Frequently Asked Questions

A Certified Professional Midwife (CPM)® is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM). The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.

Comparing hospital based care and home birth care is truly comparing apples to oranges. While certain elements overlap, the entire process is incredibly different.

Continuity of Care is the cornerstone of my Midwifery practice. Having the same provider at each appointment, knowing who will be attending your birth, and caring for you postpartum is vital in creating a sense of safety and trust. This one on one, personal care allows me to get to know both you and your baby as individuals, and to know what is normal for your particular body and baby. The lack of continuity in our current healthcare system creates gaps in care between providers. This in turn develops a one size fits all system so that things are generalized and missed on the individual level in pregnancy and birth. I schedule an hour for prenatal appointments, in comparison to the 7-15 minute hospital based providers. This allows the time and space to truly cover any questions or concerns you may have. We focus on the clinical aspects like blood pressure checks, vital signs, and listen to your baby's heartbeat, including education and informed consent around diagnostic tests, but also leave time for addressing the whole person/family emotionally and spiritually as well as physically.

Hospital care providers are typically on on-call rotation in a large practice. When you arrive in labor and delivery, you are assigned who is on call; most of the time it is not the provider you have been seeing prenatally. The reassurance that you know who will be attending your birth, is fundamental to my Home Birth Midwifery care. My team and I essentially bring and set up a birth center in your home, the only difference is the walls are yours. Women labor and birth best when they feel comfortable, cared for and supported by people they know and trust, in the hospital setting, in most cases, your provider and team when you arrive in labor, are people you have never met before. One of the largest components of home birth care is Nutrition. Many complications of pregnancy, birth and postpartum can be avoided through food choices. I will work with you, making suggestions, creating an individual plan based on your current food choices, and developing healthy strategies in order to help your body and baby get the optimal nutrients and calories you both need.

Most hospital care providers don't do a follow up visit until you are 6 weeks postpartum. I provide postpartum visits in your home on: day 1, 3, and 7, followed by visits at 2 weeks, and 6 weeks either in your home or my office. In the hospital setting, once your baby is born you are considered an OB patient and your baby a pediatric patient, thereby creating a separation in care. I see you and your baby as a unit, providing complete newborn care, with comprehensive exams at birth and in the following week until you see your pediatrician. I will fax all records to your pediatricians office so they have all the information needed to continue care for your baby.

YES! Multiple large studies have shown that for healthy, low risk pregnancies in the care of a certified professional midwife, outcomes for women and babies are as good, if not better, than those with MD and hospital care (see studies below). Throughout your pregnancy I will monitor your well-being and your baby’s well being. When a problem is detected early, we can often reverse it with simple measures such as diet, hydration, herbal medicine, and/or a change of laboring position. It is possible for a pregnancy to become complicated by a number of factors before labor and your midwife will work with you to correct these factors and collaborate with other care providers as indicated. Throughout your labor, you and your baby will be carefully monitored according to guidelines in order to maintain a safe and low risk birth.

I have both lab and ultrasound accounts and offer all the same testing you would get in a hospital setting. These are billed directly to your insurance company.

The difference is that I provide detailed, thorough and educated, informed consent around all procedures. I empower clients so that they can make choices and decisions that are right for themselves. You are free to decline any and all procedures that are not right for you.

In addition to obtaining my Certified Professional Midwife certification through the North American Registry of Midwives, including both didactic as well as extensive training in out of hospital birth, I current hold certificates in the following:

• Newborn Resuscitation in the Out-of-Hospital Setting through MEAC (Midwifery Education Accreditation Council)
• Health Care Provider NNR through the American Academy of Pediatrics/American Heart Association
• Perineal Repair through ACNM (American College of Nurse Midwives)
• Knot-Tying Skills and Suturing Skills for Midwives taught by Nell Tharpe, MS, CNM, CRNFA
• Advance Life Support in Obstetrics through the American Academy of Family Physicians
• Neonatal Resuscitation Program through the American Academy of Pediatrics
• CPR for Health Care Professionals through the American Heart Association

I began attending home births as a first year apprentice midwife in June 2007 with New Life Midwifery, and in 2009 as a second year apprentice with Black Stone Valley Midwifery. In October 2009 I opened my own supervised home birth midwifery practice under the supervision Birth Services. I became a CPM in August 2012 and work as an independent midwife in Central Massachusetts. I continue to attend a variety of conferences, courses and educational programs regarding all aspects of midwifery. I have been honored to have attended over 650 beautiful, lovely births at this time.

Yes. In addition to traditional midwifery tools; Fetoscope, herbs, tinctures and homeopathics, I carry the following medical equipment:

• Doppler for listening to the fetal heartbeat during pregnancy and labor
• Medical equipment for monitoring maternal vital signs, such as: thermometer, pulse oximeter, blood pressure cuff, and stethoscope
• Oxygen and resuscitation equipment
• Emergency medications to stop bleeding
• IV supplies
• Suturing equipment with local anesthetic
• Various additional supplies and equipment

There are no pharmaceutical pain medications offered at home (i.e. an epidural or injections). I will make suggestions and utilize various modalities to help you get through the hard work of labor and birth. Education is key, the more you understand and embrace the process, the more the cycle of fear/pain is broken. I will suggest that you take comprehensive informative childbirth education classes, along with suggest books and research resources so that you and your partner will know what to expect, and have trust in your body to birth your baby.

