Home Birth Maternity Care
- Long individualized and relaxed prenatal visits in the standard obstetric timeframe in the comfort of your own home: monthly until 28 weeks, every 2-3 weeks from 28 to 36 weeks, and once a week from 36 weeks until birth. There is also an option for centering for prenatal visits, or the occasional visit done in my Arlington office.
- Prenatal testing with informed choice (labs, ultrasounds, and referrals or collaboration with other providers)
- Nutritional counseling, herbal consultations, referrals
- Monthly Birth Workshops with an amazing doula group
- Complete access to your midwife!
Barring the occasional visit done in the office, my preference is for all visits to be done in your home. This maximizes our time getting to know you in your birthing place and minimizes the chance for transfer of care before or during labor and birth. Our visits are a time for getting to know each other, assessing both yours and your baby's health & wellness and preparing for your upcoming delivery. Regular prenatal care is paramount in helping me as your midwife to recognize and prevent physical, emotional, & mental concerns that may prevent you from having the birth you desire. Your initial visit includes a complete physical & risk assessment, medical history, and blood work. I am on call 24 hours a day for your needs. I invest in you as you invest in a safer, more rewarding birth experience.
Labor and Delivery: (Waterbirth, VBAC or Vaginal Birth After Cesarean). When it comes time for you to give birth, you call me and I come when you need me, or at least by active labor. I calmly and unobtrusively monitor your and baby’s vital signs to make sure everything is going well. I will provide encouragement and suggestions for optimal labor. I also work with a trained birth assistant and often a student midwife to help set up and clean up and to work as a team in case of complications.
You can choose to labor and/or birth in a water pool or in whatever position(s) you find comfortable. It’s up to you whom you want to invite to be present, your other children are welcome and we can help prepare them for what to expect. I encourage my clients to hire a doula to ensure continuous labor support for the birthing parents.
I carry all necessary equipment to your home birth. Naturally I watch for signs of things getting outside the bounds of safety. If our knowledge, skills and tools can’t bring it back on track, I will let you know that it’s time to use more advanced medical care at a hospital. Transfers to a doctor or hospital are a small percentage and are usually not a time-sensitive emergency, but we are grateful for these extra resources when needed.
After a home birth we clean up any mess there may be, do a head-to-toe newborn exam, review postpartum instructions, and I don’t leave until you are both stable and doing well. Routine newborn procedures are available.
Postpartum Care, Breastfeeding: I cannot stress to you the importance of continuity of care from your maternity service provider after the birth of your baby before 6 weeks! During the crucial postpartum period, I come back to your home to check on you and your newborn at 24-48 hours and 4-5 days, and see you in the office 2-3 more times in the first 6 weeks. I will also be in touch by phone if you have any concerns. I help with getting breastfeeding going, help make sure you and baby are thriving, and watch for signs of postpartum depression. At the six-week visit I can provide a family planning consult as well or plan your next annual exam or gyn appointment.
Newborn Care, from birth to 6 weeks: I believe in the Family-Centered model of care and my moms and babies are never separated. Early breastfeeding is encouraged and supported. You'll have as much time as you want to bond with your baby and you'll be able to have anyone you want see, touch or hold the baby. We will do a newborn exam within the first two hours after birth, with baby right by your side. I take care of the birth certificate and will provide you with information regarding the State of Virginia's requirements for newborns, such as newborn screening/dried blood spot screening, vitamin K and hearing/audiology screening. I support your right to make decisions regarding your newborn's care. I provide well baby care up to 6 weeks, after which or concurrent to the pediatrician or family doctor of your choice.
The total fee is $4,000. This includes the birth/midwife assistant. Compare this to the thousands of dollars disbursed in the conventional maternity and hospital system, and the 5 minutes with a surgeon during prenatal and postpartum appointments. Although the option for an office setting is available, it is preferable that all care is done in your home. Long personalized home visits and access to your midwife 24/7 leads to lower transfer rates and optimal outcomes. A strong relationship is really formed by the time your baby decides to arrive.
Alexandria Midwife understands that the financial aspect is an important part of your decision in choosing a care provider. It is hard to pay for these services yourself when insurance may cover 100% for a different provider or a hospital birth. Alexandria Midwife will work with you to help you have your Home Birth. Alexandria Midwife is a Virginia Medicaid Provider. Tricare does not cover your home birth with this practice but Alexandria midwife offers a discount for military families. MedLoan Finance Company also offers a twelve month 0% interest loan option. Health savings accounts can also help pay for what insurance does not cover.
GENERAL INFORMATION ABOUT HEALTH INSURANCE, INSURANCE BILLING FOR YOUR MIDWIFERY CARE:
For clients that have insurance Alexandria Midwife L.C. can provide billing services for a reasonable fee.
Alexandria Midwife L.C. is not contracted with any health insurance plans, but there is always some level of coverage for out of hospital midwifery care under your out-of-network maternity benefits. Even with a deductible you can ask for an in network authorization or gap coverage to have them cover care at the in-network rates.
Insurance plans typically have a deductible and co-payment that the client is responsible for paying.
Your insurance plan determines the amount that the company will pay for your care. Sometimes the amount that your insurance plan is willing to pay (the allowable amount) is significantly less than the amount that is billed for your care.
Your co-pay is based on the allowable amount determined by your insurance plan, an example(not Alexandria Midwife's fees): your insurance plan has a $500 deductible and then pays 70% after the deductible has been met. Your health care provider bills your insurance company $5,000 for the care they provide and your insurance plan determines that the allowable amount is $2,000. You pay the $500 to meet your deductible and your insurance then pays 70% of the remaining $1,500 which is 1,050. You owe your provider $3,950
Your insurance plan will not release allowable amounts for out-of-network providers prior to the service being rendered. This makes it difficult to estimate your out-of-pocket expenses. Being an out-of-network provider enables us to be more flexible in making financial arrangements with you.
How the Billing Service Works
At the onset of care, you will complete a Financial Agreement, intake and history, and a payment plan agreement with Alexandria Midwife L.C. - typically paid in full by 36 weeks.
Alexandria Midwife L.C. provides billing with the services we provided and they bill insurance companies. Your insurance cannot be billed until the birth of your baby or a transfer of care happens. If your care is transferred to another provider and Alexandria Midwife L.C. does not assist you in the birth of your baby, all services rendered will be itemized instead of billing the Global OB Care code. This means that if you transfer during labor and delivery your insurance company will be billed for every hour of labor support, prenatal care and every other service provided that is normally part of the Global OB code. Please be aware that any special visits will be billed separately as they are not a part of the Global OB Care.
Insurance Billing Fees
There is a $20 fee to be paid in advance, for your Verification of Benefits, unless you are using Medicaid (Submitting a Patient Registration Form for a Medicaid/Medicare policy using the portal is a free service as these plans do not require a verification of benefits. Please note that you must choose the Medicaid/Medicare option under the "Covered By:" section, in order to forgo payment.)