|
|
| FAQs ~ Frequently Asked Questions It is quite common for prospective clients to ask the same questions and seek the same type of information! Here are the most Frequently Asked Questions (FAQs) and the answers that will help you on your quest for comprehensive, personalized, quality maternity care:
How much do your services cost?
Please contact us to discuss our fee schedule. Fees are fully outlined is our: 
Home
birth midwifery maternity care fees, generally speaking, are markedly lower, as
much as one third the cost, than hospital services for similar services. Our
professional package fee for self-pay home birth clients includes all your
care: prenatal, labor, birth, postpartum & newborn. Because there are no
"facility fees" involved, clients save considerably on the cost
associated with having their baby and all the related fees.
See our Services page to
learn more about all our services; what is and is not included in our fees.
Helpful financial information, PayPal payment options, and
financing links are placed within the Services page for
you.
Will insurance cover the cost of your services?
We are encouraged by the number of insurance companies that DO cover care by a licensed midwife and home birth services! Sadly, not all companies do.
We bill based on credentials, not place of birth. We use a billing service that enables us to file insurance at the beginning of, during, and after your final course of care visit. 
Complete
the following: Insurance
Registration & learn about Verification of Benefits
in order for Larsen Billing Service
to make the proper inquiry to your insurance company regarding your specific Schedule
of Benefits. When inquiring regarding coverage with your insurance,
these questions include if they cover licensed midwives, what your
out-of-network benefits are, what are the deductible, co-pay, and
co-insurance (%) amounts, and other pertinent questions.
We choose to practice Out-of-Network at this time. Although entering into insurance network contracts is not out of the question,
the rules and "red tape" involved to do so, is an
area of medical business that we are cautious to respond to;
we do not like the idea of being told by insurance companies what we can or
cannot do or HOW to practice.
Clients
can request an In-Network Exception or
Authorization, also sometimes called Gap Coverage,
from their insurance companies.
ASK for one! You have the right to be cared for
by the practitioner of your choice!!
**
We are NOT Virginia
Medicaid Providers and do not have plans to
apply for such anytime in the near future. Pregnant women on VA Medicaid are
automatically enrolled in an HMO plan, however these administrative
organizations will NOT pay LMs. Anthem BCBS is the only
company, thus far, which will authorize a one-time "IN-Network
Exception." Women should request such an authorization, explaining
that their chosen provider, a Virginia Licensed Midwife (CPM, LM) provides home
birth services, whereas, all other midwives in the area only attend
hospital births or have a different credential. If you acquire and In-Network
Exception, an authorization letter is provided to you. Please make a copy
for us to forward to our billing service.
We encourage ALL uninsured
clients to apply for VA Medicaid, as a financial resource in the event
that a transfer of care to a hospital is required.
Visit the Virginia Department of Social Services for information on eligibility, application, and other important information regarding Virginia Medicaid.
What are prenatal visits like and where do they take place?
Prenatal visits occur on a similar schedule as most OB physician care,
although midwives encourage beginning care as soon as possible, rather than
waiting until after 12+ weeks. Visits occur every four weeks until the
28th week, then every two weeks until the 36th week, then visits occur
every week until the birth. A home visit is done about 35-36 weeks.
A typical prenatal lasts about an hour and encompasses the following:
discussions about nutrition, discomforts, family relationships, desires for the
birth, parenting issues, emotional readiness, questions about pregnancy and/or
birth, prenatal testing options, dipstick urinalysis, blood pressure check,
edema check, maternal weight, measurement of baby's growth (fundal
height), abdominal palpation to determine baby's position, and listening to
baby's heartbeat.
Prenatal
appointments: We typically do all your prenatal care at our Midlothian office.
Occasionally, an extra home visit may be offered at the end of the
pregnancy, as needed.
Postpartum appointments: all early postpartum visits (24 hours through
the first week) are made in your home; afterwards, later visits (two weeks
through six weeks) are done in our office.
In addition to appointments, we are available to clients via phone and
email to answer any questions or concerns. There are no such things as “silly or stupid”
questions & we encourage any concerns about you or your baby's well-being
to be brought to us between appointments via phone and/or email. You
are not “bothering” us… that’s why you are hiring midwives, we are with
woman throughout pregnancy & postpartum.
How many births do you do per month and what happens if you have two women in labor at the same time?
