- Pregnancy
- Baby & Toddler
- Parents
- Getting Pregnant
- Baby Names
- Product Reviews
-
Registry
- Community
-
More
Want a personalized experience?
Download the free app
Natural Birth
Baby4OT
member
Starting to consider homebirth... questions
Baby4OT
member
I've had two natural childbirths already, but am starting to consider homebirth. My labors have all been really short (4 hours and 2.5 hours). I think one of my fears would be that the midwife not get to me in time. Though, likewise, I fear that I could end up giving birth on the side of the road!
Anyway, some questions I have about homebirth...
1) When are newborn checks done and the newborn bloodtest and all that? Who does them? I know the midwife would do the immediate checks for apgars, but beyond that would I have to take baby to the pediatrician when he or she is 24 hours old?
2) How do you find a homebirth midwife? I currently use hospital-based midwives and I like them, just don't want to deal with the hospital policies. Last time after I have birth I was ready to get out of there! I had to wait a day and a half before DD and I were both discharged.
3) What questions do I need to ask potential homebirth midwives?
4) Does insurance still cover it? I know it will depend on the policy, but do they ever cover it or is it always out of pocket?
5) What else do I need to consider? DH's first hesitation was that he didn't want to have to clean up all the afterbirth! I told him I was pretty sure that the midwife would take care of that.
This discussion has been closed.
Re: Starting to consider homebirth... questions
1 - My MWs check the baby after the birth and then come back 1 week PP to check again. My family doctor will do all of the normal newborn screenings at her office 48 hours after the birth. Most people wait until much later to go to the doc, but my babies tend to have jaundice, so I want this one checked as soon as possible.
2 - My state has an association of MWs. I sent an email to someone on their website and they gave me a list to start my search. I also sent a mass email to a bunch of MWs I found listed on another website. From there I schedules interviews.
3 - You can google a list of standard questions. I wanted to know how many births they had attended, their training, fees, what type of prenatal care they give, their birth philosophy, transfer rates/criteria, etc.
4 - It depends on your insurance plan, what state you live in, and your MWs. My birth is not covered by insurance, but it is applied toward our out-of-network deductable. It only ends up being $3000 for everything (prenatal care and delivery with two midwives, as well as my 1 week PP visit and another 6 week visit). That is just about the same amount we paid out of pocket for my son's hospital birth that was covered by insurance (he was born in January and our deductable had started over).
5 - My MWs do all the clean-up. Other things to consider IMO are your health (HB is only a good choice for low-risk women) and how close you live to a hospital in case of an emergency.
Thanks for asking...these are some of our questions too!
1) ?
2) We searched:
https://www.mothersnaturally.org/midwives/findAMidwife.php
https://www.birthnetwork.org/guide.htm
we just tried googling "midwife groups in OUR TOWN" and that got a couple hits
We have found WAY more homebirth midwives than hospital ones! That is one reason we are considering a home birth now.
3) The directory on this page is for Michigan, but there are questions broken down into categories that you could use:
https://michiganmidwives.org/links/
Choosinga Maternity Care Provider
Choosinga Midwife or Doctor is an important decision and should be researchedcarefully. Here is a list of questions you might start with to begin toevaluate potential providers.
For maternity care in general:
1. What is your basicphilosophy of care?
2. What is your trainingand background in birth? How many births have you attended? In what settings?
3. How many births doyou attend annually?
4. How many providersare in your practice? Will I get to know them all well? Do they all share thesame philosophy and beliefs about birth? Are they all equally experienced?
5. How will you help mebe healthy during pregnancy? How will you help me prepare for giving birth?
6. Who will attend me atmy birth? What is the back-up system if you are unavailable?
7. How do you handlecomplications?
8. What arrangements areavailable if complications occur and other providers are involved in my or mybaby?s care? What will your role be if that should be necessary?
9. What are your routineprenatal visits like? What are my options for testing or ultrasound? (Are theyrequired or available?)
10. Can I reach you 24hours a day? What if I just have a question?
11. What are your feesand what are my payment options? What do those fees cover?
12. What are yourexpectations of me?
At our Birth:
1. When do I contact youwhen I go into labor?
2. What are your routineprocedures for labor? If in a birth center or hospital, what are their routineprocedures?
3. Under whatcircumstances would you induce labor?
4. How do you monitorlabor and my baby?
5. Under what kinds ofcircumstances do you recommend interventions (pitocin, episiotomy, forceps,vacuum extraction, cesarean section) ?
6. Who is present when Ihave my baby?
7. What do you do tohelp me cope with the intensity of labor and any fears I may have?
8. What are yourroutines after the baby is born, for me and for my baby?
After Birth:
1. What does yourpostpartum care include?
2. How will you help mewith breastfeeding and new baby care?
3. What is yourphilosophy about circumcision? About immunizations?
4. Are you available forquestions after the birth?
Keyto Abbreviations
Midwives:
CPM
Certified Professional Midwife
CNM
Certified Nurse Midwife
DEM
Direct Entry Midwife
Maternity Related Services:
CCE
Certified Childbirth Educator
CD
Certified Doula
CHt
Certified Hypnotherapist
ICCE
ICEA Certified Childbirth Educator
Physicians:
DO
Doctor of Osteopathy
MD
Medical Doctor
Nurses:
LPN
Licensed Practical Nurse
RN
Registered Nurse
4) I've read and heard that basically it is out of pocket, then reimbursed if applicable.
