Frequently Asked Questions
Who will attend the birth?
Every birth is attended by a Licensed Midwife. Every birth is also attended by at least one additional highly qualified assistant, who may be a licensed midwife or an apprentice/student midwife. The apprentices and assistants are involved in the prenatal care, so you will be familiar with all of the staff present at the birth. In the extremely unlikely event that more than two moms are in labor at the same time, we have excellent back up midwives available. In that case, an apprentice or assistant who you knows well will also attend your birth, so you will still have a familiar presence at the birth.
Who can be with me when I give birth?
We encourage you to invite whomever you would like to attend your birth, including your children if you desire. Some moms choose privacy while others choose to have many people at their births. We ask that you have a designated adult present to care for your small children if they will be at your birth.
Is home birth messy?
Planned home birth usually creates a bit of clutter around your house, consisting of towels for getting in and out of the birth tub, half eaten snacks for the birthing mom, the birth supplies, baby things and the midwives’ bags and equipment. The ‘mess’ at the time of birth is well contained and we’ve never ruined a carpet or a comforter!
Do you take insurance?
We are able to take some private insurance PPO plans. No HMOs cover us at this time. Unfortunately we are not covered by Medi-Cal, AIM, or military insurance. Midwives across the country are working to get Certified Professional Midwives recognized federally as providers.
We are committed to providing accessible home birth midwifery care for all women who desire it, regardless of their insurance. We have created a sliding scale to make our services as affordable as possible. We do not turn anyone away for lack of funds.
What options are available for pain management?
Labor is usually very hard work, and often painful. Not all women experience pain in labor, but most do, so we are glad you are asking this question and seriously considering your options.
We encourage women to prepare themselves during the pregnancy for the realities of labor. We recommend families take a childbirth preparation class, such as Birthing From Within, for women to prepare physically and emotionally for the experience of labor. Many other classes are available in the community as well, such as Bradley, Hypnobabies, Hypnobirthing and others, each with different ways of preparing women for the experience of childbirth. Prenatal yoga and other exercise and relaxation classes can be very beneficial as well.
During labor, we offer a variety of means to help cope with the intensity of labor. We offer freedom of movement, the use of water, both the shower and immersion in a deep tub, massage, emotional support and many other non-pharmaceutical techniques. At our birth center we have 3 rooms with tubs available for comfort, and we offer portable tubs for rent for home births.
Pharmaceutical anesthesia and analgesia are not available at the birth center or at a home birth. WE DO NOT OFFER EPIDURALS. Epidural anesthesia is not safe for use outside of a hospital, and we find nearly all women who desire an unmedicated birth with our practice can do so without anesthesia. In case the woman requires or desires an epidural, we will accompany her to the hospital.
What do you do if there is a complication or an emergency?
Most complications are not emergencies. Midwives are experts in the pregnancy and birth process, and are able to recognize slight deviations from normal, and usually get them back on track with minimal, at-home intervention (such as diet changes, position changes, feeding mom, herbs, medicines, etc). If a complication does not resolve, we will transfer the mom’s or baby’s care to a hospital provider, in pregnancy, labor, or postpartum.
In the case of a true emergency, we are qualified to stabilize mom or baby while the Emergency Medical Service is called and we transport by ambulance. We are certified in CPR and Neonatal Resuscitation and have oxygen, IV fluids and medicines to control postpartum bleeding.
What happens if we have to transfer to the hospital?
In an emergency, we call EMS and transfer by ambulance. In an unrushed transfer, we go by private vehicle to the most appropriate hospital. Some women prefer a specific hospital if they are receiving concurrent care, or due to insurance.
For women giving birth at the birth center, we will transfer to the nearest hospital in a true emergency. In a non-emergent situation, we transfer to the hospital of your choice.
If you have been seeing a doctor or hospital midwife, the doctor or midwife on call for that group will be your primary caregiver when you arrive at the hospital. If you have not had concurrent care, the ob/gyn doctor on call at the hospital will take over your care. Every hospital has a doctor on call for ‘walk in’ patients, and you will never be turned away in labor or postpartum. We will give the nurses and doctor or midwife report on your situation in labor, and then we will remain as labor support for you until your baby is born and/or you or your baby are stable. However if you transfer to a hospital outside of San Diego county, we will not be able to accompany you to the hospital.
If I give birth in the birth center or at home, how do I get a birth certificate and social security number?
We are happy to assist you with the registration of your baby’s birth. As soon as your baby is born, we schedule an appointment at the San Diego County Office of Vital Records to register the birth. This appointment is usually 2-4 weeks after your baby is born. The midwife, mother and baby will attend this appointment together, and the father is welcome as well. You will be able to leave this appointment with a certified copy of your baby’s birth certificate. For registration of the birth, the mother must provide current valid identification, as well as a visa or permanent resident card if she is not a US citizen.
If you need a verification of your baby’s birth prior to the birth certificate appointment, we will provide you a formal letter verifying the birth. This will allow you to cross the border with the baby, register the baby with some insurance companies and the military, etc.
After you receive your baby’s birth certificate, you can apply for your baby’s social security number. You can do this in person at any social security office or by mail. We will provide you with an additional verification of your baby’s birth for use with the social security office.