Why Choose a Midwife?
The midwifery model of care differs fundamentally in its approach to pregnancy, labor and birth. It is characterized by personal, respectful, and customized care and has been shown through high quality research to improve pregnancy outcomes and client satisfaction, while lowering the rates of intervention, including cesarean section. Whereas the cesarean rate for an obstetrician typically ranges from 25-50%, the cesarean rate for midwives is usually 3-10%, well below the World Health Organization’s recommendation for safe cesarean rates.
Unlike the pathological perspective of the medical model, midwives view pregnancy and birth as normal, natural processes with physical, emotional, psychosocial, spiritual, cultural and financial components.
The midwifery assistant model of care is characterized by:
- Respectful treatment
- Personal attention
- Centering the client
- Confidence in women’s bodies
- Continuity of care
- Appropriate monitoring
- Trust in the process of labor and birth
- Fewer interventions (including Cesarean section)
Midwives spend about 45-60 minutes at each prenatal visit. (A typical visit with an obstetrician is about 5-10 minutes, after waiting for up to an hour or more!) We spend this extra time getting to know our clients, addressing concerns, answering questions, and providing plenty of information. Midwives know that feelings, hopes, fears, physical and practical needs, and spiritual or religious beliefs can all affect your pregnancy and birth. We aim to address all of these needs so you can give birth naturally, safely, and confidently.
Midwives focus more on the importance of nutrition and exercise than most doctors do. We help to empower you to discover your body’s ability to give birth in its own way and its own time and to trust the process and yourself. We provide sensitive, attentive care throughout your time with us.
During labor we provide continuous, one-on-one support and monitoring throughout labor. In the hospital setting, doctors follow an on-call schedule so you may not have the same doctor during your birth that you had during your pregnancy. In addition, doctors do not come in until you are about to push your baby out, so it is the nurses who will be with you during most of your labor.
In the midwifery model, you have peace of mind that the midwife with whom you developed a trusting relationship during the pregnancy will be the one with you when you’re giving birth. According to the World Health Organization’s (WHO) statement on Health Promotion and Birth in 1986 “Midwives are the most cost effective and appropriate primary care givers for all pregnant women in all instances and all settings”.
Is homebirth safe?
Over the last twenty years numerous studies have been done to determine the safety of out-of-hospital birth. All of these studies have shown that home or birth center birth with a skilled attendant are just as safe, and in some instances, safer than hospital birth for healthy, low-risk women.
In fact, the countries in the world with the best birth statistics are those in which midwives are the primary care givers for pregnant women and the home birth rate is much higher than in the United States.
Of course, there are some situations in which the hospital is the best place for a woman to have her baby, and for these situations we are grateful to have the hospital as an option. Part of what makes community birth safe is having a collaborative relationship with hospital based providers to allow for a smooth transfer of care should acute care become necessary.
But the fact is, out-of-hospital birth is a safe alternative to hospital birth for the vast majority of women.
Perhaps we should be asking a different question altogether. Is hospital birth safe? In fact, for low risk women, the hospital has never been proven to be the safest place to give birth. The U.S. spends more money on maternity care than any other industrialized nation and yet when it comes to maternal and infant mortality rates, we have some of the worst outcomes. We also have disturbing racial disparities in both maternal and infant mortality. In a wealthy country with all the resources to do better, this is criminal. Approximately 98% of births in America take place in the hospital.
When does care begin?
Care begins as soon as we decide to work together. The first step is to set up a consultation, which you can do here. This is essentially a meet and greet where we get to know each other, you can ask questions, and we see if we are a good fit. Sometimes this happens at the beginning of the pregnancy and other times people are switching from a doctor later in pregnancy.
What if there are complications?
While good prenatal care will a pick up or eliminate most complications during the pregnancy, there is always a possibility that a complication may arise during labor. For this reason midwives are trained in handling several kinds of emergency situations and also know when transfer is appropriate. We have working relationships with several back up obstetricians in case there is a need to transfer to the hospital for any reason.
The vast majority (98%) of transports in labor are for non-emergency reasons and transfer is done by private car to the hospital of the back up physician. In the case of a true emergency transfer might be by ambulance to the nearest hospital with an obstetrical unit. An emergency care plan is completed for each client by the 36th week of pregnancy to outline the plan for emergencies. The midwife accompanies the client and her family to the hospital to provide support and facilitate a smooth transfer of care.
What about cost? Will my insurance cover a midwife?
Cost for care varies depending on medical history and obstetrical. It is important to me that midwifery care is accessible so I do offer a sliding scale for those who do not have the capacity to pay the standard fee. In additions, payment plans are available. Payments may be made in small increments throughout the pregnancy or all at once, as long as you are paid in full by 36 weeks.Insurance coverage depends on your particular plan benefits. To check your benefits with my biller (Nora from Midwives Advantage) go here.
There are some fees that are not covered by insurance, including childbirth classes, your birth kit, as well as my matrescence support services. You may also be responsible for any deductibles, co-pays, or co-insurance, depending on your plan. Payments may be made in cash, by check, or by credit card.