Research has shown that home birth with a skilled provider:

• Reduces risk of infection

• Reduces risk of unnecessary medical interventions

• Reduces rate of morbidity and complications from interventions

• Reduces risk of errors compared to hospital care

• Reduces interference in bonding and breastfeeding due to hospital policy

• Reduces risk from poor staffing levels in hospitals

• Reduces risk from unnecessary separation from your baby

For more information, please visit the Midwives Alliance of North America to read the Consensus Statement on Physiologic Birth. And ask us all of your questions; this is why we are here!

Clients contract for our care directly with us and, although our small practice does not bill insurance, we provide full documentation that clients submit to insurance for reimbursement. Many insurances will reimburse for the cost of your prenatal and some postpartum visits. While insurance does not pay for home birth, it typically does cover labs and ultrasounds, which are billed directly to insurance.

We strongly believe that every family that desires midwifery care should have access to it. However, our current medical system does not yet support this. We encourage our clients to advocate for better coverage.

There is no ‘single type’ of person or family that chooses home birth. The desire to feel heard and understood; to make informed decisions for oneself; to receive compassionate, family-centered, trauma-informed care; and to experience a safe, physiological labor and birth transcends race, ethnicity, religion, socioeconomic status, education level or culture.

Believe it or not, a large percentage of our home birth clients are actually doctors, nurses, and other healthcare professionals themselves!

We even have obstetricians, pediatricians, anesthesiologists, and labor & delivery nurses who seek out our home birth services because they intimately understand how the current system of overly interventive, defensive maternity care puts low-risk, healthy birth givers and their babies at risk.

You may consider watching the documentary, Why Not Home? which “examines the latest evidence on risks and rewards of different birth settings as told through the lens of doctors, nurses, and midwives.”

Our team carries the following supplies and medication with them during every home birth:

• Oxygen with bag and mask for neonatal resuscitation or maternal CPR

• Medications for postpartum hemorrhage

• Intravenous fluids

• Fetoscope and hand-held doppler to auscultate fetal heart rate

• Urinary catheters

• Suturing materials

• Newborn deep suction catheters

• Nitrous oxide for pain relief during labor, birth, or suturing

• And more!

Most importantly, our midwives and nurses are experienced and clinically skilled at recognizing warning signs, managing obstetrical emergencies and transferring to a higher level of care when necessary.

While we never hope to transfer care to another provider or hospital, there are conditions when we do recommend a transfer. Conditions include and are not limited to:

• Fever during labor

• Thick meconium in early labor

• Fetal heart rate issues

We will discuss each of these issues and more during the course of your pregnancy. Our practice guidelines are available to you for review at any time. Our backup plan for emergency transport will be created with you and your family at the 36 week home visit.

However, it is important to note that the need to transfer to a hospital during a home birth is rare, and the majority of home birth transfers are for non-emergent reasons, such as a long labor or the birthing person’s desire for an epidural.

Many clients have commented that our midwives leave their home cleaner than it was before they came!

Not only do we provide you with a list of supplies to have at your birth that we will use to contain or clean any mess - like mattress covers, paper towels, hydrogen peroxide, and large, absorbent, disposable underpads - but we will also wash your sheets and towels, dispose of soiled trash, and tidy up your birthing space before we leave. That way you can rest, recover, and focus on bonding with your baby.

First, the experience of skilled labor support in your own home environment and the feelings of safety and privacy increase your body’s own pain easing hormones (including oxytocin and endorphins) and decrease your pain perception.

Second, home birth providers are skilled in recommending and facilitating a multitude of labor positions and non-pharmacological comfort measures to promote relaxation and to ease pain. These include and are not limited to:

• Breathing

• Relaxation techniques

• Emotional support

• Massage

• Counter pressure

• Heat/cold

• Aromatherapy

Embrace Midwifery is also proud to offer all of our patients the option of nitrous oxide (also known as “laughing gas” or “gas & air”) in the home birth setting. Nitrous oxide is a mixture of nitrogen and oxygen and is an odorless and tasteless gas that provides relief from both anxiety and pain.

Read more about uses for nitrous in the home birth setting here.

Absolutely! In fact, our birth fee includes the rental of a portable birth pool. Even if you do not plan to birth in the water, many birth givers find water immersion to be a very effective comfort measure for labor pain. Water immersion during labor is associated with shorter labors, decreased use of pain medication, decreased anxiety, and increased client satisfaction with their birth experience.

Since epidural anesthesia poses additional risks to birth givers and their babies in labor, requires specialized, continuous monitoring, and requires placement by an anesthesia care provider, epidural anesthesia is not available in the home birth setting.

