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.
Home birth midwifery maternity care, 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. We will provide you with both: Insurance Registration & Verification of Benefits forms 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. An In-Network Exception or Authorization may be obtained from some 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.
We typically do all prenatal appointments 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 four clients per month to minimize the possibility of births overlapping. Two to three births per month is more the average. In 16+ years of home birth practice, simultaneous births have occurred only once. 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!), we will split into two teams with an assistant and a midwife 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!!"
Virgina 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, 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-
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 birth at the time.
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; nvertheless there are risks and 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 as normal, 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 happens after the birth?
We generally stay for 2-3 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" and sometimes we need a "baby fix," too!!), and 6 weeks 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! This is the BEST way for prospective clients to learn about us and the services
which we offer. A Consult Visit is an hour in duration and costs just $50!
This fee defrays the cost of time spent and is deducted from your balance if you retain us.
Please email Kim or call to schedule an appointment:
(901) 292-4876