Frequently Asked Questions
Welcome to the Birth Matters FAQ page. At Birth Matters, our goal is to help you become as informed as possible, giving you the confidence to be the lead decision-maker in your birth. Click on any of the frequently asked questions below in order to read the answer. If you have a question that is not listed on this page, we’d like to hear from you. Please send us a message with your question and we will respond to you with an answer promptly. We look forward to hearing from you and serving you soon.
Prenatal Care & Fees
The initial visit is approximately two hours and includes a medical and obstetrical history, physical exam, labs as appropriate and education. Regular prenatal visits are once a month to 28 weeks, every other week until 36 weeks and weekly until birth. Additional visits will be scheduled when indicated.
Between 36-38 weeks a visit in your home is scheduled to meet others attending the birth, to be sure your homebirth supplies are ready and to assure we know how to get to your place. At this time we review your birth plan and when and how to contact us when you are in labor, and discuss your specific desires for your birth.
Two home visits are provided after the birth and follow up care at the office at approximately 2 weeks, 4 weeks and 6-8 weeks are also provided for comprehensive care and guidance through this delicate time in your life. Newborn care is also provided at these times.
We will offer you all tests that are considered “standard of care” recommended by the American College of Obstetricians and Gynecologists (ACOG), the American College of Nurse-Midwives (ACNM) and those of the State of California. We will provide education on the various tests and screenings, so that you can make an informed choice. Some of these screens include:
- “The Prenatal Panel” which includes your complete blood count (CBC), blood type, Rh factor, antibodies, rubella, hepatitis B & C, HIV screening and syphilis status.
- Pap smear offered if indicated or requested
- Gonorrhea and Chlamydia screening*
- Early Pregnancy Screening
- Diabetes Screening Test and Anemia screening between 26 and 28 weeks
- Group B Strep (GBS) screening
- Non-stress test (NST)*
- Biophysical Profile (BPP)*
* Indicates test is not routinely indicated.
With the exception of the prenatal panel, other tests may be deferred or declined because the philosophy of our care is mother directed.
We will collect your lab work in the office, send it out for diagnosis, and the results will be sent back directly to our office. Ultrasounds are by referral.
Midwives offer thorough premium prenatal care and in most cases, you will not need to see an obstetrician during your pregnancy. However, there are conditions that are outside the scope of practice of a midwife that will result in a referral for a consultation to a physician. This may or may not result in a transfer of care depending on whether or not the condition would significantly affect the course of your pregnancy and/or birth.
Should you desire, you may choose “co-care”, seeing your doctor and midwife at their prospective offices throughout the course of your pregnancy. If your insurance is an HMO, it is financially beneficial to stay in contact with your assigned doctor where labs and other tests will be covered or in the case of a transfer of care. Midwives may attend a woman in labor at home between 37 and 42 weeks. Should a woman go to 42 weeks, the midwife will only be able to continue prenatal care if you are under the care of a physician. If you are not under the care of a physician, she may join you at the hospital once you are admitted. Hospital based medical care during your pregnancy, birth or postpartum, is available to you whenever necessary.
All lab fees and other diagnostics such as ultrasounds, non-stress testing, etc will be billed directly to you or your insurance and are not included in our fees.
Yes, we love to assist mothers through their journey to having their vaginal birth after a caesarean, also known as HBAC’s (Home birth after cesarean). We believe in the empowering process of a natural delivery, and do our best to provide tools and resources for the mother to have an optimal experience. We highly believe in education and provide HBAC clients with a myriad of helpful articles and current studies on the risks and benefits of attempting a VBAC. VBAC’s are currently unavailable through the birth center.
No. The current law does not allow licensed midwives to attend twin births. However, because we believe in the value of midwifery care for all pregnancies, we do offer prenatal co-care with an OBGYN, where the client can enjoy the benefits of relational, gentle and educational care.
No. The current law does not allow a licensed midwife to knowingly attend a breech birth.
Labor & Birth
With two midwives and well trained midwife assistants, our staff will still be able to attend both families in the rare occasion two births are occurring at once.
In a combined thirty years of childbirth experience the midwives at Birth Matters have encountered complications such as meconium stained fluid, fetal distress, tight cord around the neck, shoulder dystocia, postpartum hemorrhage, respiratory distress, and surprise breech presentation of which most have been successfully resolved at home without incident.
We do not carry pain medication that you would find in a hospital because we are not willing or authorized to use these drugs in a homebirth setting. Additionally, their use does increase risk to you and your baby. We offer a variety of traditional modalities such as herbal tinctures, herbs, homeopathy and essential oils. Our greatest traditional pain remedies are the tender loving care that you receive and hydrotherapy (use of water in labor).
Transports to the hospital are usually not an emergency. The most common reason for transport from home to hospital is lack of progress in a first time mom. This is after the midwife has done all that she can offer naturally and safely at home to help you progress. Other reasons for transport may include unresolved fetal distress, thick meconium with birth not eminent or excessive blood loss. Because mother and baby’s safety and well-being are of primary importance, whenever a labor complication warrants hospital care, the midwife will arrange the transfer and accompany you. We are pleased to be able to report a transport rate of less than 7% and only 1⁄2 % of these are considered an emergency.
Prenatally with your permission we will use a Doppler until 20 weeks and thereafter a fetoscope. If you desire we will use the Doppler throughout your care. During labor it is more convenient for mother and midwife to use the Doppler. We will use a fetoscope if that is your preference as long as we can adequately hear your baby’s heart. This will take more cooperation on your part to move into positions that will enable us to hear your unborn baby’s heartbeat.
Water births are wonderful! They are extremely relaxing for mother and provide an unbelievable gentle transition into the world for baby. We are happy to assist you with a water birth and will help you with the additional preparations in planning for one. We have birthing pools available to rent or borrow, based on your tub preference.
We stay for at least two hours after mom and baby are stable. This means you and your baby will be evaluated for signs of wellbeing such as normal vital signs, normal amount of bleeding and uterine tone, breastfeeding, healthy normal baby with normal respiratory effort and appropriate bonding.
We provide a complete newborn exam prior to our departure but ask that you bring your baby to a pediatrician or care provider of your choice within one week after the birth. Check with your care provider as to when they would like to evaluate your newborn.
We offer routine antibiotic eye prophylaxis, which is an ointment used to prevent infection caused by bacteria in the birth canal. The law requires that we offer this treatment, which you may refuse. Another standard for newborn care is routine vitamin K. A small amount (0.5ml) is injected to prevent hemorrhagic disease, which is rare. An oral application may be substituted by the parents. This is not considered standard of care however most pediatricians are not opposed to this route of delivery. At the home visit we will offer the Department of Health Services Newborn Screening Test, which is a blood collection from the heel of your baby (also known as the PKU test). This is also a required test. If you choose not to have this test, you simply sign a waiver. Aside from hand-outs and discussions during your office visits, it is our hope that you will educate yourselves as much as possible to make informed decisions about your baby’s care.
Yes. We are licensed to perform vaginal repairs and carry supplies necessary for suturing including local anesthetics. Only in the event of a very severe tear that we feel is outside of our scope of practice, would we need to transfer to the hospital for a more extensive procedure.
We encourage you to meet with both midwives at the initial consult, which can help you to then choose your primary midwife. This midwife will attend the birth, accompanied by 1 or 2 assistants, who are either qualified assistant student midwives or another licensed midwife. We encourage meeting with both midwives throughout your care, so in the event your primary midwife is unavailable, you are still able to receive excellent, relational care.