We restrict our calendar schedule to no more than 3-4 clients per month
to minimize the possibility of births overlapping. Two births per month is more
the average. In 18+ years of home birth practice, simultaneous births have
occurred only once, with one other time when two clients labored
simultaneously, but each giving birth one before the other. More often, we will
be attending a client in the course of her birth, when another calls to report
early or other signs of labor. In response, someone from our midwifery team
will visit this second client to evaluate her labor progress, report by phone,
and may stay with her or return to the first client’s home.
Should the rare instance occur where two women are birthing closely or at the
same time (very, very rare!), I can call another midwife and assistant to be at
each client location.
What supplies do you bring to a birth?
 The following equipment and supplies are carried
to all births: respiratory & resuscitation equipment, anti-hemorrhagic
herbs, homeopathic remedies, Chinese medicinals, and other evidence-based
therapeutics. Fetal heart tone doppler, sterile instruments, suturing
materials and non-pharmaceutical topical anesthetics for perineal repairs, tape
measure and scale for baby exam, sterile disposable supplies (gauze, underpads,
etc.) and general labor support items such as massage oils, aromatherapy,
birth balls, rice socks, etc.
Our motto or slogan is, "We Bring the Birth Center to YOU!!"
Virginia law prohibits Licensed Midwives from carrying or
administering any controlled substance. The Commonwealth
Midwives Alliance, along with the Board of Medicine & other
interested stake-holders, are working together to amend the Midwifery Practice Act so that certain medications,
such as but not limited to Oxygen, Pitocin, Methergine, Rhogam, Lidocaine, IV Antibiotics, Vit
K, Erythromycin Ophthalmic Ointment, etc. can be carried and administered.
Until such amendment is passed by the VA Legislature, Licensed Midwives utilize
many non-allopathic (non-medical), alternative remedies that are empirically proven to be safe
and effective. We look forward to the day when we can use certain medications
when indicated.
 Do you attend at water births?
OF COURSE! Hydrotherapy for labor and birth has so many
benefits and advantages. Water is soothing, relaxing, and
can ease the pain of contractions, backache, and the tension which creates more
pain. Water helps facilitate various positions that might be cumbersome "on land."
We encourage women to consider having a large tub available. Whether or
not a mom actually gives birth in the water is entirely up
to her & the course of her birth at the time; sometimes it is best to
get OUT of the water.
Our Services ~ Water Birth
page has TONS of helpful information on the benefits &
preparations for a water labor and/or water birth.
What happens if there is a COMPLICATION during my labor, birth, or postpartum, or with my baby?
While there is a wide range of situations, complications, and emergencies that we may encounter during a home birth, we strive to be as non-interventive as possible, thereby reducing the risk of complications. Most intrapartum (during labor, birth and immediate postpartum) complications occur as a result of iatrogenic effects, meaning “caused by medical interruption or intervention”. Complications are rare when the pregnancy, mother, and baby are healthy, and normal; and when labor/birth/postpartum progress without interference; nevertheless there are risks & complications that are inherent to birth. 
Transport to a hospital due to complications is not inevitable, but because we practice safety first, the probability of transport due to complication is high. Should a complication arise, there is usually ample time to transport to the hospital; whether by car or ambulance depends on the specific needs at the time or transport. Hospital transport choices are discussed prenatally, taking into consideration insurance coverage, physician relationships, and general support/respect for homebirth families. Of course, priority is given to the closest hospital for more emergent transports. Once we transport a client to the hospital, we stay by her side helping her and her partner with decisions, support, encouragement, and continuity of care until her baby is safely delivered and both mother and baby are stable.
Your 6 weeks of Postpartum Care then continues with HBMS as normal (visits at 2, 4 & 6 wks) as well as breastfeeding and parenting support. 
Birth is a beautiful and normal event in the lives of most people. Yet emergencies can and do happen. The unexpected outcome of a complication or emergency during labor, birth, or postpartum can be difficult to cope with and oft’ times the outcome would have not been any different had the setting of the birth occurred in the hospital. The mysteries of birth, life, and death cannot be controlled or can they be avoided. And because there is no such thing as a "perfect birth," even in the most ideal of circumstances, we acknowledge the hand of a greater, divine power over which the balance of life and death is not ours to control.
What about the mess? Who cleans up the mess?
This is such a common question, one that many people worry about and most interestingly
enough, dads or partners are most concerned about this matter! We suppose
that this is due to a concern that we might leave it for others to clean
up! Not so... Within just 30 minutes of your birth, you cannot tell a baby
had just been born there! When we arrive at your home, we protect your
mattress, carpeting and other furnishings, fabrics, so they stay clean and dry;
and underpads are included in the Birth Kit to
help absorb fluids during the birth process.
