Common Questions


I'm still considering whether a home birth is right for me. Can I meet with you beforehand to talk about my concerns?

I encourage you and your partner to meet with me to discuss any concerns you may be having about making the decision to have your baby at home. I only work with normal healthy low risk mothers having normal pregnancies and anticipating a normal low risk birth.  I charge a $50 consultation fee for this service if you live more than 60 miles from the Richmond area. If you do decide to hire me as your home birth midwife, the fee will be applied towards your balance. You can also find me on Facebook at Richmond Virginia Home Birth. A link to my Facebook feed is on the contact me page right below the submit button. Please call me at 804-382-8222 to talk more and set up a consultation appointment.


WHAT IS YOUR FEE AND DO YOU ACCEPT INSURANCE?

My fees are based on a sliding scale which is determined by your total family income. You will find my rates very affordable.  Please call me to find out what this would be for you. I can work with you on the amount and when your payments are made. At this point in time, I do not accept Medicaid. To find out if your insurance will cover a home birth, go to http://www.midwivesadvantage.com/verification.   I am new to using a billing company so your questions may best be answered by the staff at Midwives Advantage.. The most that I have seen or heard of insurance paying for home birth services is 85% of the total cost. Most insurance plans do not cover the total cost of out of hospital births unless you have few other options in your area. You can contact your insurance company to talk about this and see what you would need to do to have them cover a home birth. I would require the whole fee for your home birth up front as a deposit by your 36th week of pregnancy and your insurance company can reimburse you for the services afterwards, if they make an exception for you. Many women find insurance does not cover very much of the costs of prenatal visits, home birth, and postpartum follow up visits as they also take out for deductibles and copays that are your responsibility. They also find they must file many appeals to get any reimbursement from their health insurance company. That is why it is good to have  Midwives Advantage look up your insurance benefits to see if out of hospital birth is covered.. Additional fees of up to 35% of the total cost will be added if you want your insurance to cover your midwifery services. I also work with MedLoanFinace.com to help you get a small loan to cover your midwifery care. You will work out with them the loan arrangements but you must submit the application when we are together so that I can give you a quote for this. Many times the service fee is small if you agree to pay off the balance within 3 years. Ask me for a brochure when you set up your consultation visit. I occasionally put out coupons for a certain percentage off of your fee and I always give you a nice discount for paying in full when you decide to hire me! 


HOW SOON SHOULD I HIRE YOU IN MY PREGNANCY?


This is up to you. However, seeing that I would be your care provider, as soon as you know you are pregnant is optimal. It is important to have early prenatal care to optimize your chances of having a healthy baby.  If you wait until your last trimester, I don't give you a discount because you have (hopefully) obtained prenatal care elsewhere. I don't usually take on clients past 35 weeks because I provide a lot of education about home birth throughout your pregnancy and I need to have a good understanding of your specific needs/desires when giving birth.


CAN YOU COME TO MY HOME FOR PRENATAL AND POSTPARTUM VISITS?

Yes. At this point, I do not have an office and ONLY go to clients homes for prenatals, the birth, and postpartum visits. I do not charge any extra for this unless you are more than 60 miles from my home then there is a .57/mile additional charge. I will travel within a 60 mile radius from where I live in Midlothian (zip code 23113). Partners, children, and family members are always welcome at your prenatal appointments.


WILL YOU BE THERE FOR MY BIRTH?


I am a solo midwife and I do not overbook clients. I also will not induce my clients with any of the remedies available to home birth midwives so that you have your baby on my schedule. I will not send one of my assistants to your birth in my place. Unless you have a very fast birth, I will be there. Even if your birth is very fast, I will be on the way and will get there before the baby is an hour old.  I will be the one who will attend your birth and all prenatal and postpartum visits. You are not required to see an OB while in my care although I do reserve the right to request that you see another provider if I feel you are exhibiting some complications in your pregnancy or if you have another health issue that may put you at an increased risk for home birth if not managed by an appropriate provider.


how many other clients do you work with who are due around the same time as me?

I limit my practice to 4 clients a month. I try not to take clients who are due in the same time frame. However, birth can be unpredictable and I will make every effort to let you know if other clients are due around the same time. I feel it is important to be there with you when you are in labor when you feel the need for me to be there. And I do not want to have you laboring alone for very long. Most of the time, I will arrive at least a few hours before your baby. I am on call for you from 37 weeks until your baby is born. If you go into labor prior to 37 weeks, you need to contact me then go to the hospital as I am not equipped to handle premature babies as home.


Can my partner/husband and other family members be with me while i am in labor?

I encourage you to have your husband or significant other with you during your labor and birth. I will also show your partner how to catch the baby if that is something you both desire. If you want other family members present, please help them come up with a task to be responsible for so that they can feel included and you feel the most supported. It is important that all of your support people are on board with what you want your birth experience to be like and that they offer help only when appropriate. No one knows you better than your partner or your mother. There may be things that help you feel comforted that only they can provide. I do not mind you having your other children present during the birth as long as they have a support person to help them understand what is going on and how they can best support you. Please plan to have someone to be with your children who won't mind taking them out to the park or to play while you are in labor if they get overwhelmed. It can be distracting to a woman in labor to have her other child/children crying and needing attention. I like to have a birth support team meeting with everyone who will be present at your 36th week appointment in your home. We will go over roles and how they can best help you out then.


what about the mess? is there a lot and who cleans it up?

