Frequently Asked Questions

What’s a Certified Professional Midwife (CPM)and a Licensed Midwife (LM)?
A Certified Professional Midwife (CPM) is a trained professional certified by the North American Registry of Midwives (NARM), who is qualified to provide the Midwives Model of Care. Licensed Midwives have been granted a license by the Medical Board of California to work with low risk women in homebirth and birth center settings.  CPMs are the only maternal care providers required to receive training in out-of-hospital settings. Midwives specialize in supporting normal, healthy pregnancies and births. They provide individualized care to women and their newborns throughout the childbearing year.

Do I need to see a doctor in addition to a midwife?
Not necessarily. Some women never see a doctor throughout their pregnancy, others use an OB/GYN or medical facility selectively, and some women prefer to have concurrent care throughout their pregnancy. Midwives provide comprehensive prenatal, labor and birth, and postpartum care. We are able to draw labs and administer certain medications. We do not, however, perform ultrasound, and we do not diagnose or treat medical conditions that make the pregnancy high risk. We are trained to care for low-risk women and identify when transfer to a medical professional or medical facility is necessary. We are make a transfer of care plan during the prenatal care to allow this to go smoothly.

Do I need to have an ultrasound?
An ultrasound is a useful tool but is not routinely necessary in a healthy pregnancy. Some reasons an ultrasound may be recommended include uncertain dates, vaginal bleeding, possibility of twins, abdominal pain, decreased fetal movement, or if you have previously had a cesarean. For women who choose to have an ultrasound, you can arrange to have the procedure done with physician.

How do you manage pain at home?
One of the benefits of birthing at home is that you are in a familiar environment where you can relax and let your body and baby do the work. Research shows that stress hormones increase pain and slow the progress of labor. Therefore the goal is to make your labor as low-stress as possible. We can do this by offering our loving support and the freedom to labor at your own pace in a comfortable environment, surrounded by people you trust. We encourage you to move freely during labor, which helps you cope with contractions and helps the labor process. You’ll be free to eat and drink as you wish, which lowers your pain threshold. Many women choose to spend at least part of labor in water, which is soothing and facilitates rhythmic movements. Having less intervention in your labor allows your body to naturally release hormones that help with pain management. In addition, we carry herbs and homeopathic remedies to help you cope, when appropriate.

I live in a small apartment/house. Do I have enough room for a home birth?
Yes! Babies can be born just about anywhere. As long as you have freedom to move to respond to your body’s cues, you feel safe, and the birth place is reasonably clean and warm, your home is a fine place to give birth.

Can my baby be born in water?
Yes! Almost every woman spends some portion of her labor in water. It helps “take the edge off” of the intensity- so much so that many women stay in and push their babies out in the tub! You do not have to rent a birth tub, although many families do simply because they are larger and deeper than their bath tub,providing enough space for laboring moms and their partners.  Some of the benefits of waterbirth include:
•    Reduction of sensory stimulus, producing fewer stress-related hormones
•    Increased production of pain inhibitors, such as endorphins
•    Reduced sensations of pain
•    Increased skin elasticity, reducing the amount of perineal tearing
•    Gentler birth for baby

How do you monitor the baby during birth?
We typically use a handheld Doppler to periodically listen to your baby’s heart during labor. Doppler is a form of ultrasound that allows us to hear the baby’s heart beat through your abdomen. It can be used under water and with you in almost any position. If you prefer, we can use a fetoscope (a type of stethoscope) instead, but you may have to move into a position that allows us to hear the baby’s heart.

What happens if there’s an emergency?
Although home birth is statistically safe, it does not guarantee a problem-free pregnancy or birth. If complications arise during pregnancy, you may need to consult with and possibly transfer care to an obstetrician. Both midwives who attend your birth are trained to provide immediate care for emergencies, including neonatal resuscitation (CPR for newborns). We bring all the necessary equipment and supplies, as well as herbs and homeopathics, to manage any special challenges. Since we only provide care for healthy women, and intervention during labor is limited, the chance of a true emergency is very low. In fact, most transports (to hospital) are for non-emergency situations, such as a long labor without progression or the laboring woman’s desire for pain medications. If complications develop during labor or birth that are beyond our scope of care, you will be transported to the nearest hospital. We will continue to provide support for you there, but care will be transferred to a physician. We will also continue to provide postpartum care and breastfeeding support.

I’ve had a cesarean before. Can I have a home birth?
Probably. Uterine surgery (for example, cesarean delivery) leaves a scar on the uterus. Scar tissue is weaker than surrounding tissue, so women who have had cesareans are at slightly higher risk of having the uterine tissue tear during birth (uterine rupture), compared to women who have not had cesareans. This risk is lowest if you have only had one previous uterine surgery, had a low transverse incision, eat a healthy diet, do not smoke, allow at least a year after surgery before becoming pregnant, and labor is not induced. If the reason for surgery does not necessitate another surgery (for example, you had a cesarean for breech or for failure to progress), you may consider having a home birth after cesarean (HBAC). We can discuss this further during a free consultation.
Isn’t home birth messy??Birth is usually not very messy. Midwives are very good at containing any mess (after all, we’re the ones to clean it up afterwards!). You can expect to have a garbage bag full of trash and one full of laundry when the birth is over.

Who can be at my birth?
Anyone you like! You can have a doula, your mother, your best friend, anyone who can provide good support for you during birth and who accepts your decision to give birth at home. Children are welcome, as long as you have a support person for young children. I encourage family-centered birthing and have books and videos to help you prepare your children for the birth.There will be two midwives at your birth – myself and another midwife to assist. We can be as involved or as hands-off as you’d like. We can be by your side, or quietly sit in another room, ready and available. This is your birth experience! You decide who will be present, and how each person will support you.

Doesn’t a doctor need to see the baby right away?
Midwives are trained to provide care for moms and babies-both during the pregnancy and after the birth! I provide a complete newborn exam within a few hours after birth. If anything is not normal, I will let you know and we will discuss whether your baby needs to be seen by a pediatric care provider right away. I ask that all families select a pediatric care provider by 36 weeks gestation, and that you know how to reach that provider urgently. Most babies do not need to be seen immediately, and you are encouraged to get the rest you need following birth.