FREQUENTLY ASKED QUESTIONS
1 / What if "something happens"? (The most popular question from grandparents to be.)
One of the keys to safely birthing at home is a healthy low-risk pregnancy. Good prenatal care screens out the clients who should be delivering in hospital. Midwives monitor your baby's heart rate off and on in active labor and more frequently once you begin pushing. Medications like cytotec, pitocin, epidurals, or IV narcotics may cause your baby to react poorly during labor, and it's why we will never offer these medications to you at home. Midwives are skilled attendants and can manage long deliveries, IV antibiotics, monitoring your vitals, and birth emergencies like shoulder dystocia (when the baby's head is born and shoulders need help to be delivered). We carry oxygen and other supplies for newborn breathing assistance and are certified and recertified every two years in Neonatal Resuscitation so if a baby has difficulty breathing at birth, we have the skills and equipment to help them. In the state of Kentucky, we are also able to carry the same medications hospitals would have for preventing or stopping a hemorrhage after birth (misoprostol, methergine, injectable pitocin, & TXA) as well as IV fluids. We monitor the well being of you and your baby through birth and for multiple hours afterward to ensure everyone is stable and doing well. We are easily reached until your next postpartum appointment within 48 hours if you are concerned about the health of you or your baby. The midwifery model of care allows us more time together to pick up on health issues whenever they arise and we are often only a text or call away in the early weeks after baby arrives.
2 / How is midwifery care different than regular appointments with an OB?
The schedule is very similar except that midwives spend about 4 to 5x longer with you per appointment ( about 45 minutes), special appointments may be even longer. We lay out your options for standard procedures and have time to help find what works for your family if you are undecided. After our attendance at the birth, we visit you in home for two appointments in the first 10 days and again at 6 weeks in office. We take our time so we can build trust, answer questions, and understand the health of you and your growing baby. Labs can be drawn in office and billed through your insurance. You will have the option of an early ultrasound order and all clients receive the usual anatomy scan. Extra lab work and scans are discussed as needed. For the full outline of the homebirth package please see the tab in our menu.
3 / When Will I hear my Baby's Heartbeat?
You might be able to find the heartbeat with a doppler as early as 8 weeks, but it's usually still difficult to do so. Babies are very small at this point and can move away from the doppler probe easily. The uterus is just peaking over the pubic bone, so you may have to point behind it to find the sound. We schedule our initial appointments around 12 weeks and by then most babies are able to be found with a doppler and we begin listening at each appointment. A full bladder can help the heartbeat to be found in the first half of pregnancy since it pushes the uterus up higher, but sometimes it's simply difficult to find until babies get bigger. A transvaginal ultrasound is a more reliable method of finding an early fetal heart rate.
4/ What if I have GBS?
GBS stands for Group B Strep - a bacteria found in about 25% of pregnancies, so it is fairly common to have a positive result. GBS is not a rule out for home birth and we routinely test for it at 36 weeks by giving you a swab kit to use in the restroom - you will be directed how to swab your vagina and rectum for the culture. We then send the kit off to the lab to see if you are colonized with GBS and decide from there on a care plan for labor (whether or not to use IV antibiotics at home). While it's commonly found in pregnancy, and you'll likely have no symptoms, newborns that pick it up during delivery have a chance of becoming ill from the bacteria. The chances of illness are low, but can be very serious even with treatment, and even more rarely, fatal for your baby. In the hospital setting in the US, all GBS positive mothers are given IV antibiotics in labor every 4 hours due to this risk. If you are GBS positive, we will discuss risk factors and you will be provided with handouts and resources to make an educated decision regarding IV antibiotics in labor. If you know you have GBS and would like to read up on the evidence, page 9 of this pdf begins with the absolute risk of illness for your newborn. and page 10 goes over factors that increase risk. (AOM GBS Clinical Practice Guideline)
5/ Do you offer Water Birth?
Yes! If you've decided you'd like to try water during labor, I'll bring one of our Birth Pool In a Box tubs (in it's bag) to your 36 week home visit and we will discuss set up for labor. There is an extra charge for the pool liner (about $50) and a couple of extra supplies to have on hand.
6/ Are there any tests or procedures required for your practice?
Some labs are required to ensure safety and eligibility for homebirth. We like to know what your hemoglobin or iron level is, if you are dealing with gestational diabetes, if you have any Sexually Transmitted Infections, etc. We also want to know the location of your placenta to ensure it isn't covering your cervix at term - typically clients find this out an anatomy ultrasound scan at 20 weeks of pregnancy.
7/ Are doulas and Midwives the same thing?
Nope! Doulas don't provide medical care. They are there for emotional, educational, and physical support. You can think of them as a coach for the biggest day of your life - prepping you for labor as one coaches someone for a big race or how a wedding planner might support you by preparing for your preferences (if birth was as predictable as a wedding). They often meet with you multiple times prenatally and get to know you - show up earlier in labor than a midwife typically would and help guide you verbally and physically through comfort techniques whilst supporting your partner or loved ones to help you as well. They might help gauge when to call the midwife and are usually very hands on with positional changes and advocating for you when it comes to decisions in labor.
8/ If you're my midwife, will you for certain be there at my birth?
Homebirth midwifery works best when we practice what's called "continuity of care". This is when you see the same person for all of your care so they know you and your normal when attending your birth. We want to see you through to the end of care ourselves. Midwives are; however, people. We get sick or throw out our backs and every now and then are attending the birth of another when your labor starts. We utilize back-up midwives in this scenario and discuss who these midwives would be + how to contact them all before your 36 week home visit.
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