A CNM is a Certified Nurse Midwife. CNM’s are advanced practice registered nurses (Masters degree) who are trained to care for women throughout their lifespan. Most commonly during pregnancy, birth and postpartum. A CNM can be the primary care provider for women with low risk pregnancies. This scope of practice also includes offering GYN care, preconception counseling and family planning.

IBCLC stands for International Board Certified Lactation Consultant. It is considered the gold standard for professionals offering lactation care. They can provide expert lactation care in all it’s forms (directly from parent and/or indirect feeding; bottle, cup, finger) and assist in optimizing and customizing the feeding journey for the parent-baby dyad.

Prenatal visits occur in the clients’ home. It may be a visit with just the client and midwife or include anyone else that the client chooses. Some visits may include the client’s older children, the partner or the grandparents or even friends.
During the visit, the midwife will use a fetal doppler to listen to the baby’s heartbeat and a measuring tape to assess interval growth. The client’s vital signs will be monitored. At later stages of pregnancy, the baby’s position will be assessed as well. Some visits may include testing (i.e blood work and/or cultures) all of which can be collected by the midwife in the home. In addition to all this, we discuss and address any questions or concerns you may have at any given point throughout the pregnancy. We can then also discuss and practice different modalities to address issues, such as common discomforts and ways to alleviate them.

All the routine testing that you are offered at on OBGYN’s office can be done at home as well. These tests include blood tests that are recommended by ACOG (American College of Obstetricians and Gynecologists) throughout the pregnancy. Any additional testing that the client may need to address/diagnose a health issue may be done as well.
Also, genetic carrier screen and NIPT (non invasive prenatal testing) can be done at home. I work with Quest diagnostics for routine labs and cultures and with Unity for NIPT and genetic carrier screens.
Not all tests are mandatory. Throughout the pregnancy we will discuss timing for testing, review the risks/benefits/alternatives to tests and you may opt in or out of certain tests.

For routine assessment and care during labor and birth: We have the fetal doppler, blood pressure cuff and stethoscope, which you’ve gotten used to as you see it during prenatal visits.
We bring sterile equipment, like those used to cut the umbilical cord, suturing kits if laceration repair is necessary.
Fetal stethoscope, tape measure and a scale for when the baby arrives.
For emergency cases: We bring resuscitative equipment: oxygen tanks with masks for mom or baby, suction, IV fluids.
Medications we carry may include antihemorrhagic drugs to stop excessive bleeding and antibiotics.

If a complication arises during the pregnancy that requires you to transfer your care prior to 35 weeks of pregnancy, fees for your prenatal care will be itemized to the services rendered only. If the need for transfer occurs after 35 weeks or during birth, there will be no refund.

If a transfer is necessary during labor, the midwife will transfer with you to the hospital to ensure a seamless transition and proper communication with hospital staff. Postpartum visit schedule will continue unless you opt out of this service.

There are multiple ways homebirth midwives work with MD’s and/or MFM’s (Maternal Fetal Medicine). We can either consult, refer, collaborate or transfer care. When/if an issue arises that we need to discuss with a physician, an MD is consulted to receive recommendation on how to proceed with care. Some cases may justify having the physician meet the client for a visit (referral) in order to better understand and offer recommendations. When pregnancies fall out of the “low risk” categorization, then an MD may become a part of the OB team and co-manage care or the MD will become the primary care provider for the remainder of the pregnancy, labor and birth.
I work with OB’s who I consult with, but if a transfer is necessary, we work together to establish your care with the physician of your choice. If a transfer of care is necessary during pregnancy, a timely transfer of records will occur to facilitate a seamless transition.

Yes, it is your choice whether to have a water birth or just use a birth pool for labor. I will provide you with the tub at your 36 weeks visit. This birth pool is loaned to you to use during labor and birth and will be collected on one of our postpartum visits.
You will be required to buy the liner and hoses for the birth pool.

Studies show that a planned home birth is a safe option for birthing families who have low risk pregnancies. These studies demonstrate that the outcomes are similar to two groups with low risk pregnancies,whether they birth in a hospital or at home. Most of the time, the group that birthed at home have a higher satisfaction rate, better birthing experience, less trauma, lower rate of intervention (use of pitocin, epidurals, operative deliveries, laceration repairs).
Midwives are trained professionals who understand the physiology of birth but will recognize when situations deviate from normal and respond to them. Our goal is always to keep the birthing family safe.

I am not an in network provider with insurance companies. A lot of insurances (mostly PPOs) will offer reimbursement. I can provide the client with a super bill and fill out all the forms that the insurance requests in order for a claim to be approved. This process can be done independently or with the help of a biller/ billing entity. I will be available to provide all documentation necessary to help you receive the reimbursement you deserve. In some cases, services are reimbursed in full and in some they are barely covered. It is advisable for you to start these conversations with your insurance prior to pregnancy or throughout the pregnancy, in order to understand your benefits.