5) Clean up is a HUGE issue for us too, but one midwife I emailed said:
Typically I ask the couple to have two garbage cans with bags in them. One is for the garbage (used gloves, empty packages, used blue pads, etc) and one is for linens (towels from waterbirth, washcloths, clothes, sheets, etc). Your bed will be protected with a plastic covering. (The bed will be made like this: mattress, nice sheets, plastic protective sheet then sheets that are already stained or cheap ones you don't care much about.) While you and your baby are relaxing in a warm soothing herbal bath, my assistant and I go around the room and collect all of our things and clean the "mess." A load of laundry will be started right away so that anything with blood or other fluids won't stain. Your baby comes out of the herbal bath first and dad will dry him off and put clothes on him. When you get out, we will help you to the toilet and then help you get dressed. When you come back into your room, your bed will be made (plastic sheet and top sheet removed) and you won't even be able to tell that you just gave birth there.
Hope this helps, or gets you started. I am going to watch to see what kinds of other info people have. You asked great questions (and in an organized fashion). Much better than how I have been wording my questions.
Good luck!
Make a pregnancy ticker
I'll answer based on my midwife, but I think this is pretty typical.
1. My midwife does the blood tests (sent to independent lab), and she comes for a home visit the next day. We continue to see her for post-partum visits until about 6 weeks, so we won't bring DS to a pediatrician (really, just our family NP) until his next appointment.
2. I am using the same group I used last time, except that I was a birth center client then. A good friend used them, and there are only two birth centers in the area! If your family doctor is midwife-friendly, perhaps she could refer you to one. Otherwise, maybe ask a local natural childbirth instructor (Bradley, for example) or someone you know who has had a home birth. I used to have great discussion lists at my work for all sorts of non-work-related things, but I don't think that's typical. If you are on a PPO network, you might start by seeing what midwives are even covered!
3. I would ask about their training and experience, transfer rates, risk policy (what makes you a home birth candidate), transfer policy/walking you through a transfer, special skills, what childbirth classes/methods they recommend, etc. You really need to find someone that you trust, and that is something you can only find out by interviewing them. I would also ask them why they think home birth is safe!
4. It totally depends on the policy. My policy specifically excludes homebirth, but: a) if I paid completely out of pocket it would still only be a few thousand dollars, b) billing depends on how it's coded, and many MWs bill one lump sum as "global services", and c) there are laws in some states that may require your insurance company to provide you with equivalent options for different types of providers. The insurance I had last time would have covered a home birth, and my current insurance does cover birth centers. If that's the case for you, a birth center might be a consideration.
5. Yes, midwives typically clean up for you. What do you think they would do if you were single? Leave you with a newborn baby and a pile of bloody towels? LOL!
Baby4OT, you are expecting again!!! Congratulations!!!
i definitely think you should homebirth. it would be perfect for you! especially considering your history of short labors.
to answer your specific questions:
1) my MW did all the newborn screenings (except the hearing test). she did some the day audrey was born. and she came back the next day to do the PKU.
2) google! i googled to find MWs in the area. but i also asked around. i asked friends in the area who are birth professionals, and i searched www.midwife.org and www.mana.org. then i interviewed the midwives that had good references.
3) i wanted to know about their experience. i asked specific questions that led me to better understand their style and their birth philosophy. i wanted to know their back up plans. i wanted to know what i could expect at appointments. obviously i wanted to know about fees and how they were paid and what that covered. i wanted to know their relationship(s) with local OBs and hospitals, in the event that a transfer of care was at any point necessary. mostly, however, i wanted to know that she understood my baggage, being a vbac after a failed homebirth with a sucky midwife. when i interviewed the "one," i knew.
4) BirthCare is the only HBMW practice in NoVA that is covered 100% by my insurance, as my insurance only covers CNMs at full coverage. My CPM was paid at about 55%.
5) my MW cleaned everything up both times i homebirthed. even did the laundry and made sure i ate! i think the biggest consideration for you is your comfort. will you be comfortable birthing at home? if yes, then go for it! everything else can be worked out!
G/L!
2. I googled "mycity midwife homebirth".
3. What is their transfer rate? What's included in your fee?
4. Ours paid part.
5. The midwives did a nice job cleaning up. They even started the first load of laundry (we had to do a couple loads).
I will add that the closer I get to my due date (Friday) the more I cannot possibly understand why anyone would want to do anything but a homebirth. Each time I ride in the car for even a few minutes, I am so uncomfortable, my BH and real contractions get intolerable, and it is so cold and icy outside. I cannot even imagine having to drive to the hospital when I am in active labor. I am so, so, so pleased we are doing a homebirth - it feels like the most "right" decision I have ever made.
