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| • Why choose a Midwife? • Is homebirth/birth center birth safe? • What happens if there’s an emergency? • Will my insurance pay for this? Frequently Asked Questions About Breastfeeding |
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Why choose a Midwife? The midwifery model of care differs fundamentally in its approach to pregnancy, labor and birth. Unlike the medical model which defines these processes from a pathological perspective, midwives view pregnancy and birth as normal, natural processes with physical, emotional, psychological, spiritual, and financial components. The midwifery model of care is characterized by: • respectful treatment • personal attention • education • confidence in women’s bodies • continuity of care • appropriate monitoring • fewer interventions (including Cesarean section) The word midwife means “with woman” and our care is very time intensive. Midwives spend about 45-60 minutes at each prenatal visit. (A typical visit with an obstetrician is about 5-10 minutes, after waiting for up to an hour or more!) We spend this extra time getting to know our clients, addressing concerns, answering questions, and providing plenty of information. Midwives know that feelings, hopes, fears, physical and practical needs, and spiritual or religious beliefs can all affect your pregnancy and birth. We address all of these needs so you can give birth naturally, safely, and confidently. Midwives also focus more on the importance of nutrition and exercise than most doctors do. We help to empower you to discover your body’s ability to give birth in its own way and its own time and to trust the process and yourself. Midwives provide sensitive, attentive care throughout your pregnancy and birth. We provide continuous, one-on-one support and monitoring throughout labor. In the hospital setting, doctors follow an on-call schedule so you may not have the same doctor during your birth that you had during your pregnancy. In addition, doctors do not come in until you are about to push your baby out, so it is the nurses who will be with you during most of your labor. In the midwifery model, you have the peace of mind that the midwife with whom you developed a trusting relationship during the pregnancy will be the one with you when you’re giving birth. According to the World Health Organization’s (WHO) statement on Health Promotion and Birth in 1986 “Midwives are the most cost effective and appropriate primary care givers for all pregnant women in all instances and all settings”. Finally, the midwifery model of care results in less chance of complications, fewer interventions (including cesarean section) and a healthier birth for you and your baby. Whereas the cesarean rate for an obstetrician typically ranges from 25-50%, the cesarean rate for midwives is usually 5-10%, well below the World Health Organization’s recommendation for safe cesarean rates.) |
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| Is homebirth/birth center birth safe? Over the last twenty years numerous studies have been done to determine the safety of out-of-hospital birth. All of these studies have shown that homebirth or birth center birth with a skilled attendant are just as safe, and in some instances, safer than hospital birth for healthy, low-risk women. In fact, the countries in the world with the best birth statistics are those in which midwives are the primary care givers for pregnant women and the homebirth rate is much higher (as much as 50%) than in the United States. Of course, there are some situations in which the hospital is the best place for a woman to have her baby, and for these situations we are grateful to have the hospital as an option. But the fact is, out-of-hospital birth is a safe alternative to hospital birth for the vast majority of women. At the first prenatal visit, the midwife will obtain a complete medical history and determine whether you would be a good candidate for an out-of-hospital birth. For a complete reference on the safety of home and birth center birth please (click here-Go to section belowJ Home Birth = Safe Birth The following research studies from well-known and respected medical journals attest to the safety of homebirth and midwifery care. Outcomes of Elective Home Births: A Series of 1146 Cases. “Journal of Reproductive Medicine,“ 1977. Gives data showing the safety of home births by licensed midwives. Home or Hospital Births. “Journal of the American Medical Association,” May 1980. A partial review of home birth data by two physicians, neither of who believe in or practice home birth. They nevertheless conclude that no valid data exists that proves hospitals to be safer than home. Licensed Lay Midwives in Arizona. “Journal of Nurse-Midwifery”, Jan.-Feb. 1984. Reports a successful program of licensed direct-entry midwives engaged in home birth, regulated by recently enacted Arizona statute. Neonatal Outcome of Planned vs. Unplanned Out-of-Hospital Births in Kentucky. “Journal of the American Medical Association,” March 1985. Gives data showing safety of home births attended by direct-entry midwives. The Place of Birth and Perinatal Mortality. “Journal of Royal College General Practitioner, “ August 1985. Analysis of statistics for Britain shows that mortality rates in hospitals with board-certified obstetricians is unjustifiably and significantly higher than for general practitioners or for home birth. Data brings in question as to whether even high-risk mothers actually benefit by hospitals and certified obstetricians. Scientific Basis for selected Perinatal Procedures and Their Psychosocial Effects. “World Health Organization”, 1983. Points out the fact that hospitals have never been proven to be the safest place for most mothers to give birth and that home is at least as safe for low-risk mothers. Do Intranatal (during labor) interventions make birth safer? “British Journal of Obstetrics and Gynecology”, July 1986. A detailed scientific study showing that obstetrical interventions during labor make birth less safe, not more safe, for the vast majority of cases. Conclusively proves case for non-interventive midwifery approach to childbirth. Safer childbirth? A Critical History of Maternity Care. “Chapman and Hall, Publishers, London 1990. More than 15 years of original research and statistical documentation by an instructor of medical statistics, Nottingham Medical School, proving that midwifery care and non-interventive obstetrics are far safer than current hospital practice—even for the high-risk. The most rigorous and complete statistical support for midwifery and home birth published to date. |
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| What happens if there’s an emergency? Most complications can be picked up through good prenatal care. Transfers during labor are usually for non-emergency reasons, such as failure to progress. True emergencies are rare, occurring about 1-2% of the time. However, there are situations in which complications come up suddenly and this is when the midwife’s skill and expertise become crucial. Midwives are trained to handle all types of emergency situations, including newborn resuscitation and postpartum hemorrhage, and to know when to transfer. (We carry oxygen, resuscitation equipment, and anti-hemorrhagic medications to all births). Midwives work in collaboration with physicians so that when necessary we can consult and/or transfer care to an obstetrician. |
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| Will my insurance pay for this? By law insurance companies within the state of Florida must reimburse midwives for out-of-hospital birth. Women have the right to choose their birth setting and care provider. However, if you call your insurance company they will likely tell you that they do not cover midwives or homebirth. Don’t be discouraged, we often have to educate them about the laws protecting midwives and women’s choices. It is better to have us call and speak to someone as we are more familiar with the process. You may be responsible for co-pays, co-insurance, and deductibles, but everything else should be covered. Medicaid is also accepted. Cost/payment options The cost for care from the beginning of pregnancy up until six weeks after the birth is $3900. This fee includes all prenatal exams, childbirth classes, one prenatal visit in the home at 36 weeks of pregnancy, monitoring of active labor and assistance at birth until at least two hours postpartum, three postpartum visits in the home, filing of the birth certificate, and 2 postpartum visits in the office. This fee does not include labwork, or birth supplies. If you have insurance I will gladly bill your insurance company. However, you will be responsible for any co-pays, co-insurance, deductibles, or other fees which your insurance does not cover. If you have Medicaid all services, including labwork, are covered. If you are self pay, my fee is flexible and a payment schedule can be set up. Fees for bellymasks or blessingways are separate. All fees must be received by 36 weeks of pregnancy. If you transfer care during your pregnancy, refunds will be made according to my fee schedule. |
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Bellymama Midwifery * Corina Fitch, L.M., R.N., C.P.M.
Bellymama Midwifery is a private midwifery practice offering pre-pregnancy counseling,
complete prenatal care, childbirth education, blessingways, and bellymasks,
home and birth center birth,VBAC, waterbirth, postpartum care, and breastfeeding support.