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Donna Barlow, LM, AAHCC

Frequently Asked Questions

about Homebirth, Birth Center Birth, and Water Birth

about Midwives

Q: Is an out-of-hospital birth legal in California?

A: Yes, healthy, low-risk mothers can legally birth their baby out of the hospital.

Q: How safe is an out-of-hospital birth?

A: Statistically, home and birth center births are just as safe if not safer than hospital births. Despite our high technology, there are 23 countries that have better infant mortality rates than the United States. The countries with the best rates use midwives for a large percentage of their births.

Q: Is home birth messy?

A: Birthing at home does not make a birth messy, and any mess created is cleaned up by the midwives. A home birth does not leave marks or smells that are unwanted.

Q: What about the eye drops for the baby, and other tests?

A: Midwives can administer the eye drops and vitamin K shot after the birth if the parents wish. Other tests for newborns are done through a pediatrician or family doctor.

Q: Can twins or a breech baby born at home?

A: Yes, twins and breeches can be born at home; however, if a midwife is licensed or certified, she is restricted from managing these births out of the hospital in California.

Q: How does being in the water affect labor and birth?

A: Water is a wonderful labor tool that cuts the intensity of the contractions by about half. A baby born into the water is generally very calm. It has lived in water for all of it’s life and does not take it’s first breath until it comes into contact with air, when it is lifted out of the water.

Q: What if something goes wrong? What if we need a doctor?

A: Midwives are trained to detect and correct possible problems during early labor. In the rare case that a problem should arise and there is a need for transport, midwives will utilize their training to control the situation until the mother is transferred into the care of a doctor. For instance, if a mother is bleeding more than normal after her birth, the midwife can start an IV and administer the same drugs that the doctor would give - while transporting.

Q: Are there advantages to birth center births over home births?

A: Birth centers typically offer a home-like atomosphere, with a bedroom type birthing room. The midwife's equipment is the same for birth center birth or home birth. The main difference between home and birth center is location. Couples who live in a small apartment or who live far from a hospital sometimes prefer a birth center location for their birth.

Frequently Asked Questions.......

about Midwives

Q: Do midwives do check-ups, or just come to deliver the baby?

A: Most midwives offer a full scope of care, from before conception all the way through the post-partum period.

Q: Are midwives legal in California?

A: Licensed Midwives and Certified Nurse Midwives are protected legally in California.

Q: Can midwives give ultrasounds?

A: Midwives generally do not perform their own ultrasounds, but can refer a client to a place that offers ultrasounds, should this be necessary or desired.

Q: Do midwives listen to the baby during labor?

A: Midwives with a license are required by law to listen to the baby following *ACOG’s standards. Most midwives carry a doppler, which easily picks up the baby’s heartbeat during labor.

Q: Do midwives give episiotomies?

A: Midwives are capable of giving episiotomies, but most very rarely do. The birth process usually happens best without any cutting.

Q: How do midwives get their training?

A: CNMs are registered nurses who have additional training in midwifery. Their training is through a university or college program. LMs take courses and classes in midwifery while also training with another qualified midwife(s). They then take a “challenge process” to demonstrate their competency before taking the written Medical Board exam. Upon passing, they are eligible to become licensed through the state Medical Board.

Q: What do midwives take with them to a birth?

A: This varies according to the midwife, but these items are usually included in a midwife’s birth bag: instruments; oxygen and resuscitation equipment; doppler; medications for controlling the mother’s bleeding; suction devices for meconium; eye drops and vitamin K for baby; stethoscope; IV set-up and fluids; antibiotics; scale to weigh baby.

Q: Do insurance companies cover midwives?

A: PPO insurance companies recognize and will reimburse for out-of-hospital midwives; however, HMO and other insurance plans do not currently cover them. For these situations, a cash-pay plan is used.

Q: How much do midwives cost?

A: Midwives in southern California generally charge about half of what a hospital birth would cost. A hospital birth runs roughly between $5,000 and $10,000, and an out-of-hospital birth $2,500-$5,000.

*ACOG: American College of Obstetrics and Gynecology

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