ask the midwife

Hullo Baby Midwifery In The News!

Click here to read my interview with the St. Joseph News-Press article about homebirth midwifery care. 

Questions in this section:

  • What is a Certified Professional Midwife (CPM)?
  • Is home birth safe?
  • Why home birth?
  • What if there is a complication?
  • Who is a good candidate for a home birth?
  • If I had a previous c-section birth, can I still have a home birth?
  • Do you offer water birth?
  • Does insurance cover home birth?
  • How much do you charge?
  • What is prenatal care with you like?
  • What is home birth with you like?
  • Do I need a doula for my homebirth?
  • Can my other children come to my prenatal appointments and birth?
  • What supplies do I need for a home birth?

What is a Certified Professional Midwife (CPM)?

A Certified Professional Midwife (CPM) is a knowledgeable, skilled, and independent practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The Certified Professional Midwife credential, issued by NARM, is accredited by the National Commission for Certifying Agencies (NCCA), the accrediting body of the Institute for Credentialing Excellence (ICE, formerly NOCA). The mission of ICE is to promote excellence in credentialing for practitioners in all occupations and professions. The NCCA accredits many healthcare credentials, including the Certified Nurse-Midwife. The CPM is the only NCCA-accredited midwifery credential that includes a requirement for out-of-hospital experience.

Certified Professional Midwives (CPMs) are trained and credentialed to offer expert care, education, counseling and support to women for pregnancy, birth and the postpartum period. Based on the MANA Core Competencies, the guiding principles of the practice of CPMs are to work with women to promote a healthy pregnancy, and provide education to help her make informed decisions about her own care. In partnership with their clients, they carefully monitor the progress of the pregnancy, labor, birth, and postpartum period and recommend appropriate management if complications arise, collaborating with other healthcare providers when necessary.

Is home birth safe? The studies say YES.

The safety and benefits of midwifery care have been proven again and again in countries across the world, including the United States. World Health Organization statistics show that births attended by midwives have lower infection rates, lower Cesarean section rates, fewer complications and healthier outcomes—thus, lower overall medical costs—than physician-attended hospital births. In addition, there is no difference in infant mortality between midwife-attended and physician-attended births for low-risk women. Countries such as the Netherlands, Sweden and New Zealand, which have the best birth outcome statistics in the world, use midwives as their main maternity care providers. About 2/3 of all babies in these countries are born at home with midwives.

According to the Journal of Midwifery & Women’s Health 2013, the C-section rate for low-risk women giving birth in hospitals is approximately 25% versus 6% for those delivering at home or birthing centers in the United States.

Home Birth Safety Outcomes – Midwives Alliance of North America (MANA) This study, which examines nearly 17,000 courses of midwife-led care, is the largest analysis of planned home birth in the U.S. ever published.

Outcomes of Planned Home Birth with Registered Midwife versus Planned Hospital Birth with Midwife or Physician – Canadian Medical Association Journal

Midwife-led Care is the Best Option for Childbearing Women – International Confederation of Midwives

Benefits of Planned Home Birth for Low Risk Pregnancies – National Library of Medicine – PubMed Health

The Most Scientific Birth is the Least Technological – Alice Dreger, professor of clinical medical humanities and bioethics at Northwestern University’s Feinberg School of Medicine

Home Birth Safer Than Hospital Birth: Nation-wide Study Netherlands – Health Impact News

“Low risk women in primary care at the onset of labor with planned home birth had lower rates of severe acute maternal morbidity, postpartum hemorrhage, and manual removal of placenta than those with planned hospital birth. For parous [at least one prior birth] women these differences were statistically significant. Absolute risks were small in both groups. There was no evidence that planned home birth among low risk women leads to an increased risk of severe adverse maternal outcomes in a maternity care system with well trained midwives and a good referral and transportation system.”

Why home birth?

In most cultures throughout history, women have given birth at home. The majority of women worldwide continue to birth their babies in non-hospital settings today. The advent of obstetrics in this century had a tremendous effect on childbirth customs in the United States. By the 1950s, most births in the US were taking place in hospitals. Cesareans, epidurals and heavy doses of pain medication became the norm. Women were denied the feeling and experience of birthing naturally, and drugs were having adverse effects on mothers and babies. Many people were led to believe that the only safe birth was a hospital birth. Though doctors and hospitals took credit for statistics that indicated that birth was more successful than in previous centuries, in reality better nutrition, hygiene, and disease control improved outcomes. Even today, US statistics do not support the premise that the only safe birth is a hospital birth. For women with a low-risk pregnancy who have had good prenatal care, homebirth is actually the safest option. There is a cascade of interventions at most hospitals that has become routine that may be the culprit of many problems during and disrupt a normal labor and delivery.