As part of the clean-up during and after the birth, we wash all used linens,
prepare a meal for mom, and clean the bathroom and kitchen. If a water birth
pool is used/rented, we drain the pool and clean up all areas associated with
it.
While there are fluids such as amniotic fluid and blood involved in birth, the
mess is often less than people think. Your midwifery team takes care of and
cleans up “ALL THE MESS.” Instructions are given in your Informed
Choice Agreement Booklet and we discuss the
preparations and supplies needed, as well as how to prepare your birthing
supplies.
Who can be there? Can family, friends and our children attend?
YES, most certainly your loved ones, children and friends can attend!
Those who a couple chooses to have witness their birth is a personal
choice. Prenatally, we will discuss your plans, hopes, and concerns
regarding your birth, the atmosphere, and what is important to your family. The
top priority is to include people at your birth, who are not only supportive of
your choice to home birth, but are comfortable witnessing it.
Siblings are encouraged to be present for the birth, and we like for each
of them less than 13 years old to be supported by another adult. Very young
children (under four years old) need special attention and consideration. Planning for siblings must be made in advance, with toddlers and younger children needing support by
another adult at all times. This means that support-adults must remain with the
children at all times, whether or not the child(ren) participate at the
birth, are in another room in the home, or are removed from the home to be
attended in another location.
We prefer to have those who will be at the birth, to attend
the "home visit" (done ~ 36 wks). This is so that we can all meet, become
familiar with each other, and any concerns, questions, and expectations
can be voiced. All those whom you invite must understand that they may be asked to
leave the room or even to leave your home if you or we, together, decide it is
best for your birth experience. All those invited to your birth may
also join you at prenatal visits.
What is a Doula? A friend of mine had one at her birth...
In ancient Greece a doula was a woman who
served. Today it refers to trained women who support mothers emotionally and physically before,
during and after childbirth. She is the mother's advocate.
This support can come in the form of information, physical and emotional
support during the prenatal, postpartum, and labor/delivery periods. Some
doulas specialize in one of these areas, while others are willing to provide a
wide variety of services.
A birth doula or labor assistant is
trained to help mothers by:
- recognizing birth to be one of her most important life events
- providing continuous labor support at home and in the
hospital/birthing center
- being an experienced liaison with medical
staff
- accessing information she desires to make informed decisions
- helping their partners to participate fully and confidently
- providing immediate breastfeeding support and postpartum care
Research evidence shows that women using a birth
doula/labor assistant experience:
- fewer cesarean sections
- shorter labors
- decrease in use of pain medications and epidurals
- better mother-baby bonding
- easier breastfeeding
Can I have a Doula at my home birth?
YES, most certainly you can have a Doula to support you at your home birth!
We encourage our clients to have the support people they want and need at their birth!
What happens after the birth?
We generally stay for 2-4 hours after the birth of the baby. We ensure
mother and baby are stable, clean up and pack our vehicles, provide breastfeeding
support, we perform a thorough newborn exam (right next to the mother and only
after nursing has been well established), we check mom for tears and repair if necessary,
complete documentation in the chart regarding the details of the labor, birth and newborn
exam, and make sure the new family is fed and are "tucked in" for
their postpartum nap. Specific instructions are given to both the parents and
any other adults in the home, regarding the monitoring of mother & baby in
the first 24 hours.
 .
We return for postpartum, in-home visits at 24-36 hours, and 5-7 days. Mother
and baby visit us in our office at 2, 4 (Optional ~ Sometimes you need a "midwife fix" &
sometimes we need a "baby fix," too!) , and 6 wks postpartum.
We are completely available 24/7 for questions/concerns any time during
the postpartum period (and beyond!) including
breastfeeding support. We encourage our clients to stay in touch, as it is
often a hard "separation" for mom and midwife, after the baby comes!
Do you offer a consultation to learn more about your services?
Certainly !
A Consult Visit is an hour long and costs just $50!
This fee defrays the cost of time spent and is deducted from your balance if you retain us.
An in-person consult visit is the BEST way for prospective clients to learn about us and the services which we offer. Come prepared with questions to ask and an interest in learning more about your home birth option.
Please call or email Kim to schedule an appointment:
(901) 292-4876
| |
|