Frequently Asked Questions
Midwives are healthcare professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which results in confident, supported labor and birth.
While there are different types of midwives practicing in various settings, all midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns.
Many midwives also provide preconception care and routine well-body reproductive care, and primary care throughout the life cycle. Learn more about our GYN, IUI and primary care services.
- Monitoring the physical, psychological and social well-being of the mother/birthing person throughout the childbearing cycle
- Providing individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and comprehensive postpartum and breastfeeding support
- Holding the space, supporting, and celebrating the power of each woman/birthing person to birth her/their baby, and recognizing and respecting each woman's/person’s autonomy, sovereignty, and expertise regarding her/their own body, baby, and family.
- Avoiding unnecessary medical and technological interventions.
- Identifying complications and referring individuals who require medical obstetric care.
INDIVIDUALIZED CARE
All decisions about your care are made together with you. We have thorough conversations about your needs, preferences, and values, your individual health, and the choices available. We respect you as the expert on your own body and as your baby's primary care provider.
CONTINUITY OF CARE
Your midwife will follow you throughout the course of your prenatal, birth, and postpartum care. At every point in your journey, you will see the familiar, comfortable, friendly face of your very own midwife.
EVIDENCE-BASED CARE: We stay current on the research around pregnancy, birth, postpartum, and breastfeeding so that we can provide up-to-date information to assist you in your decision-making.
YOUR OWN ENVIRONMENT: For many families, the comfort and security of your own home cannot be matched. You choose who attends your birth and who cares for you. You choose what to eat and drink. Walk, dance, shower, or sleep uninterrupted - it's your birth!
Comprehensive postpartum care: From the first minutes of your baby's life to your six week postpartum checkup, M.A.M.A.S. midwives combine frequent home visits and phone check-ins that can always convert to in-person visits, so that you feel supported in early parenting, breastfeeding/chestfeeding, and healing your body after your birth journey. Extra visits are at no extra charge during those 6 weeks.
Your relationship with your M.A.M.A.S. midwives can continue after pregnancy, birth and postpartum, since we offer GYN, inter-conceptional, contraception, and primary care throughout the childbearing years, menopause, and beyond.
Multiple studies on planned home birth, including one study of 17,000 families released in 2014 by the Midwives Alliance of North America, found:
- Better outcomes for babies: 97% of babies were carried to full-term, and weighed an average of eight pounds at birth. Only 1% of babies were transferred to the hospital after birth, most for non-urgent conditions.
- Low rates of intervention: Only 4.5% of the 17,000 study participants required oxytocin augmentation and/or epidural analgesia. This is much lower than average for the United States, where 26% have oxytocin augmentation and 67% have epidurals.
- Low rates of cesarean birth: The 2014 MANA study also found that of the 17,000 planned home births, only 5.7% ended up birthing their babies via cesarean. This is compared to the national average of approximately 31% for full-term pregnancies.
- High VBAC success rate: For low-risk birthers, chance of having a vaginal birth after cesarean ranges from 68-87% with birth outside the hospital (90+% with M.A.M.A.S.).
Yes! Waterbirth is a lovely option for those who desire it. Many families choose to have birth tubs for comfort in labor, regardless of whether the family plans to have the baby in or out of the water. We can help you find a tub to rent, buy, or borrow, if that is what you choose. About 20% of our families birth in water, with the other 80% using a tub for labor only, or skipping the tub and having a wonderful birth on dry land.
Most likely. Trying for a home VBAC has a high success rate - over 90% with M.A.M.A.S.- but there are some additional risks during labor, and some people are better candidates for home VBAC than others. Cesarean birth or other uterine surgeries leave a scar on the uterus, leaving some of the tissue weaker and slightly more prone to separating during labor. This is known as uterine rupture. The risk of uterine rupture is minuscule if you have never had a cesarean or other uterine surgery, and is very slightly higher if you have had a cesarean. Barring any unusual circumstances, VBAC can be a safe and desirable alternative. It is also notable that a repeat cesarean also carries risks--of bleeding, damage to other organs, and complications for the baby. We can discuss your prior birth experience and desire for VBAC during a free consultation.
During the early part of labor, you will be with your partner and anyone you invite to your birth. Once you are in active labor, one of the midwives will come to be with you. As you get closer to birthing your baby, she will call in a second midwife to act as the birth assistant (we rotate those roles). A student midwife may be present during your care and birth, with your permission. You will be provided with a Call Schedule for the last month of your pregnancy, so that you will know who is on 1st and 2nd call on any given day.
Yes! The presence of loved ones can make your birth even more special. It is important to choose only people who make you feel safe, loved, and supported. We can also offer support for setting boundaries when you desire privacy.
We welcome and celebrate all variations of human beings, and have enjoyed working with many different kinds of people in our birth, well-body care, IUI/fertility, and primary care services.
While every birth is a little different, at a typical birth we wait for you to take your baby (either from our hands or from the bed or the water) and bring them onto your stomach or chest. Until the placenta is born we watch carefully for signs of placental separation and monitor your baby's adjustment to life outside the womb.
Once the placenta is born and any needed repair is done, and baby has latched on to your breast/chest, we leave the room so you can have some family time, staying close by with an ear out for your needs and checking on you periodically. When we return to the room, we help tie off and cut the cord, and hand baby to your partner, skin to skin, while we help you to the bathroom to pee and shower.
