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Frequently
Asked Questions
Here are answers to
our frequently asked questions. If your question is not listed here, please
contact us and we will be happy to answer you.
What kind of woman
does Orange County Midwifery care for?
We care for healthy women who are free of major medical or obstetric problems
and who are seeking an active role in their pregnancy and birth with minimal
intervention. They must live within a 1-hour driving distance to one of
the midwives.
Why don’t
you take clients that live farther than an hour?
The farther away your clients are, the more births you miss. We feel you
are paying us for that service and we want to do our best to ensure we
provide it. We are available to cover a very wide area of Southern California.
Areas of service range from Orange County to the Inland Empire, Riverside
and San Bernardino County, and the Temecula Valley. If you’re not
sure, call us and we’ll be happy to help you or refer you to a midwife
who can.
What is considered
a 'Low-Risk' pregnancy?
We only deliver babies at home to women who are expected to have a good,
normal outcome for both mother and baby. By maintaining healthy lifestyles
– eating right, exercising, avoiding harmful substances such as drugs,
alcohol, tobacco and pesticides most of our clients remain low-risk. Some
conditions that would not qualify you to deliver your baby at home are
diabetes, epilepsy, HIV, hepatitis, heart disease and severe hypertension.
Conditions occurring during pregnancy such as anemia, gestational diabetes
or pre-eclampsia could also cause you to ‘risk-out’ although
these conditions can often be prevented or even reversed with proper prenatal
care and nutrition. The focus of midwifery is to prevent problems from
occurring, not just treat problems as they occur. Very few of our clients
have ever needed to be transferred to an obstetrician due to risk factors.
How soon should
I begin my care?
You can call if you think you are pregnant and we will be happy to do
a free pregnancy test. Most women try to schedule a first appointment
around 6 week’s gestation. Statistics show that women who start early
prenatal care have fewer complications and better outcomes.
Does insurance
cover midwifery care?
PPO Insurance almost always covers homebirths and we’ve had a few
instances of HMO’s doing so. In California, if you have maternity
coverage on your policy, the law mandates coverage for Licensed Midwives.
Although your policy may cover midwifery and homebirth, many insurance
companies do not pay the total fee for services, in spite of what they
claim to do. We will do our best to help you get the maximum reimbursement
from your insurance company.
Do you take credit
cards?
Yes, we accept payment by credit card through Pay Pal for an additional
4% processing fee.
What vitamins or
supplements should I take?
Although we believe most vitamins should come from a healthy diet, our
preferred prenatal is Rainbow Light Prenatal vitamins. We also recommend
taking a good quality fish oil, Calcium/Magnesium supplements as well
as acidophilus, flax seed and plenty of garlic. These are all available
at health food stores such as Trader Joes, Henry’s, Whole Foods,
Clarks and Nature Health.
How much weight
should I gain?
We believe it’s more important to ask, “What are you eating?”
We monitor your weight gain to make sure you are gaining enough but we
do not lecture about "gaining too much weight." Some women will
have perfectly healthy pregnancies while they gain a lot of weight. Others
can be unhealthy but have seemingly "ideal" weight gain. For
this reason, at your first visit, you are asked to fill out a diet diary
of everything you eat for at least one week so we can assess your nutritional
needs. We continue to do nutrition counseling throughout your pregnancy.
For more info on pregnancy nutrition, visit http://home.mindspring.com/~djsnjones/id36.html
.
What about childbirth
classes?
Please visit our childbirth class information on our
services page.
Do you have books
or videos that we can borrow?
Yes, we have an extensive lending library, with books and videos covering
many topics, including baby names, breastfeeding, labor and birth, nutrition,
massage, parenting, immunizations, herbs and books for children.
Do I have to see
a doctor for lab work or tests?
No. As licensed midwives we have lab privileges and can order any lab
work or ultrasound that you may need. You will have the option of having
all the same tests that are available with a physician and we will either
draw your blood or have you go to the lab for them to draw it. If a client
were to choose to have amniocentesis we would refer her to an obstetrician.
What lab work do
you routinely order?
At the first visit we order your prenatal panel which includes a Complete
Blood Count (CBC), blood type, Rh factor, antibody screen, rubella titer
(German measles), Hepatitis B and Syphilis. At risk clients will be screened
for HIV, Chlamydia and Gonorrhea. Around 32 weeks we repeat the CBC to
check for the presence of anemia and offer a vaginal culture for Group
B Strep. We usually do pap smears at the 6 week postpartum visit. If our
clients choose to have Alpha-feto protein test (AFP) through the State
of CA, we can draw that too.
You don’t
routinely order ultrasound?
No, we believe ultrasound can be a useful tool but isn’t routinely
necessary. Some women want ultrasound and when making an informed decision
we respect their choice to do so.
We have a tiny
house, will I have room for a homebirth?
That’s a common concern but rest assured, babies can be born just
about anywhere. We’ve delivered babies in nearly every type of ‘home’
- from a 10x10 rented bedroom to mansions by the beach to motor homes.
A clean, warm space is all you need.
What will I need
to do to get ready for my homebirth?
Less than you might think! You will need to gather a few supplies, clean
sheets and towels, make up your bed with plastic and old sheets and keep
food and beverages for your labor and postpartum. You will want to make
sure that the spaces you plan to use for the delivery are reasonably clean
and vacuumed. Additionally, you will need to select your baby's care provider
and arrange for postpartum help.
Do I need to purchase
a Birth Kit and other supplies?
Yes... you can purchase our birth kit at www.confidentbeginnings.net
What about special
equipment and sterile supplies?