1) Our MW requires that we have a pediatrician lined up who will see the baby within 72 hours of delivery. She had a list of recommended pediatricians, and there was one on there that I also have heard rave reviews about from other holistic minded parents - so I have that all set and ready to go. She called me personally earlier this week (I am due this week) to say she is looking forward to meeting our little guy and to go over what we will do once he is born - which is basically just call the office and they will set us up for an appointment within 48 - 72 hours.
2) Our friend who had done 2 homebirths sent us the links that a PP put on here so we could find someone in our area. The closest homebirth MW is also someone who has been interviewed for multiple articles in respected citywide papers doing features on the business of birthing - so I was already familiar with her name and philosophy.
3) Things that were important to me that I asked during our initial interview included: her position on post-due babies (I will not accept an induction for any reason other than proven medical necessity - I have friends that delivered healthy happy babies at 43 weeks); her position on breech delivery; what are some of the "emergencies" that she can handle at home, and what would she transfer us to the hospital for; if a transfer was needed where would we go, would she come with us; what is her position on the use of herbal medicine and complementary medicine like acupuncture and chiropractic (I am a licensed acupuncturist and herbalist - so I wouldn't see a practitioner that forbid the use of these things); if something in the pregnancy disqualified me for a homebirth - how would treatment change and would she transfer care (she has hospital privileges so we would have made arrangements to deliver at that hospital and she would still be our primary care attendant).
4) My insurance (BCBS PPO) covers homebirth just as it would hospital birth -- I pay my $1200 deductible and the rest is covered at my 10% co-insurance rate. My husband's insurance (BCBS HMO) would not cover a homebirth. If we had decided to switch me to his policy, the total cost of services (pre-natal and the actual birth are bundled together) would be $3500. In addition to that, we have rented a birth tub ($150) and we must pay the birth assistant ($650), neither of which are covered by insurance but did qualify for our HSA money.
5) They clean up EVERYTHING! My friend who has done multiple homebirths says you wouldn't even know you had a baby. They take all the afterbirth away. Your husband does no clean up. It's quicker and cleaner than a hospital delivery where they don't really care/need to clean up immediately.
1) Newborn checks/blood test: My midwife came to our home 2 days after the birth to check him/me and do his first blood test. Then we went to her office at 1 week, 2 weeks, and 6 weeks postpartum. The second blood test was done at 2 weeks, and she forwarded the results to our pediatrician. We had no need to see our pediatrician until his 2-month checkup, but she (the ped) asked to see him at 2 weeks. No problem. It worked out well because he ended up getting sick with RSV at 4 weeks, so it was nice that our first visit with her was NOT a sick visit
2) Finding: Mothering.com's Find Your Tribe section. I also have a message board for local moms that I used. From those places, I knew who I wanted to use. Then I asked my doula for recommendations and confirmed that she recommended her, too
3) Questions: Same as you'd ask any hospital-based provider, really. How would you handle things if my membranes had been ruptured for 24 hours and I still wasn't having regular contractions? What will you do if I'm GBS positive? How do you feel about eating/drinking while in labor? etc. Maybe a few questions on what would cause you to risk out from homebirth, transfer rates, etc.
4) Insurance: Believe it or not, I'm still fighting with my insurance company over coverage... my son is about to turn 1
But yes, they did cover a large chunk of it. Totally depends on the policy, though.
5) Midwives do all cleanup. I ended up delivering DS in the bathtub and the placenta on the toilet, which made cleanup super easy!
Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)
I will answer based on my experience and you are in VA so you may likely be looking at the same place I delivered with (Birthcare).
1- I was required to take DS to the pediatrician within the first few days of life for the metabolic screening and check-up. The MWs did all of the initial assessments and came back the next two day to check on us. We did the hearing screening at about 2 weeks old.
2-I have always gone to Birthcare (for at least 11 years now) for well-woman care, so I knew that I would birth with them also. But, you can also google local midwives in the area or you can ask several people in VA who are on this board who they would recommend or not.
3-I don't have any new ones to add. You should feel comfortable with their care and their statistics.
4- My insurance covered it 100% (although they never said they would prior to me delivering- they just covered it when the papers came to them).
5-Midwives and birth assistants do the cleaning- except my DH helped some too because that is the kind of guy he is. you both need to be on board for a homebirth to work well. also, since you deliver fast, home is a wonderful option. You will have most of the supplies in your house. If you deliver too fast for the MW to get there, they can talk DH through the delivery and you would have the supplies already there. I think that beats delivering on the side of the road with no supplies.
Thanks everyone! This gives me a good place to start from. My DH was surprised when I mentioned it recently and I know he'll have a lot of questions and concerns, but I don't think he's inherently against it. We've had two Bradley births so he's already on board as husbnad-coach. We only live 15 minutes from the hospital where I would deliver if I had a hospital birth (good thing too - DD2 was literally born 5 min after I arrived last time! If we lived further away she'd have been born in the car!). I read Ina May's book when I was pg with DD2 (took Bradley classes before DD1). I just recently watched Business of Being Born. DH took the classes of course and we refreshed the Bradley info on our own last time, but he hasn't read or seen the more "crunchy" stuff that I have.
I'm sure I'll have more questions if we decide we definitely want to go this route. I'm certainly leaning in this direction. Thanks again! If anyone else has additional input, I'll happily read it.