Midwives specialize in normal, healthy pregnancy, labor, birth and postpartum care. This also means midwives are trained and experienced in recognizing when things fall outside the normal range and are able to see warning signs long before an emergency would occur. Your midwife and her assistant are certified in both adult and neonatal resuscitation. During your prenatal care, you will learn when it is safe to be at home and when we would need to go to the hospital. If there is a need to transfer to the hospital, your midwife will coordinate your transfer, making the transition as smooth as possible. She will accompany you to the hospital and stay with you as additional support and as your advocate. For further reading, see Midwives Alliance of North America, MN Council of CPMs, and our statistics.
No! This is often one of the first questions that comes to mind when someone considers having a birth at home. Surprisingly, birth is not at all like it is portrayed in the media and it really isn’t very messy. You will order a birth kit, which includes large flat pads to help protect your bed and floor. Your midwife will start the laundry and clean up any sign of your birth before she leaves your home so your visitors won’t even know where the birth happened.
There isn’t an easy yes or no answer, since it depends on the plan you have. Our midwives are considered out-of-network providers and will be covered based on your out-of-network benefit levels. Twin Cities Midwifery provides insurance billing services to make billing and insurance reimbursement smooth and easy. Many insurance plans cover a portion, if not all, of the costs of having a home birth. When you schedule your free consultation, we will gather your insurance information and call your insurance company to learn more about your plan’s benefits. By asking very specific questions about your plan, we can get a better estimate of what costs you can expect your insurance company to cover. Twin Cities Midwifery works with families to make affordable payment plans that are unique to each family’s financial situation. Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) generally can be used to pay for midwifery services. Most often, even paying 100% out-of-pocket for your home birth is less expensive than the out-of-pocket costs for a hospital birth after insurance processes the claim and you pay your deductibles. For more information on insurance coverage of home birth services, check out our Insurance Benefits blog post.
There are two common types of midwives in the U.S. Nurse midwives are primarily trained in a hospital setting and most often attend births in the hospital. They are called Certified Nurse Midwives (CNMs). Some CNMs gain additional experience to offer out-of-hospital care, as well. The second type are direct entry midwives. These midwives are primarily trained and provide care in the home birth or out-of-hospital setting. Some direct entry midwives earn the national credential of Certified Professional Midwife (CPM). In Minnesota, CPMs also have the option of becoming licensed by the state, which also gives them the title of Licensed Midwife (LM). It is a good idea to ask your midwife what her credentials are, especially in Minnesota where there are so many possible combinations.
Every visit includes assessment of the baby and the health of the pregnancy, such as listening to the baby’s heartbeat, measuring uterine growth, and checking vitals (blood pressure, pulse, and weight). We discuss any pregnancy discomforts you might be experiencing and remedies for them. As various choices and options come up throughout care, we discuss them at least one visit prior to when decisions should be made so you have ample time to ask questions, do further research, and determine the best decision for your family. In addition to discussing any questions or concerns you may have, hour-long visits also provide an opportunity for you and your midwife to build a close relationship.
Doulas provide continuous emotional, physical, and informational support before, during, and after birth. Our midwives offer this kind of physical and emotional support, as well. However, unlike midwives, doulas don’t provide any medical care. Doulas are great at offering comfort measures and supporting both the laboring client and not-laboring partner from early labor until after baby is born. Twin Cities Midwifery encourages each family to consider having a doula at their birth. Be sure to check out the Childbirth Collective for donation-based parent topic nights and ample opportunities to meet with and interview doulas.
Our midwives are certified in neonatal resuscitation and CPR and will have related equipment on hand. They will also bring medical supplies such as oxygen, suction for baby, medications for hemorrhage, a fetoscope and doppler to monitor baby’s heartbeat, a baby scale, equipment to check vitals (blood pressure cuff, stethoscope, thermometer, a watch), IV equipment, suture and lidocaine for perineal tears, a pulse oximeter, and a variety of herbal and homeopathic remedies. Clients in our practice also have access to use of a birth stool and birth tub during labor.
No. Planned home births can be in a house, townhouse, apartment, trailer, hotel, friend’s house, birth center, or even a back yard! Our midwives are pretty flexible with space needs and can make almost any “home” work. Ideally, there should be running water, electricity, and a phone (or cell phone service), but even those can be negotiated!
If you have a healthy pre-pregnancy medical history and a healthy, low-risk pregnancy – and you want to birth at home – you are a fantastic candidate! To make sure you have the best chance of a successful home birth, our midwives and clients engage in an ongoing risk-screening process that begins at the initial visit and continues through the completion of care.
Occasionally issues come up during pregnancy, in labor, or after birth that indicate we should consult an additional provider or transfer your care to a hospital. Our clients rarely transfer to the hospital; when they do, the most common reason is a very long labor with no or slowed progress. Transfers to the hospital are most common in first-time births. The vast majority of time transports to the hospital occur from our practice, they are non-urgent, and involve the family driving their own car, not needing an ambulance. Our midwives help make smooth transitions from home to hospital, and they stay with the family during and after the transport to continue supporting them. Learn more about the specific situations that require transfer of care. For the most common reasons people transfer out of our care, check out Twin Cities Midwifery’s statistics.