What is the difference between care with an OBGYN and a Licensed Midwife?

Midwifery care is an evidence-based model that emphasizes parental choice. This differs somewhat from the obstetric model which centers the care provider as the primary decision-maker.

Midwives spend more time with their clients than OBs are able to.

Midwives emphasize preventative care.

How many prenatal appointments do I get?

The prenatal appointment schedule is:

• Once a month until 28 weeks of pregnancy

• Twice a month until 36 weeks of pregnancy

• Once a week until you give birth

Postpartum visits last around 8 weeks post-birth. Ask your midwife about her specific schedule, but generally there are 2-3 visits in the first week, with several follow-up visits.

Postpartum care includes both the parent and baby’s check-ups, risk assessment, and preventative care.

What is your Cesarean Section Rate?

Presently Leah has an 8% Cesarean rate. This can go up or down from year to year. It is very important to midwives that our clients get the care that they need, regardless of what our statistics look like at the end of the year.

What is a “licensed midwife?”

Licensed midwives are trained delivering providers and specialists in normal and unmedicated pregnancy, childbirth and postpartum care. LMs in California are licensed through the Medical Board of California.

Why would I choose a midwife?

Normal pregnancies and births with midwives have 30-40% lower C-section rates than births planned in-hospital. The care of a midwife can change not only the emotional experience but in a very real way the medical outcome which affects the birthing person, their baby and their family forever.

Is water for labor and birth safe?

Water birth is safe in most low-risk laboring people. Birthing in the water is not required; many people find that simply laboring in the water was helpful for relaxation and pain management.

What about pain management?

We support your process by creating a safe and relaxing environment, free of stress or fear. When you feel safe and supported, the normal pain of labor doesn’t go away but is easier to integrate, and it allows the hormones of labor to work their magic.

We have many modalities of physical support which include but are not limited to: warm water (shower, bath or birthing tub), massage, essential oils/aromatherapy, position changes, herbs and homeopathic remedies, emotional support, full freedom of movement and freedom to eat and drink.

What’s the difference between a midwife and a doula?

A doula is a person trained in emotionally supporting a birthing person through the labor process and can be helpful in assessing for the transition into active labor. A midwife is a medical professional who is licensed to be the primary care provider for normal pregnancies. We love doulas; they support both you and us in facilitating a healthy birth!

Who can be with me in labor?

There are no restrictions on who can be with you in labor. However, we do guide you in choosing a birth team that will be the most supportive to you.

How do I decide whether to birth at home or at a birth center?

Birthing at the center and birthing at home offer the same care and scope from your midwives. The benefits of each really have to do with what the birthing person and family are desiring - it’s personal!

Many of our clients choose a birth center because of its proximity to hospital resources should they be needed, or to have access to a space specially set up for the birthing process. Many people choose home birth because of the comfort and familiarity that home provides, as well as the convenience of your birth team coming to you.

Do you attend vaginal births after Cesarean (VBAC/TOLAC)?

May midwives do. We screen each previous Cesarean client to ensure that they are an appropriate candidate for an out-of-hospital VBAC/TOLAC.

Do you accept insurance?

That’s up to your individual care provider. Typically midwives ask for payment up front, with reimbursement from the insurance company going to you after the birth. Many midwives work with a third-party billing services so that you have an advocate for getting the best reimbursement possible.

Is out-of-hospital birth safe?

Out-of-hospital birth is safe when the birthing person has been screened and assessed throughout pregnancy and birth for risk factors. For healthy, low risk pregnancies and births, out-of-hospital birth with licensed midwives reduces unnecessary medical interventions and increases satisfaction with care.

What happens if there’s an emergency?

Most transports to the hospital are initiated due to maternal exhaustion from a long labor and/or the need for labor augmentation. While these situations are not ideal, they are not considered emergencies.

However, emergencies are something we are trained and prepared for. We carry oxygen, suction and resuscitation equipment, intravenous infusion (IV) and anti-hemorrhage medications.

Sometimes it is more appropriate to transition to the hospital, such as in the case of a needed Cesarean. We can transport by car or by ambulance to our nearest hospital (just over 2 miles away). We communicate with the hospital staff and OBGYN directly so that they are prepared for the situation.

Care with your midwives is resumed once parent and baby are stable and discharged from the hospital.