Frequently Asked Questions

What is a Licensed Midwife? Do you work at the hospital?

Prenatal Care, Photo by Petal & Vine Photography

Prenatal Care, Photo by Petal & Vine Photography

In the United States, legalities and education/experience of direct entry midwives varies from state to state. In Florida, Licensed Midwives are required to attend a 3 year approved in-state midwifery education program, complete clinical requirements for hours and births attended under the supervision of a preceptor midwife, pass a national written examination, report annual statistics, and pursue continuing education for license renewal. We are trained as guardians of normal pregnancy and birth, accepting into care only low-risk families for out-of-hospital care, and are required by law to consult/refer/transfer care for situations that fall outside our scope of practice.

I chose to provide out-of-hospital midwifery care based on my observations and experiences in multiple birth settings over the years as a doula and birthing mother. Home visiting home birth care meets your family where you are in every way. It creates a relationship between midwife and family that I believe is responsible for heightened awareness and more positive outcomes. I am grateful for the place of Licensed Midwives in the local birth community, serving families where they want to be, and for the relationships I have with clinical providers who work best in the hospital setting and treat my clients so well when needed.

Hands on support during a homebirth

Hands on support during a homebirth

Is my house even big enough for a home birth?

I look fondly on the many births I have attended in apartments, small homes, and even an RV once! You would be surprised how little space we need. A couple clear surfaces for supplies, space to labor (and an inflatable tub if you want one, though I’ve seen folks birth just fine in standard issue bathtubs or in their own beds), a bathroom with toilet, running water, a place to shower/bathe if you wish, and a place to recover—your bed or a couch are perfect. This is the home you’ll nurture your baby in, you don’t need much more space to bring them out into.

How do I know if I’m a good candidate for home birth?

I’m happy to answer any specific questions about your health history and homebirth over the phone or in person at a free consultation. Licensed Midwives are required to complete a risk assessment of each client, reviewing a number of health conditions and history. Even certain risk factors do not mean you cannot have a homebirth, but will require you to consult with an OB or Maternal Fetal Medicine Specialist during your care, which would help arrange. By law, Licensed Midwives in Florida cannot facilitate breech or twin/multiples births.

What do you bring to the birth?

I carry two bags and a rolling oxygen tank. One bag contains supplies that I usually have at prenatal and postpartum visits—a blood pressure cuff, stethoscope, fetal doppler and fetoscope to listen to the baby’s heartbeat, thermometer, a sling and scale to weigh the baby, measuring tape for bellies AND babies, and a pulse oximeter to measure blood oxygen saturation levels at the baby’s hand/foot. In my birth kit I have sterile birth instruments, neonatal and adult resuscitation equipment, IV fluids and supplies, suturing kit, medications as needed (antibiotics, anti-hemorrhagics, vitamin K and erythromycin eye ointment) as well as herbal tinctures for support.

What happens after the birth?

Undisturbed and watched over postpartum after a homebirth in St. Pete

Undisturbed and watched over postpartum after a homebirth in St. Pete

After your homebirth, we watch over you and your baby while you bond. This time is so special and important for many reasons. We can assist with feeding, observe and monitor vital signs, await your placenta, and cut the umbilical cord if/when you are ready. We make sure you are comfortable, assess for any lacerations, repair with sutures if needed, and get your family/support team to work preparing you a meal. I do a full newborn exam which gets sent to your pediatrician, and you will follow up with them in the first days of life to begin care of your baby. I stay with you at least 2 hours following the birth, and when all is well and you are ready to begin your journey as parents, I head out. I continue to be on call for you during the postpartum period, following up with a home visit in the first 48 hours, available by phone or visit in the first week for breastfeeding support, and we have full postpartum visits scheduled at 2 and 6 weeks. I file your birth certificate too!

Do you have a back-up doctor?

I don’t have one specific back-up doctor. I consult with multiple area OB specialists and Nurse Midwives as needed for risk factors and transfers.

Do you take TriCare? Other insurances? Medicaid?

The Licensed Midwives in this area would LOVE to be able to accept TriCare but they do not provide benefits for LM services. At this time, TriCare covers Certified Nurse Midwives only, and I can recommend some great ones. I do offer a discount for military families.

I am not in network with any insurance providers. At this time my care is self-pay with the goal of insurance reimbursement after your birth. You can verify your benefits through Express Claims to find out what they expect your insurance to pay/what your refund would be. The fee for verification of benefits will be refunded from your total amount owed for care.

Accepting Medicaid and providing easy-access care is a long term goal of mine. While I am growing my practice and determining its sustainability for my family, I accept self-pay with a sliding scale. I encourage families who qualify to apply for Medicaid to cover lab and ultrasound expenses, as well as to connect with WIC & Healthy Start/Families for food and resource support. I do not want to turn anyone away for lack of ability to pay, and commit to financial flexibility and creativity for motivated families.

What about the mess?

A complete newborn exam after a homebirth is done right in your bed, with your family as involved as you’d like them to be.

A complete newborn exam after a homebirth is done right in your bed, with your family as involved as you’d like them to be.

There can be one sometimes, but it’s never what you imagine. Waterproof pads, towels, and cleaning supplies are part of your supply list and and my assistant and I will make sure to leave your home as we found it or better. We start the laundry, take care of any dishes, take out the trash, and make sure your bed is freshly made as we tuck you and your family in together after birth. Even in case of transfer, we do our best to leave things as we find them so that you do not return home to more work.

Who comes to the birth?

Though birth as a “spectator sport” can present some challenges for all involved, you are welcome to invite whoever you wish into your birth space. In addition to your chosen birth attendants, I will call an assistant when birth is imminent. My first choice for this person will always be another midwife or student-midwife, and there are a few I may call on, with your permission. Any non-midwife/student assistant in attendance will be trained in birth emergencies and considered a trusted member of my team.

More coming soon, ask away!