We will bring all the medical equipment needed at the birth, as well as
sterile instruments.
What do people
who have home births do about the mess?
Home births are usually very tidy and we try to be careful. We recommend
protecting the floor and bed and having plenty of towels – all of
which can be thrown in the wash and soaked afterwards. Occasionally there
will be a few drops of blood on carpeting (usually when mom gets up to
go to the bathroom) which be cleaned with cold water and hydrogen peroxide.
I want to labor
in water and possibly have a waterbirth, where do I get a tub?
We provide an inflatable birthing tub as part of your Birthing Package.
All you need to do is purchase the sterile liner when you purchase your birth kit from www.confidentbeginnings.net
When will the midwife
come for my birth?
Because the midwife provides labor support and management as well as delivering
the baby, she will usually be at your home for most of your active labor.
We ask you to always call as soon as you think you may be in labor so
we can be prepared to respond when you need us.
What will I do
while I'm in labor at home?
For the most part, you can do whatever is comfortable, soothing and pleasing
to you. This is one of the distinct advantages of homebirth. In the early
stages, you might want to continue your household routine, or wrap up
some loose ends in your life such as folding laundry, addressing birth
announcements or watching a video. When the labor becomes more serious,
you might walk around, rock in your favorite chair, take a hot shower
or bath and relax.
Who can be at my
birth?
You can share your birth with anyone that you choose. Some families choose
to include their other children, grandparents, other relatives and close
friends. Some hire professional doulas to assist them. Others prefer a
very quiet birth with only the father and the midwives. It’s your
birth!
How do you feel
about children attending births?
We encourage family centered birthing and have books and videos to help
you prepare your children for the birth. Children should know that they
can choose to leave if they want to and they need to have a familiar adult
to supervise and care for them. We love children and relate to them throughout
your prenatal care so they are familiar with us by the time we come to
your birth. We find they usually do wonderfully at the birth.
What do you use
to help women at home manage their pain?
First we recommend that our couples take childbirth classes so they can
be superbly prepared beforehand. During labor we take our cues from both
mommies and daddies as to what they need. Some just need a hand to hold,
eye contact and reassurance. Others need “Verbal Anesthesia”
- talking them through the contractions, reminding them to breathe, reassuring
them and praising their work. We also encourage mobility and frequent
changes of position, rhythmic and repetitive movements, making noise,
aromatherapy and homeopathics. Of course, nothing compares to an “Aqua
Dural” (using deep water immersion). When needed we lavishly use
coaching and support for mother-to-be and her family so that labor, while
challenging, is a good experience for all.
What position will
I be in for the delivery?
There is no one perfect position in which to deliver a baby. Some women
prefer to sit or recline on the bed, a birth stool or on the floor. Others
stand up or squat down, kneel or lay on their side. Many choose to deliver
while in the birthing tub. Our midwives can also suggest positions which
may help you to be more comfortable, or enhance your delivery. Your perineum
will be supported with counter pressure and warm compresses. This usually
feels really good and helps you relax your bottom. Tears rarely happen,
but if they do, we are prepared to suture.
What happens after
the birth?
Baby is placed where she belongs, on your tummy where she makes her gentle
transition into the world, begins to breastfeed and integrates into your
family. There is no rush to cut the umbilical cord and we never separate
the two of you. After you’ve had time to bond we will do the newborn
assessment and examine you. We make sure you have something to eat, assist
you with the bathroom and showering and help clean up. We stay a few hours
after the birth to make sure that both mother and baby are stable and
usually leave the family snuggled up in bed together for a nice rest.
We come back to check on the family within 24 to 48 hours.
What kind of newborn
care do you provide?
We will do a newborn baby exam within the first two hours after birth
– with the baby right by your side. We don't separate babies from
their mothers. You'll have as much time as you want to bond with your
baby and you'll be able to have anyone you want touch or hold your baby.
Follow-up on the baby and further breastfeeding assistance is done at
your postpartum visits. We will provide you with newborn treatment and
immunization information - but keep in mind that notwithstanding State
requirements, the decision on whether to use these interventions is up
to the parents and many of our clients choose not to do some or all of
these interventions.
What happens if
everything doesn’t go ‘perfect’?
Our midwives are highly qualified to manage birth complications. Equipment
for infant resuscitation is on hand. IV solutions and medications to control
excessive bleeding after delivery are available if needed. Should you
have a tear that requires suturing, we can do that at home, first numbing
the area with a local anesthetic. We bring all the necessary medical equipment
and supplies as well as herbs and homeopathics that may help mother and
baby and allow them to safely stay at home.
Although homebirth
is statistically safer, it does not guarantee a problem-free birth. If
complications arise during the pregnancy, a woman may need to consult
with and possibly transfer care to an obstetrician. If complications arise
during labor or birth that are beyond the scope of care of the midwives,
mother and baby would be transported to the nearest hospital.
What if a transfer
to the hospital becomes necessary?
Most transports to the hospital are not emergencies, but rather arise
from long, slow labors and tired mothers. In these cases, the client,
support people and midwives travel by car to the hospital. In the event
of an emergency, we will call 911 and the transfer will occur by ambulance.
Your midwife will make every effort to accompany you to the hospital and
stay with you. We highly recommend that our clients pre-register at their
hospital of choice.
What percentage
of Orange County Midwifery clients have cesarean sections?
About 2 percent – a BIG difference from the 25% national rate!
How do I get started?
Contact us and we will set up a free, 1-hour
consultation for you to meet our midwives.
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