- Do you offer midwifery care for planned homebirths?
- Where do visits/appointments take place?
- The interview is at the office.
- Prenatal visits are at the office with the exception of the 36 or 37 week visit.
- From the birth until you are out and about in the world again are at your home.
- After 3 weeks postpartum, visits may rotate between your home and the office depending on your mobility.
You do not need to memorize this schedule, as we will inform you of the location when scheduling appointments.
- How long are the visits?
- How often do we meet?
Prenatally, we will meet with you in your home every 3-5 weeks depending on your needs until the last month of pregnancy, then we meet weekly until the birth.
Postpartum- We routinely see families seven times in 6 or 7 weeks after the birth. The first visit is one day after the birth plus two more times that first week, followed by two visits in the second week. There is another visit between weeks three and four, then a final home visit at week six or seven. For those having more challenging postpartums we schedule more visits as needed.
- What hours are visits held?
Visits are held during normal business hours, Monday-Friday (subject to change).
A 5/5:30 pm slot opens under select circumstances, and are only offered in the office. These circumstances include:
- Any visits that require the partner to be present (interview, intake visit, and the visits in preparation for the birth) but only if the partner has work-related limitations.
- A full schedule
- Rescheduling due to cancellation from a birth
- Do I get to decide what time we meet?
We decide together what times we will meet. However, as the weekly schedule solidifies or changes, we may require a different meeting time than originally planned. For example, if we have two families in Fremont scheduled on different days, we will change the schedule to see the families on the same day. This will require your patience and flexibility.
Scheduling can be very challenging, and is nearly impossible to meet everyone’s preferred appointment times. We do our very best to accommodate your preferences, and much of the time succeed.
Please let us know if there are any days or times you know you will not be able to meet, we will do our best to work around those limitations. We will happily write you a “doctor’s note” to address any work related expectations. It is your right and obligation to take care of yourself, which means you may have to miss work for the appointments.
Here are factors to consider:
- We serve families all over the bay area and drive a lot (and love offering this high quality care!)
- We schedule families in similar areas on similar days.
- We are working with 12-36 families at any given time. We unfortunately cannot accommodate partners schedules as well. We will if we can.
- Do you serve families in my neighborhood?
We are based out of Oakland, and provide home care for families in North to Richmond, South to Fremont, East to Walnut Creek.
We currently do not serve San Francisco.
- How many birthing families do you take each month?
We offer primary birthing services to only 1-3 clients in any given month. This ensures that we are not overworked, are coming to your birth well rested, able to be fully present, and ready for however long we are needed. Our low client census also means that the situation of two women birthing at the same time is very low!
- What is covered in the visits?
During the visits we go through all of your questions. We present educational materials and informed decisions for us to discuss together. We strategize common discomforts. We can discuss any physical, emotional or spiritual challenges arising and use them as opportunities for personal growth. We may introduce new techniques for health and well being and practice them together or encourage you to integrate them outside the visits. There are often tasks, reading or food for thought for you to take care of between appointments.
The physical part of the visit includes health check and analysis for the Mother. For the baby we focus on tracking growth and reactivity as well as helping to encourage appropriate positioning in third trimester. We are able to order diagnostic lab tests or ultrasounds as needed.
We focus on nutrition as the gateway to good health. We excel at differentiating between normal, variations of normal and true high-risk. We are skilled in the process of in-depth nutritional analysis in order to achieve optimal outcomes. We believe there are many good ways to eat and are interested in discovering what works best for each individual.
- What do I need to do to prepare for a homebirth?
- Prioritize midwifery care and the self-care/pregnancy/birth/parenting tasks at hand over other obligations. Allow for time to address the multitude of informed decisions you get to make. Allow time and resources for self-care.
- We will offer resources for you to find the Childbirth Education class that is best aligned with your approach to birth. Awakenings offers Childbirth Education classes quarterly. If you are a first time mama, you are encouraged to take this class, however there are a few other instructors in the community who may also serve your needs.
- You are encouraged to secure a doula. (Asking for funds at the baby shower to cover this is a great idea!)
- You may choose to secure a tub for labor and/or birth.
- Gather the recommended supplies and materials for the birth.
- Plan to be complete with work obligations by 37 weeks of pregnancy.
- Make arrangements for postpartum support, including a month of “lying-in.” This means calling on your community to prepare meals, take care of household tasks, run errands, and manage daily needs, so that you may be with your newborn, heal and soak it up!
- Join support groups and ask questions!
- What happens immediately after the birth?
We continue to provide care for an average of three to six hours after birth. The first few hours are for family bonding and we support your privacy during this time. While we will visually assess you and baby, it is only after the first hour or two hour that we will do a complete physical exam and assessment of both Mama and baby. We will help with the first breastfeedings, shower, meal and cleanup before we leave.
- Do you allow for water births?
Water births are wonderful and we think every Mama should have a tub, even if she does not plan to birth in it. We do believe there are pros and cons for birthing in water, and we will discuss this at prenatal visits, where you will get to choose if you plan to birth in water or not.
For in-depth information regarding the use of birth tubs for labor and birth see Waterbirth International.
- Can you suture tears?
Yes, we are able to suture most tears. There are select circumstances where we may need to seek the care of an obstetrician.
- Do you have emergency equipment?