Surprisingly, there is rarely a big mess during and after a home birth. I have attended births where there was less than half a kitchen trash bag of used supplies and only a full load of laundry that needed to be done. Most of the time, my assistant and I will help keep the place tidy as we work and start the laundry before leaving. We will also take down and clean the birth tub, if you decide to use this. Most of the time, we leave your place with few signs that a home birth has just occurred there. You can keep your placenta or I can encapsulate it for you for a little extra added to your fee.


what is your philosophy about birth?

I believe that birth is a normal, natural, physiological event that every woman is designed and equipped to do from the time they are a female inside of their own mother's body. Birth is innate and inborn. It is also a rite of passage into womanhood. Our current culture has taught us that we should fear birth and the sensations it brings. I will work with you to learn to trust your body and to step out of the way mentally so that your body can do the work it knows how to do. I act as your guide during this process. I cannot do it for you. CPMs cannot carry or administer medications in VA, including for pain. I do encourage all first time mothers to attend child birth education classes especially for home birth and I recommend hypnobirthing classes for everyone. We will address any fears and concerns you have about birth in your prenatal visits and during your labor as they come up. Home birth midwives work with normal healthy mothers who are having normal healthy births. Most of the time, the woman who is choosing a home birth willingly acknowledges that she is solely responsible for her own health and that of her unborn baby. I firmly believe that all healthy low risk women should have the choice as to where and when they have their babies.


​Do you have hospital privileges and do you have a back up doctor?


CPMs do not have hospital privileges as we are trained exclusively in out of hospital births. We do not go to nursing school or attend hospital births as part of our training. Many CPMs have been birth doulas and have attended hospital births as a doula before becoming a home birth midwife. VA laws do not require CPMs to have a back up physician either. However, I have worked with many of the doctors in the area as a doula and will be able to refer you for additional care or testing as needed. In addition, CPMs do not carry malpractice insurance or liability insurance. If your care must be transferred to an OB or you are transferred to the hospital for safety reasons, you are still responsible for the amount incurred for your home birth prenatal visits and labor. Most of the time, if you are transferred for life threatening reasons during the birth, myself or my assistant will remain with you until the baby is born to help ensure continuity of care and to advocate on your behalf. I do have a consulting doctor who can prescribe medications for you during your pregnancy and postpartum period.


what kind of tests will you do?

At each prenatal visit, I will take your vital signs, palpate your belly, and listen to the baby's heart rate. With your consent, I will draw your blood for initial blood work with your first prenatal visit, if this hasn't been done before. I can also offer the glucose tolerance test and the group B strep test later on in pregnancy, after offering you informed consent. CPMs are noted for always offering their clients informed consent/informed choice and you will always have the option to accept or decline any testing or procedure unless it is an emergency situation and you or your baby's life are in danger. Many women having a home birth do not choose to get any testing done once informed about the risks and benefits. For additional testing such as ultrasounds, AFP, or amniocentisis, you will be referred out to another facility for this and the results will be sent to me to go over with you. Your insurance will usually cover these tests if you decide to get them. I can usually accompany you to these appointments if you desire. If you have already decided to switch from a doctor or hospital midwife to me for a home birth, I ask that you get your medical records before our first meeting. If you had any complications with your last pregnancy, please get your birth records for that birth as well. I will go over your records with you and tell you what they mean in a way that you can understand. I can do the metabolic screening test for an additional fee.


WHAT IF I TEAR?

Midwives are trained in helping women have gentle birth experiences and I will use that training to help you avoid tearing. However, sometimes women who have had an episiotomy with a previous birth may tear more easily in the same place. I will use natural remedies to numb your bottom and then suture your bottom if necessary.


Do you offer water births?

Yes! They are an ideal way to help a woman cope with the sensations of labor and to avoid tearing during the birth! My tub is available for rent for  my clients or you may choose to purchase your own. I use La Bassine tubs and they will require special liners that will come in your birth kit. There is also a fee for rental of my tubs as I expect it to come back to me in the same condition that I loaned it to you in..


how long do you stay after the baby is born?

I usually stay with you for at least 2-4 hours to make sure you and baby are adjusting well. I assist you with breastfeeding for the first time and make sure you have had something nutritious to eat before I leave. I come back to do postpartum checks and answer questions at 24 hours, 4 days, 7 days, 14 days and again between 4 weeks and 6 weeks. I am always available to answer questions by phone or text during this time. I do recommend that you take the baby to see your pediatrician before they are 5 days old though as I am not trained in pediatrics. I will do the newborn exam within an hour after your birth and provide you with a copy to take to your pediatrician. I have an extensive list of area  pediatricians that I recommend to families during the prenatal visits. If you want the metabolic screen or vitamin K for the baby, the pediatrician should have plenty of those tests on hand. I you elect to not have this done, I will have you sign a waiver after we have discussed the risks and benefits.


do you support vbac and vbamc?

Yes! I am a VBAC mom myself and a long time leader of the areas VBAC support group. I have helped women have primary VBAC at home (HBAC) as well as VBAC after more than one c-section. You will need to get a copy of your operative report for your cesarean for me to review with you. We will need to discuss the reasons for your cesarean and your health history. Contact me for more information about the River City VBAC Support group.