When you return to the bed, you will have a nutritious meal while we go over postpartum instructions with your loved ones and perform a thorough newborn assessment, including head-to-toe exam, reflexes, suck/oral exam, and routine newborn procedures such as weighing, measuring, vitamin K and erythromycin (if desired). Once birther and baby are stable and content, we clean up, do a load of laundry, and leave the family to take a nice long nap (if baby allows!). We return for postpartum checks frequently (6 times or more) over the next 6 weeks.
We bring everything you would expect to find in a free-standing birth center or a level 1 community hospital (except for an OR and a blood bank), including but not limited to:
- Monitoring equipment for you and your baby, including a doppler, blood pressure cuff and stethoscope, thermometer, and infant stethoscope.
- Supplies for the newborn exam and any newborn procedures that you choose, including a scale, measuring tape, erythromycin ointment, and vitamin K.
- Antihemorrhagic drugs to stop excessive postpartum bleeding.
- IV set-ups, IV fluids, antibiotics, and anti-nausea medications
- Resuscitation equipment for baby and birth parent: a bag and mask resuscitator and oxygen (all attendants are NRP-certified)..
- Suturing equipment for any repairs needed after birth, and lidocaine to numb for suturing.
Midwives are trained to recognize early signs of complications, to handle certain complications at home, and to know when a transport to the hospital may be necessary. One of the most common of the very uncommon complications we handle at home is excessive bleeding from the uterus immediately after the baby is born, and we carry the same medications used in hospitals to stop the bleeding. The second most common complication in a home birth is a baby who needs some help to take his or her first breaths. Every midwife at your birth is certified in neonatal resuscitation. Again, in this scenario, we follow the same standards as the hospital.
It is important to note that 96.4% of transfers from home birth are NON-emergent, and the very most common reason for transferring to the hospital is a very long labor in which the mother/birthing person and midwife gradually come to agree that it would be best to go to the hospital and “buy some technology”--usually in the form of an epidural and some pitocin--to allow the birther to rest and regain their energy for a safe delivery.
During your pregnancy you will order a registered M.A.M.A.S. birth kit which includes all the disposable supplies for your birth. Many of these supplies are meant to keep your house clean during the birth. While you have family bonding time with your new baby, we quietly tidy up, and we generally leave the house cleaner than when we arrived!
No. Midwives provide the same clinical components as doctors during prenatal care, such as listening to the baby and taking your blood pressure, plus much more. In our longer visits, we get to know you and your health, and address all your questions. We have found that “parallel care,” or duplicative care, ends up with different providers telling you different things, which causes discomfort for you, the doctor, and the midwives. Clients with Kaiser might need to visit there periodically for ultrasounds and routine labs, but most people will not need any care beyond the comprehensive prenatal care that M.A.M.A.S. provides, which includes care for many primary care ailments, if they pop up during pregnancy, such as UTIs, sinus infections, migraines, and other common health problems. M.A.M.A.S. midwives are able to diagnose and write prescriptions for these and other problems if they arise.
M.A.M.A.S. midwives obtain lab samples for blood draws, urine tests, pap screening and infection swabs during regular appointments or in between if any concerns arise. There is no extra charge for drawing these labs and sending them to LabCorp or Quest for processing (the lab will bill your insurance for the actual testing). We also provide referrals for ultrasounds as needed or desired, and for consultations with other specialists, such as endocrinologists, nutritionists, massage therapists, cardiologists, chiropractors, acupuncturists, and physical therapists, as needed. There are no tests available in obstetric care that we cannot provide for you or help you access. Charges for those specialists will be billed to your insurance by them, and we will try to refer you to practitioners who are "in network" for your insurance when possible.
Our fee for complete midwifery care services is split into two parts:
$5,500 global fee includes prenatal, birth, postpartum and newborn care for the first 6 weeks, primary care during pregnancy and postpartum, and midwives who are on call for you at all times during your pregnancy and 6 weeks postpartum. It also includes breastfeeding/chestfeeding support up to 6 weeks postpartum, (a considerable cost-saving if problems arise!).
$1,000 birth assistant fee covers the 2nd birth professional attending your birth, and is due at your 36-week supply check.
We offer discounts for early payment, return clients, and clients who qualify for medicaid. This fee is paid in increments throughout your pregnancy. In order to receive any discounts, the fee must be paid by 32 weeks, or the second visit, whichever comes last. (Note: our fee does not include your birth kit, labs or ultrasounds, or a birth tub, which will be billed by those that provide these services.)
After your birth, we will work with our billing company to get you reimbursed for as much of the fee as your insurance will cover. Since we pay the billing company to do this, you don't have to do any of the paperwork. And since we pay the biller according to how much they are able to get back for our clients, they are incentivizes to get you reimbursed for every penny allowable under your plan.
Often, PPO insurance companies will reimburse for midwifery services at the out-of-network or sometimes the in-network rate. We work with an insurance biller to help you get the maximum reimbursement allowed by your plan, so you don't have to do any of the paperwork. Generally, people pay out of pocket and then get reimbursed once the baby is born (insurance companies don’t pay for things that haven’t happened yet).
We are Tricare Authorized Providers but are not in-network with Tricare. For more information about reimbursement rates for Tricare you can search your plan at Tricare.mil.
