As a homebirth midwife I screen and teach, I support. I document, guide, and guard the normal pregnancy. I encourage good health and am committed to supporting every person's right to guide their own health care. Part of why the Midwifery Model of care works is because it is a mutual decision making model. There are families who need midwifery support and compassion but are out of a midwives scope of care and I still offer occasional doula support and offer the same type of care under my scope as a certified birth doula, not as your primary care provider. I enjoy the positive relationships I have with staff in hospitals and am completely comfortable working in this role in supporting your choice of provider.
It is not my place to convince any person to consider homebirth as homebirth isn't for everyone. I believe where a client feels the most comfortable will serve them best. Pregnancy and birth are a family's own experience, a parent-led process, an intense and intimate journey. I believe in choice. Each client has their own criteria for where they feel safe and well-grounded to give birth.
I love that my DC area clients love being in control of their own well being, their own health. I help normalize much of pregnancy through our time together and do quite a bit of screening. It is very intimate, it is just me you are seeing, not a busy practice. I have seen what lack of continuity of care in today's normal obstetric model can bring to families. Families in the area also like high tech, and after offering informed consent should you like, my practice offers every test. We have many ultrasound facilities I can refer you to and an endless list of referral for perinatal consultations just as any primary care provider or specialist does.
What I expect of my clients: I expect parents to make responsible efforts essential to their healthy pregnancy, birth and baby, including accurate and complete information regarding health history, attention to nutrition, preparation of the home and communication of concerns and questions. I expect that we will reach a rapport prenatally that will enable us to work together for a positive experience. Open and honest communication are essential to ensuring the safest possible birth at home. My understanding of a parent's needs and wishes regarding their birth are fundamental to the job of facilitating their unique journey through labor.
What does home birth look like?
Homebirth can look like many things:
- Healthy families, experiencing normal pregnancies, speak with me if you have questions about this.
- Family centered
- One-to-one care with ongoing assessment
- Labor unhindered, in familiar and comfortable space
- Safety, when it is a safe option families often choose a non medical option
- Freedom of activity
- A supportive environment with somebody you know and trust
- Parents who desire to be an active participant in birth and in all of their care
- Undisturbed bonding
- No separation of parents and baby
- Lower your chances of a cesarean
- Feeling safe, relaxed, and confident
- Giving birth in a comfortable, familiar environment
- Have personalized attention from your midwife
- Avoid interventions unless truly necessary
- Reduced risk of infection
- Continuity of care, no shift changes
- Have a water birth or use water pool for labor
- Involve your partner/family as you wish
- Move around in labor, eat and drink
- Have an optimal start to breastfeeding
- Full support by the same midwife whom you grow to know before and throughout your pregnancy (and her birth team) and you knows you so very intimately..leading to a healthy vibrant pregnancy with healthy outcomes, and less need for interventive options or transfer of care.
There are disadvantages of birthing at home such as having a higher level and responsibility and commitment, potential for societal negative judgement and/or lack of support, delayed access for emergency situations, cost may not be well covered or reimbursed by insurance, and there is always the possibility of transport to the hospital.
What about safety, what if complications arise?
A well trained midwife makes all the difference! The preventative healthcare I offer prevents most major complications from developing and close monitoring of expectant parent and baby help allow any problems to be treated before they become true emergencies. If the midwife cannot treat a if complications do arise the midwives and assistants are trained to transport.
What about transfers to the hospital?
The most common transport is non-emergent and is generally with first time parent's who have long labors and make the decision to do so, not because of any midwife lacking patience by any stretch of the imagination! In the event of transfer during labor I become your doula after medical care is amicably transferred to hospital staff. I am perpetually working on positive relationships and collaboration with all area hospitals and staff.
What more to consider?
In the year 2000, statistics were collected on all CPM intended homebirths in North America. Researchers also reviewed data on all low-risk births that occurred in the hospital for the same year. The study compared and contrasted these two groups and in June 2005, the results of this study were reported in the British Medical Journal. The researchers found both similarities and differences in the two groups. The similarity was in the outcomes of the births: expectant parents and babies were equally safe in both settings. The difference was in the intervention rates: in all categories, medical intervention was far more likely to occur in the hospital than in the intended home birth setting. For example, in the intended homebirth group, 2.1% of the parents had an episiotomy, while in the low-risk hospital group, 33% had an episiotomy. On the one hand, home offers privacy, familiarity and flexibility. This allows a parent to follow their own instincts without interruption. On the other hand, the hospital offers immediate emergency technology and personnel. In rare instances, during the birth process, unforeseen complications threaten expectant parent or baby's life, either in the hospital or at home. The outcomes of birth, like life, cannot be completely safeguarded. Each family chooses the setting and attendants which they feel will most effectively support their birth process, the parentbaby, and the beginning of a new family, in a way that reaffirms their values, beliefs and sense of well-being.
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Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009
Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician (Canada)
Dutch homebirth study – Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births
Outcomes of planned home births with certified professional midwives: large prospective study in North America.