwifery and the childbearing year.  

Do you participate in continuing education? What kind?

Yes, we stay current in CPR, Neonatal Resuscitation, and complete at least 30 hours of continuing education every 3 years. 

What is your birth philosophy?

We believe that pregnancy and birth are normal and that empowering mothers and their families to make their own choices for care leads to the best outcomes. We believe that being in a familiar and supportive atmosphere helps the process of birth go smoothly. We believe that home and birth center births are safe and low-intervention choices for women with normal, low-risk pregnancies.

How many births have you attended?

Our team has collectively attended about 500 births. Most of those births occurred in homes or birth centers. Overall, 15-20% of births will transfer to physician care. Most transfers are non emergent, with the most common reason being long, first-time labors needing pain management. 

What kinds of services are included in prenatal care?

Monthly prenatal visits from initiation of care through 28 weeks, bi-weekly prenatal visits from 28-26 weeks and weekly, and weekly visits from 36 weeks through birth. Labs are routinely drawn at the beginning of care, 28 weeks, and 36 weeks or anytime there is additional need. Ultrasounds are available in office through Ultrasound America or we can order ultrasounds through local healthcare systems. Non-stress tests (NST) can be performed in office if clients go overdue or have concerns about fetal wellbeing. 

Who do you bring to births?

The midwifery birth team generally consists of a licensed midwife and 2 trained assistants. 

How often do you travel, and who do we contact if our primary midwife is unavailable?

Travel is typically planned out long in advice with families being made aware of travel plans at the initiation of care. Each midwife does take a week off call per month for travel/family time. If travel is required last minute, all families in our care will be given instructions/phone numbers on how to reach the other midwives. With 3 midwives in our collective practice at the birth center, there is always a familiar face and voice available to help our families with any need.

How often do you miss a birth or does someone not make it to the center to birth?

It is very rare that our midwives miss births. In the rare occasion that a mother is birthing so quickly that they must birth with the midwife not present, their midwife will be on the phone with them walking them through the process and helping them evaluate the need for additional help like EMS or hospital services. Good communication and an early heads up is key to the midwifery team being available and present at births. 

How do we reach our midwife?

You will have a primary midwife for your care and you can reach out to her through a number of tools. For non-emergent needs, you may email or chat through our electronic health records system Mobile Midwife EHR. Urgent needs (labor, complications, concerns of health or safety) should always be handled by a phone call. Each midwife will have a backup providers phone number available on voicemail if she is unable to answer her phone.

What equipment do you carry?

We carry all the equipment needed for a physiological birth. This includes things to monitor the mother’s vitals, the baby’s wellbeing, herbal and homeopathic remedies, sterile instruments and suturing equipment, equipment for suctioning and neonatal resuscitation, and tools for labor support and comfort measures including a birth tub and birth stool. Additionally, there will be supplies that you gather prior to the birth to protect surfaces and clean up after the birth. 

What is your transport policy?

In the event that you transport to the hospital during labor, your primary midwife typically transfers with you providing records and a report to hospital providers. The midwife’s role in the hospital becomes more of a support person. If your labor is long, it may be necessary to switch out support people or the birth team go home and rest. Rare circumstances can impede the midwife’s ability to transfer with her clients such as hospital/ems policy, infection guidelines, or an emergency situation. For a detailed list of situations that we require or recommend transfer of care, please read our Practice Guidelines and Emergency Care Plan documents. 

How do you handle problems or complications at home/birth center?

Our goal is to prevent as many problems or complications as possible. However, not all complications can be prevented or foreseen. We handle complications individually based on our experience, scope of practice, and our practice guidelines combined with informed consent and shared decision making with each family. Whenever possible, we utilize non-invasive and natural therapies. Some complications will require the emergency use of interventions. Additionally, some complications will require medications, procedures, or surgical intervention only available at the hospital. 

What kind of postpartum care do you provide?

We provide a minimum of 4-6 postpartum visits through the initial 6-8 week postpartum period. All visits within the first 2 weeks will be at your home. We are available by phone and telehealth as well. Here is our typical postpartum care schedule: 24-48 hour home visit, 3-5 day home visit as needed, 1 week home visit, 2 week home visit, 4 week office visit, and a 6 week office visit. 

What is your knowledge of herbs and homeopathy? 

Each midwife is trained in basic herbal and homeopathic therapies. We carry a wide array of high quality herbal tinctures. We frequently utilize recommendations from Dr. Aviva Romm’s text, Botanical Medicine for Women's Health along with many other reference texts we have available in our office. We respect that herbs are natural medications and indeed intervention, using them only as necessary and in the smallest amount possible for clinical benefit. 

How do you assist with breastfeeding? 

Uninterrupted skin to skin care is our standard of care from birth through the first hour postpartum.  We assist with latching and troubleshooting throughout the postpartum period. We help with the prevention and treatment of engorgement, nipple trauma, slow neonatal weight gain, and infections. 2 of our midwives are Certified Lactation Counselors (CLC). We also have a list of IBCLC’s that we frequently refer to for more advanced needs. 

Are you available for nursing support beyond the 6 week postpartum period?

Yes, we are happy to help throughout your breastfeeding journey. 

Do you recommend alternative practitioners and complementary therapies?

Yes, we have a long list of regional practitioners that we refer to frequently. 

What options are there for networking with other mothers birthing out of the hospital?

We admin several social media support groups, host a monthly meetup, and are currently building the framework for a group prenatal program and several online support groups for our clients to network and build relationships within the birthing community. 

How many births do you attend per month? 

On average, each midwife attends 2-4 primary clients’ births per month. 

What happens if there are two women in labor at the same time?

Although multiple women may be somewhere in the birth process simultaneously, it is very rare for 2 women to be actively birthing at the same time. Generally your primary midwife will be with the family that is closest to birthing. If 2 women are both in advanced labor, another midwife (typically from our practice) will attend one of the births. 

What is the cost of services? What is/isn't included?

The total cost of midwifery care is $4000. There is an additional $500 facility fee for those birthing in our birth center. This fee will be waived for everyone birthing there during 2020. For a full disclosure and breakdown of costs and potential discounts, check out our Financial Agreement.