We have our hands, which is often the most valuable tool in urgent and emergent situations. We also carry oxygen, anti-hemorrhagic medications, and newborn resuscitation equipment. We find certain herbs and homeopathy invaluable in urgent and emergent situations.
- Do you do VBACs (Vaginal Births After Cesareans)?
We have both a strong commitment and the skills to help this special group of mothers achieve their goal. We will review your previous birth history, clarify any questionable information and help you identify the direct causes for your surgery. Utilizing our own research and external resources, we will look at the differences between obstetric myth versus research reality, uncovering any hidden fears along the way. Our VBAC rate is over 85% (vs. approximately 19% in Bay Area hospitals).
- Are apprentices involved?
YES! This is an important piece in continuing the wisdom of midwifery. Generally apprentices are an integral part of the practice and comes with the package, thus their participation is not optional.
- What if we have to transfer care or go to the hospital?
We will call ahead to the hospital to let them know we are coming and a complete copy of your chart will be given to the staff. We will stay with you until after your baby is born and you are stable. Our practice has a very low transfer rate of 10-15%, with most of the transfers due to maternal fatigue due to a long, slow labor.
- Do you serve as a midwife in the hospital as well?
If we transfer care, we are still your midwives. We, however do not have hospital privileges, and are no longer considered your primary care provider for your stay at the hospital. We resume your primary care provider when the reason for transfer has been resolved.
- Do you offer expanded postpartum care?
There is a standard of seven postpartum visits. The focus during these visits is to establish breastfeeding and learn the unique ways in which your little one communicates with you. At every visit we will assess your health and that of your baby.
Knowing that our families have many more questions to come, we are committed to providing ongoing consultation by phone or email throughout your baby’s first year.
- Can we afford to plan for a homebirth?
Most likely you can! We offer monthly payment plans to families, and we have a generous sliding scale for families who cannot afford our full fee. We encourage bartering-so share with us your creative idea!
If you have a PPO insurance plan, this may provide for reimbursement for some or all of our services at the out-of-network rate. We can give you a “superbill” to bill your insurer. Given the state of our insurance system, please do not rely on reimbursements to assess financial ability.
Under select circumstances we will consider credit card payments.
- We are planning a hospital birth, can you be our midwife?
We do not have hospital privileges, and cannot serve as your primary birth attendant in a hospital. You can look for a CNM (Certified Nurse Midwife) who may have access to a clinic. We do offer concurrent care, thus can offer prenatal and postpartum visits/care in addition to your OB/Gyn care.
- Do you offer Monatrice services?
A Monatrice is for those mothers desiring the support during labor that a Midwife would ordinarily give, but feel most comfortable birthing in the hospital (or have a health situation that makes it wisest to deliver in-hospital). A Monatrice can provide intermittent monitoring, while allowing the mother to labor in the comfort of her own home. The Monatrice will also assess dilation, assisting the mother in determining the best time to go to the hospital. Once active labor is well- established, and the decision is made to go to the hospital, the Monatrice continues support as your Doula. As Licensed Midwives, we are able to provide postpartum care for Mother and Baby, including lactation assistance, newborn assessment and weigh-ins.
We no longer offer Monitrice services, but can offer prenatal and postpartum midwifery concurrent-care for those planning to birth in a hospital.
- Placentas – what's their deal?
In our American culture, placentas (and birth, for that matter) have become something “gross.” We don’t expect everyone to feel the way we do, but as your midwives, we’d like to offer you the possibility that the placenta is something incredible and miraculous.
After your birth, if you like, we will make a print of the Tree of Life embedded in your placenta. This is often a fun activity for siblings.
We will dry the cord as a keepsake. In certain Native American traditions, they placed a piece of the dried cord into the baby’s medicine bag, ensuring the child’s spirit would always know the way home. It is in this spirit we dry the cord for you.
We also offer resources for placenta processing (capsules or tinctures, or a little of both).
The placenta is yours, and if you do not plan to process it, you may choose to bury the placenta in your yard (if you have one).
- Is Homebirth really safe?
Clinically, that question has been answered multiple times! There is some great accessible info out there from respected sources such as:
- Research Analyst Henci Goer, author of “The Thinking Woman’s Guide to a Better Birth” and “Obstetric Myths Versus Research Realities”
- Perinatal Epidemiologist Marsden Wagner author of “Born in the USA: How a Broken Maternity System Must Be Fixed”
- General & Family Practice Physician, Dr. Sarah Buckley author of “Giving Birth at Home” and “Gentle Birth, Gentle Mothering”
- Citizens for Midwifery has gathered lots of research for you and your family members to check out.
In our opinion, there are many other factors that make homebirth a safe option for many women. Midwives know that a healthy, well prepared mama and partner (if applicable), who feel secure with their providers and place of birth, generally have good outcomes. The physical assessment of your prenatal care takes only a small portion of our visit. The process of exploring a couple’s dreams, visions, beliefs and any hidden fears are a large part the preparation for a safe, empowering experience.
- But I don’t want the care to end! How can we stay in contact?
Well woman visits can include annual pap smears, physicals, any needed lab-work with follow-up visits to design an individualized plan for optimizing your health in the years after the birth. This is also a wonderful gift for young women approaching their first gynecological visit. There is more information in the Well Woman care section of the website.