Can I Have a Home Birth? & Other F.A.Q.

Can I have a home birth?

Yes! There are many options for families looking to have a home birth. In the past, finding a midwife in Maryland was difficult. There simply were not enough midwives who served families at home. Those whose training specialized in out-of-hospital birth were not able to seek licensure. With the legalization of Certified Professional Midwives in Maryland we are finally able to increase access to care with providers who, although were always capable, are now recognized under Maryland law.

What is a Licensed Direct Entry Midwife?

A Licensed Direct Entry Midwife (LDEM) is a Certified Professional Midwife (CPM) who is licensed to provide midwifery care in Maryland. The CPM is a national credential awarded to those who pass the North American Registry of Midwives (NARM) exam. A Certified Professional Midwife has an education that is rooted in traditional out-of-hospital midwifery, typically through a rigorous and intimate apprenticeship. Paige, the midwife of Moonstone Midwifery, has trained exclusively in home birth. Along with her clinical experience, she has earned a MEAC accredited degree from the National College of Midwifery.

Is home birth a good option for me?

Home birth is a great option for mothers who are low risk. Healthy, uncomplicated pregnancies have excellent outcomes and greater satisfaction in out-of-hospital settings. Pre-existing medical complications or the development of complications such as pregnancy-induced hypertension, pre-eclampsia, severe anemia, placenta previa, preterm labor, gestational diabetes that is not diet controlled, require a higher level of care. Other pregnancies that risk out of care with Moonstone Midwifery include multiples (twins), breech presentation, and vaginal births after cesarean (VBACs).

When should I start my care with Moonstone Midwifery?

As soon as you wish! Meeting early gives you and your baby the best start. Moonstone Midwifery offers nutritional, supplemental, and herbal recommendations to maintain healthy, low risk pregnancies from your very first visit.

What are appointments like with a home birth midwife?

Your visits will follow the standard prenatal schedule, with longer appointments (about an hour) that cater to your individual needs. You will not only discuss your symptoms and have your vitals checked. There will be time to talk about your hopes and fears, plan your postpartum, and experienced hands palpating your baby at every visit. Prenatal visits take place with Paige at her office in Towson. In a solo midwifery practice, you can look forward to developing a relationship with the person attending your birth, as she gets to know you and your baby just as well.

What if my home is not suitable or too small for a home birth?

It’s unlikely that your home is not safe for a home birth, especially if you plan to raise your children there. Babies do not require a lot of space during their entrance in the world. The most important factor is your comfort. In the last month of your pregnancy your midwife will visit your home. There will be an opportunity to answer any questions regarding the birth in your home on location at that time.

What will my midwife bring to my home birth?

Your midwife will arrive at your home with a few bags of things to assist with the birth of your baby and the immediate postpartum care. Ideally, your midwife will not need to use much more than a stethoscope and a baby scale at the birth, but she comes prepared for all of the possibilities. Moonstone Midwifery brings along herbs, homeopathic remedies, and essential oils that are utilized in non-emergent circumstances. She will have medications to manage emergencies, resuscitation equipment, and other various medical equipment that would be available in a hospital setting. Midwives do not provide medical inductions at home or pharmaceutical pain management such as narcotic analgesics.

What supplies do I need for a home birth?

In addition to the supplies above, your midwife will give you a list of household items to gather in preparation for the birth. Every client is encouraged to purchase a birth kit as welll. This kit has the disposable items that are utilized for most births, such as chux pads, sterile gloves, and gauze. At your home visit the supplies will be checked and sorted for the birth. If you would like to have a water birth there are extra supplies that you will purchase. A birth pool should be provided by your midwife at the home visit.

How messy is having a baby at home?

Moonstone Midwifery makes every effort to clean up during and after the birth. You will be given advice prenatally on how to prepare your bed and home to minimize the mess and clean up process after the birth. At the end of the birth you will likely have one bag of trash and one bag of laundry ready to be washed, along with a scrubbed bathroom and clean sheets in your bed. Clients often remark how much cleaner their house is after the birth, or that you wouldn’t have known a baby was ever born in their space.

What are my options for pain relief at home?