I will suggest different positions, utilize a Doula, essential oils, movement, encourage breathing and relaxation techniques, dancing, getting in the shower, using a birth tub and connecting with your partner and baby as methods to work with your labor sensations. Women find that when their labor is unfolding naturally, in their own space surrounded by a supportive team they trust and know well, they are able to find their rhythm and work with their contractions naturally.

It Depends. A Doula is a wonderful addition to your birth team. Doulas are especially helpful in the early stage of labor when you are in need of support, but it is not yet time for your Midwifery team to join you A common misconception is that Doulas and Midwives do the same thing. While there are areas of overlap, the roles are incredibly different.

Doulas are a specially trained labor coach, not a health care provider, and have no clinical responsibility. This allows a doula to focus solely on providing emotional and physical support along with hands on comfort measures for moms and partners throughout labor. Midwives are your health care providers.

While my team and I were all trained Doulas prior to becoming midwives, and are skilled at providing emotional and physical support to laboring women, during your birth we also will have our hands and minds busy monitoring the progress of labor, vital signs, and the well being of you and your baby.

Warm water in labor can make a tremendous difference in pain management during labor, provide a method for relaxation and rest, and is incredibly soothing for most of my clients. There is some evidence that water can make a smoother transition for baby. I provide birth tubs, included in my fee, to all my clients, you will need to purchase a liner and drinking safe hose.

The total cost runs between $5000 - $6000. This total fee includes all your prenatal visits, your birth with 3 Midwives present, 24/7 on call access, and all your postpartum visits. The break down is as follows: I ask for a $500 deposit at the time we begin care to hold the space on my calendar, this is applied to the $3600 fee for birth services. The fee breakdown looks like this: $100 for prenatal/postpartum visits in my office, and $150 for any and all home visits, due at the time of the appointment; this is where total cost varies.

*I offer individual flexible payment plans for those in need, so please do not hesitate to ask. I don't want to turn anyone away who truly desires to have a home birth, and there is true financial hardship.

Depending on your insurance, all, or part of the cost may be covered. I am not a participating provider contracted with any insurance company. I am considered an out of network provider. I do contract with an insurance billing service through which you can run a verification of benefits to see what the projected coverage may be. Clients do have to file their own insurance claims, but I am happy to supply receipts and the needed codes. However, due to the uncertainty of the insurance company's willingness to pay, I require payment prior to your birth.

It's important to note that different insurance plans reimburse different amounts for out-of-network providers. Clients with PPO insurance tend to have greater success with reimbursement than clients with HMO insurance. FSA/HSA accounts reimburse, upon submission of receipts.

Honestly it isn't an issue! This is a common question, everybody wonders what to do about the mess! Families are often surprised (and relieved) to find that we have left your home as clean (or cleaner) as it was before your baby is born. I will provide you with a birth supplies list that includes all we will need to clean and contain any mess. After your birth you and your sweet baby will be tucked into bed, laundry will be started or placed near your washing machine, the trash will be taken out, beds remade and no one will even know you had your baby in your home.

I provide all the necessary paperwork required by the state to obtain these documents. Massachusetts recognizes home birth as a valid choice and you'll have no problem with this legal process.

I attend births in both apartment complexes and triple deckers all the time, birth is really not as loud as you might expect. Honestly, birth is just another normal human biological process and we are conditioned to believe labor is loud when in reality it is pretty quiet for the most part. Chances are good your neighbors won't know you've had a baby in your home.

While I adore having siblings as well as other family/friends present for birth, I also feel it is up to you to decide what works best for you and your family. I suggest having an adult assigned solely for the care of your child/children. The labor process can be long and children sometimes get bored. There are wonderful books and materials for preparing children for the sights and sounds of labor and birth. Rest assured that children generally do great with birth, especially when they've been adequately prepared. I believe having children present at home births changes the way they will view birth for a lifetime, there by changing birth culture and views for generations to come.

My team and I attend your birth extremely well-equipped to handle the very rare un-fore-seen emergency. I carry emergency medications and equipment, and I am trained and certified in Neonatal Resuscitation, Healthcare Provider CPR, and ALSO (Advanced Life Support in Obstetrics). If a transfer of care is needed during labor/birth, we will make the necessary arrangements and accompany our clients to the hospital. Midwives are experts in normal, uncomplicated pregnancy and birth. To be a good candidate for home birth, you must have a low risk pregnancy, and be in overall good health; because of this complications are extremely rare. My philosophy is not home birth at any cost, it is home birth when it makes sense. I am trained to identify situations, before they become complications, or emergencies, and transfer care when appropriate. During your prenatal care, we will be working together to keep you in optimum health and good balance. I will also be vigilantly screening for complications. If, in spite of our best efforts, a medical complication arises, and the balance required for safe home birth care cannot be restored, an individualized transfer to a hospital provider will be in place.