The benefits of home birth include autonomy, freedom of movement and choice of position, freedom to eat and drink in labor, decreased risk of infection and disease, decreased risk of complications, no forced exams or interventions, no time limits on normal labor and birth, respectful one-on-one individualized care, empowering and encouraging support, trust in you and your body’s ability to birth naturally, a physiologically intact atmosphere that promotes early bonding and establishment of a healthy breastfeeding relationship, involvement of the whole family, and a peaceful, private, and familiar environment that is free of disruptions and distractions.

There’s No Place Like Home: Why Having a Home Birth is a Good Option

Homebirth: What Are the Issues? – Midwifery Today

What if there is a complication?

Studies have repeatedly shown that for women with normal, healthy, uncomplicated pregnancies, planned homebirth with a skilled birth attendant is as safe, or safer, than hospital birth, and 90% of all births progress normally with no complications. However, risks are involved in childbirth no matter where it occurs. I am certified in both adult and infant CPR, carry equipment and medications to handle certain rare complications that can occur at home, including maternal hemorrhage and new born resuscitation, and have managed many different types of emergencies. By carefully monitoring the wellbeing of mother and baby during labor and limiting unnecessary interventions, most complications and emergencies can be avoided. Transports are usually for non-emergency situations, such as a long labor with maternal exhaustion. We will create a Hospital Transfer Form during the last few weeks of your pregnancy so that we will prepared to transfer if it becomes necessary.

Who is a good candidate for a home birth?

Women who are in generally good health, who make a healthy lifestyle a priority, who are having a low risk pregnancy, who are well informed, who take initiative for reading and educating themselves, and are willing to take full responsibility for the outcome of their birth.

If I had a previous c-section, can I still have a home birth?

Yes! Over 80% of women who had a previous c-section have a successful VBAC (Vaginal Birth After Cesarean). I have attended many beautiful VBACs. For most women, a VBAC at home is actually statistically safer than a repeat c-section. Some hospitals do not allow women to have VBACS, and for this reason, home birth is a good option for many of them. During an consultation visit, we can discuss the risks and benefits of VBAC, and whether you are a good candidate for a home VBAC.

This is a great article on the truth about uterine rupture via VBAC.com. Visit VBAC.com and VBACfacts.com for more great information.

Do you offer water birth?

Yes! Birthing or laboring in water is wonderful for managing the intensity of labor contractions.  Warm water soothes muscles and joints and buoyancy provides easier movement.  Professional strength inflatable birthing tubs are much more comfortable and spacious than a typical bathtub, yet can fit easily in most rooms. Tub dimensions are 65″ x 57″. I offer use of my tub for a small extra fee.

If you have more questions about water birth, visit the waterbirth.org website.

Does insurance cover home birth?

Sadly, many insurance companies do not cover home midwifery care, though it is always worth checking into thoroughly. The average cost of a homebirth is about 1/3 of the cost to your insurance company for a typical hospital birth. Your out-of-pocket expense will depend on your family’s insurance plan. I will consult my billing service and discuss options regarding your particular insurance company and available benefits. Some insurance companies will reimburse for payment, others will not, or will provide only limited reimbursement.  Reimbursement, however, is not usually available until after the birth. However, money should never be the reason you do or do not choose a care provider, and I love to work with families to determine a payment plan that will accommodate their particular needs. Please contact me to find out how I can assist you!

How much do you charge?

The cost of homebirth with a midwife varies greatly based on state and region, and my rate is comparable to other midwives in the Kansas/Missouri area. I offer a discount if the full fee is paid on the first prenatal appointment. While homebirth is an investment for the family, the average cost of a homebirth is about 1/3 of the cost to your insurance company for a typical hospital birth. As midwives, we do our best to make skilled prenatal care and homebirth affordable and accessible to families of all situations and backgrounds. I love to work with families to determine a payment plan that will accommodate their particular needs. To make it easier for clients, I accept cash, checks, and Paypal. Please contact me to find out how I can assist you!