At home you have many options for pain relief, all of them being non-pharmacological. It is important to keep in mind that the pain of birth is directly related to your mental state. One cannot underestimate the calming power of being in your own environment, free to move and do what you please, surrounded by only supportive family and your chosen birth team. Many clients utilize massage techniques, essential oils, rebozo, hydrotherapy, and other pain coping techniques. As a midwife with a background in psychiatry, Paige discusses this at length during prenatal visits.

What if I want an epidural?

If at any point during your labor you decide that the experience is too intense, you may request to transfer to the hospital for pain management. During your care you will have an option to discuss how you would like this to be managed once you are in labor.

How do you handle an emergency?

Throughout your pregnancy and labor you will be monitored for signs of complications. Any concerning vital signs will be discussed with you as they emerge. In most cases a transfer can be anticipated and initiated prior to an emergency. There are times when emergencies do happen at home. Moonstone Midwifery brings along everything needed to manage immediate complications. Paige carries medications and equipment in anticipation of bleeding, infection, shock, vaginal repairs, and resuscitations at home, including oxygen and a resuscitation cradle that can be brought to the mother’s side. If a resuscitation is initiated or a complication is not easily managed at home, emergency services will be activated and efforts will be continued at home until a transport team arrives.

What happens if I need to go the hospital?

In the event of a transfer of care prior to labor, Moonstone Midwifery will assist you in finding a supportive higher level provider. Paige will continue to provide educational and emotional support throughout your pregnancy and birth as requested. If you transport into the hospital during labor, whether emergent or non-emergent, your midwife will make every effort to stay with you throughout the process. In all cases, a verbal report will be given over phone to the receiving provider/facility and records will be faxed.

Can my mother, friend, children, or doula be at my birth?

Yes! If there is someone that you feel will be an important asset to your birth space, they are more than welcome. Moonstone Midwifery practices family-centered care that involves your children and family throughout the prenatal and birthing process. During your care you will discuss who you would want to invite to your birth, who is inviting themselves, and what influence this may have on your labor and birth. Your midwife should guide you during these decisions, but the choice is ultimately yours.

Should I make a birth plan if I am having a home birth?

Moonstone Midwifery respects and encourages birth plans. During your care you will be given the opportunity to complete a home birth plan specifically formulated by your midwife. After seeing how different each home birth can be, Paige has written a birth plan template to help open a discussion around the various options specific to out-of-hospital birth. Discussions such as: Would you like to be coached during pushing or crowning? Who will catch the baby? How would you like to manage the delivery of the placenta? Clients are also encouraged to discuss any options that are of interest to them that may not be on this plan.

Are there required tests or procedures if I have a home birth?

Moonstone Midwifery values informed choice above all else. Families choosing home birth should be aware of all of their options. You will be offered the standard of care that is recommended in all settings. You will be offered resources and facts regarding the evidence behind each procedure or test. Clients are then encouraged to take the time to research for themselves how each test can benefit or harm them. After fully understanding the risks and benefits of care, all clients are given the option to accept or decline each choice along their path to parenthood. Moonstone Midwifery strongly believes in parental rights and views pregnancy as a launchpad into many decisions in parenthood.

I just realized home birth was for me, is it too late to start care?

Moonstone Midwifery accepts clients late to care on an individual basis. After assessing prior records and current pregnancy presentation, a determination will be made regarding whether you are a safe candidate for a late-to-care home birth.

How many clients do you take a month?

Paige values quality time with her clients while balancing a family of her own. For this reason Moonstone Midwifery strives for only two clients a month, with a max of four in special circumstances.

How much does it cost to have a home birth with Moonstone Midwifery?

The total cost of Midwifery Care is $4000, often installments are paid throughout your pregnancy. Payment plan options will be discussed prior to initiating care. This fee includes hour long prenatal visits, care in your home the day of the birth, repeat home visits during the postpartum period, and time set aside by the midwife to be in town and on call during the weeks surrounding your due time.

Will my insurance cover a home birth?

Moonstone Midwifery works closely with a biller who will verify your benefits at no extra cost. Paige does not carry malpractice insurance and therefore is not in network with any insurance company. We will automatically file for out of network gap exception and will work hard for reimbursements for our clients. A percentage of all returns will go to our biller to compensate those efforts.

Do you find yourself wondering “Can I have a home birth?” If after reading this F.A.Q. you still have some burning questions, reach out! Paige, the midwife at Moonstone Midwifery, is always happy to schedule time to chat with families considering home birth.

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