Frequently Asked Questions
Q: Am I a good candidate for a homebirth? Who is considered "high risk?"
A: The vast majority of childbearing people are “low risk” enough to give birth at home. But it helps if you:
Are in good physical and mental health
Have good nutritional status
Have adequate social support before, during and after birth
Are socially mature and able to accept responsibility to make informed choices throughout their pregnancies and for their birth outcome.
Have a positive emotional environment
Have access to childbirth, home birth and breastfeeding education such as books and classes.
Understand that technological intervention is used only when necessary.
Understand that pain medication will not be used during labor.
Are curious and excited to give birth at home!
You may not be a good candidate if you:
Have high blood pressure
Have pre-existing diabetes (this is different from gestational diabetes) or gestational diabetes not controlled by diet
Have heart, kidney or lung disease
Have certain types of clotting disorders
Have placenta previa
If you have a question about whether you are a good candidate for a home birth, get in touch!
Q: What equipment do you bring to the birth?
A: Among many other things, I bring…
sterile instruments for the birth and afterward
a doppler for listening to the baby's heart rate during labor and pushing
an oxygen tank and resuscitation bag/masks for parent and newborn
a suction device for removing mucus and other material from the baby's nose and mouth
drugs for preventing or stopping the birthing person from bleeding too much after the birth
IV equipment and fluids for rehydration of the laboring person
Herbal and homeopathic remedies for use during labor
Antibiotics for GBS positive people
Clients are required to purchase certain other supplies for the birth, such as disposable underpads and gloves. You can take a look at my birth kit here.
Q: What happens in an emergency?
A: My job during your labor is to hold space for things to unfold safely. Part of that holding of space is monitoring for signs that tell me labor has gone outside of what is normal. The majority of problems that occur during labor and birth present warning signs and midwives are extensively trained in recognizing these warning signs. We not only monitor for and recognize these signs during labor and birth, but screen throughout the pregnancy for conditions that might indicate you are best served by a birth with a higher level of medical care. This means “emergencies” during birth occur relatively infrequently, but midwives are also well equipped to manage the most common of them at home (such as postpartum hemorrhage). Circumstances that require an immediate transfer to the hospital are exceedingly rare. By far, the most common reason for going to the hospital during labor is not an emergency but exhaustion and/or request for pain relief (this is more common in first-time parents with very long labors).
Still, it must be acknowledged that birth is only as safe as life gets, and no setting is without risk. Choosing between home and hospital is a decision between risk rather than forgoing risk. Hospital birth carries with it a much higher risk of routine intervention that effect both long and short term health outcomes than home birth does, but choosing to birth at home does mean that there can be a delay in care in certain rare emergencies. Extremely rare events can also occur in either setting that present no warning signs. An example of this would be a clot (embolism) in the laboring person’s lungs or a placental abruption. These extremely rare events are life-threatening no matter where they occur, but a hospital would have more equipment and a larger number of trained health care personnel immediately available to respond than would be possible at home. But because these events are sudden and immediately life-threatening, there is sometimes nothing that can be successfully done to protect the laboring person or baby even in a hospital setting. That being said, it is important for families considering home birth to be willing to accept these risks, and we will discuss them at length before you initiate care with me.
Q: Do you support waterbirth?
A: I love waterbirths! Many of my clients choose to labor or give birth in the water. I use a waterproof doppler so I can still monitor the baby's heartbeat regularly if you choose to labor in a tub or shower. If you choose to give birth in the water, I will help you to bring your baby up out of the water and gently into your arms within a few seconds after they come out. Your baby is able to receive all of their oxygen through the umbilical cord, just like they do throughout the entire pregnancy, for these few seconds. If you are curious about the evidence surrounding waterbirth, Evidence Based Birth (a great resource!) has an entire article devoted to it here.
Q: When should I initiate care? What if I have been seeing another provider?
A: Some people may know from the start of their pregnancy that they want to give birth at home, and others may decide at some point during the pregnancy. You can begin your care with me, or transfer somewhere along the way as long as I have availability. It is normally quite easy to get your records from a prior provider if you are transferring care.
Q: This is my first pregnancy. Can I have a homebirth?
A: Yes!
Q: Do you require I hire a doula?
A: I do not "require" anyone hire a doula. That being said, I very much encourage and support the decision to hire one and think it's especially important if this will be your first experience laboring.
Q: How do I know if we are a good fit to work together?
A: I provide a free consultation visit so you can get to know a little bit more about me and ask questions to help you decide whether a homebirth is right for you. Please get in touch—I'd love to meet you!
Q: Do you take insurance?
A: Like all of the homebirth midwives in NYC, I am not in-network with any insurance. However, I have an excellent, dedicated staff member to help you navigate getting the best possible coverage from your specific plan, even when your plan has no out-of-network benefits. Your insurance may cover all of the prenatal, birth, and postpartum care, or you may be responsible for some balance, but my goal is always to have insurance pay first, not you. In this process it's important to consider that many of us budget for the life events and experiences that are important to us, such as weddings and vacations, and that there are few life experiences that have the potential to be quite as impactful, long-term, as birth.
That all being said, making homebirth accessible to all is a deep value and priority for me. I am committed to finding ways to work with low-risk individuals from all socio-economic backgrounds. Let's find a way to make it work!