What is prenatal care with you like?

I offer a free, no-obligation consultation appointment in my office, giving us the opportunity to ask questions and get to know each other. The earlier you are in touch, the greater chance I will have an opening over the time you are due, though I am also happy to being care late in pregnancy. I typically schedule your first regular appointment between 10-12 weeks along. By this point, we will usually be able to hear  the baby’s heartbeat with a doppler. Prenatal appointments normally take place at my home office, usually Tuesdays-Thursdays, although other times are possible, and last about 45-60 minutes. Along with nutrition, exercise, overall physical and emotional well-being, mother’s vital signs, normal growth and development of the baby, and listening to baby’s heartbeat, prenatal appointments allow plenty of time for questions and answers and meaningful discussions to explore and help resolve fears and concerns you or your family may have. Caring attention will develop a trusting and nurturing relationship between us that will go a long way to assisting you to labor and give birth naturally and safely. The normal schedule for visits is every month until 28 weeks, followed by bi-weekly appointments until 36 weeks, and weekly visits thereafter. For your 36 week visit, I come to your home for your appointment. In addition to normal prenatal appointment items, this visit includes a discussion of set up and supplies for the birth, roles and responsibilities, your birth plan, and Hospital Transfer plan.

The Homebirth Choice – Midwifery Today.

What is home birth with you like?

I attend each birth with an assistant midwife, at no additional cost to you. In the weeks preceding birth, we discuss When to Call the Midwife. I will keep in touch with you and/or  your partner during early labor, and we will decide together when is the best time for me to come. Once I arrive, I will help maintain a sense of calm to the birth environment. Throughout labor, I will ask permission to perform and explain any procedure to you and your family. I will unobtrusively monitor the labor, watching for complications or signs of distress in either mom or baby. The birthing process is allowed to take its own course and set its own pace. In the safety and security of your own home, you are likely to be less inhibited about trying different labor positions and locations. I may suggest different activities and positions as needed to help facilitate labor progress, such as a walk outside or hands & knees position. I encourage you to eat or drink as you are able during labor to keep up your energy and strength. When it’s time to deliver, you can birth in whatever position feels most natural and comfortable to you.

Check out the Homebirth Videos page for some beautiful videos which share a glimpse of what a typical homebirth is like!

The Homebirth Choice – Midwifery Today.

Do I need a doula for my homebirth?

For primiparas (first time mommas) or primary VBACs (first vaginal birth after one or more cesarean births) I especially recommend a doula for labor support. Primiparas and primary VBACs usually involve longer labors then subsequent births, and having a doula there for support and suggestions can be crucial. Once you are in active labor or transition, I provide some labor support services, similar to what a doula may do. However, I do not offer labor support in early labor.

Can my other children come to my prenatal appointments and birth?

Yes! Siblings are welcomed to all prenatal visits and the home birth setting. I have a toy basket in my office to entertain children while Momma and I meet. If you decide to have your other children attending the birth, I ask that you have an extra person available at home whose sole responsibility is caring for your children so that you can focus on the delivery. Besides this, whomever else you choose to have present at your birth is up to you. I’ve been at births where it was the bare minimum of people, and I’ve been to births where there was a crowd! The main issue is that you feel totally and completely at ease and comfortable with whomever is present, as that can majorly impact the outcome of your birthing experience.

What supplies do I need for a home birth?

It’s simple, really! Check out the Hullo Baby Midwifery home birth kit. I ask all my mommas to order this kit by 34 weeks. Your birth kit, along with with a stack of towels, washcloths, and an extra set of sheets; there just isn’t much to it! People are often surprised at how little mess is involved at a homebirth. Included in your birth kit are disposable waterproof underpads (“Chux” pads) and a cheap plastic shower curtain, which we use to protect surfaces, such as the bed and carpet for the actual birth. These things get thrown away after the birth. We will gather up all trash and  laundry as we go, and myself or my assistant will start the laundry before we leave your home. We also make sure to tidy things up so that you aren’t left with clean up. Take a look at the Birth Supplies List and Waterbirth Supplies for more information on how to set up!

Still have questions? Feel free to call 913.748.1753 or email