Clients that choose home birth are highly motivated to avoid the risks associated with epidurals and understand that the use of an epidural requires a hospital transfer.

However, epidurals do have their place as sometimes labor is longer, more difficult or more painful that the birth giver anticipated. Therefore, some birth givers choose to transfer to the hospital during labor to obtain some stronger pain relief. When this occurs, your home birth midwife will accompany you to the hospital as your ‘doula’ (if a second support person is allowed at the hospital you choose).

After the birth, you can expect the same basic assessments and access to the same basic care and treatments that you would have in the hospital.

At one and five minutes after birth, your midwifery team will assess the baby and perform Apgar scoring. Everyone on our midwifery team is skilled in neonatal resuscitation and we carry everything necessary to provide basic life support for a newborn.

Unlike in the hospital setting, we provide immediate skin to skin and delayed cord clamping as our standard of care. The newborn head-to-toe assessment, weight and measurements are not performed until you and your baby have bonded and fed because there is no need to rush at a home birth.

Your midwifery team will also monitor the birth giver’s bleeding and vital signs as well as facilitate breastfeeding. We don’t leave your home until you and the baby are stable, approximately two to six hours after birth.

As long as your pregnancy remains healthy and low-risk, the Embrace Midwifery team can provide all the care you will need during your pregnancy, labor, birth, and postpartum recovery. There is no need to see a doctor unless you desire to.

However, if the need for a medical consultation arises, our team can refer you to an obstetrician or maternal-fetal-medicine specialist in your area.

If labor begins before 36 weeks and a home birth is not recommended or if you develop a pregnancy complication that necessitates a hospital birth prior to the onset of labor, we will refund half of the birth fee minus the $1000 non refundable deposit and a member of our team will provide doula support to you during your labor if you desire.

Midwives are academically and clinically trained healthcare professionals that are experts in normal birth and adept at ensuring excellent outcomes for birth givers and infants.

The Embrace Midwifery team includes both Certified Professional Midwives (CPM) and Certified Nurse-Midwives (CNM). According to the Midwives Alliance North America:

“The safety and benefits of midwifery care have been proven again and again in countries across the world, including the United States. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a woman-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes such as The Netherlands, United Kingdom and Canada.”

Certified nurse-midwives (CNMs) are registered nurses who have graduated from a nurse-midwifery education program accredited by the American College of Nurse-Midwives (ACNM) and have passed a national certification examination to receive the professional designation of certified nurse-midwife.

CNMs have been practicing in the U.S. since the 1920s and provide a full range of primary healthcare services to women in the United States, including routine gynecological checkups, family planning services, preconception care, prenatal and postpartum care, and, of course, catching babies. They also have prescriptive privileges and can order medications if needed.

Team member Sarah McRell is a certified nurse-midwife who previously attended births in hospitals, but now chooses to attend births at home.

Certified Professional Midwives (CPMs) are professional independent midwifery practitioners that have met the standards set by the North American Registry of Midwives (NARM) for professional practice to care for families in the childbearing year.

What distinguishes a CPM from other nationally certified midwives is that CPMs primarily attend low-risk pregnant women only in out-of-hospital settings and are not required to become nurses before becoming midwives.

CPMs are trained via a competency-based model of education which requires both course work and direct hands-on experience as an apprentice in an out-of-hospital setting.

Team member Rachel Blessington is a Certified Professional Midwife.

The short answer is, anyone you wish! Remember, this is your labor and your birth and you get to decide who is there to support you.

In addition to their partners or main support person of choice, some clients also chose to have a doula, a trusted friend or family member, or even their older children at their home birth.

When you labor and deliver your baby in the comfort of your own home, you decrease your risk that you or your baby will be exposed to harmful pathogens found in the hospital environment (called “hospital acquired infections” or “HAIs”).

Providers in the hospital are in contact with countless patients and staff throughout their day and while we hope that everyone is performing thorough hand washing and wearing proper personal protective equipment, the reality is that in American hospitals alone, the Centers for Disease Control (CDC) estimates that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths each year.

It is unlikely that your home is too small for a home birth. What is more important is that you have a place in your home that is safe and clean with enough space for the midwives to move around to comfort you in labor and set up their equipment nearby. So while a walk-in closet would be too small, we have attended home births in bedrooms, kitchens, living rooms, dens, large bathrooms and even dining rooms!

Babies and birth don’t need a lot of space. Your comfort and privacy is more important than a sprawling home. In addition, your home birth midwifery team will hold your 36-week prenatal appointment at your home in order to advise you on the best place to set up for the birth as well as to discuss a transfer plan in the event of an emergency.

You probably will and it is totally normal! Please check out our extensive blog post dedicated to poop.