Frequently Asked Questions About Homebirth:
Will I need to see a doctor during my pregnancy?
New Mexico Midwifery Guidelines recommend that you see a physician within four weeks of your initial visit with your midwife. It is up to you, the pregnant woman, if you want to see a physician. Some women like the security of being able to say they have a physician relationship, just in case a hospital transport is necessary during the birth. Other women feel that if we are transporting, it must be an emergency, so the doctor on-call is just fine!
What is a DEM, LM, CPM and CNM?
DEM (Direct-Entry Midwife) means that ALL of the midwife's training has been in non-interventive, normal birth. S/he may or may not hold a license in the state in which s/he is practicing. Yes, it's still illegal in some states to have a home birth. Amazing, isn't it? Sometimes this type of midwife is called a "lay-midwife." This term has been generated by the medical profession to be sure that you, the customer, knows that this person IS NOT an American Medical Association trained nurse. Most DEM's don't care for this title, as a "lay-person" is usually someone who is a beginner or knows nothing about a certain topic. This definition does not apply to homebirth midwives. We are the keepers of normal birth and are experts in what we do.
LM (Licensed Midwife) usually denotes that the midwife is practicing in a state where home birth is legal. S/he must meet certain state licensing requirements and take a test in order to carry a license. S/he must then practice under a state-generated set of policies and protocols. Educational requirements vary from state to state, but most require 2-4 years of training and meeting specific requirements prior to taking the qualifying exam. In most states, these policies and protocols are generated by a group consisting of the practicing midwives and interested state representatives. A regulatory board and/or advisory board is set up to maintain the integrity of excellent care for the mothers and babies. This usually includes participating in continuing educational requirements to renew and maintain their licensure.
For example, the state of New Mexico requires all Licensed Midwives to present proof of 30 hours of continuing education in the field of midwifery care every two years.
CPM (Certified Professional Midwife) is a national license. The holders of this title have met national midwifery training standards set by NARM (the North American Registry of Midwives, which is affiliated with MANA, Midwives Alliance of North America). All licensed midwives participate in continuing education requirements to renew and maintain their licenses.
CNM (Certified-Nurse Midwife) is a nurse first; four years of schooling to become a nurse, then a year or two working as a nurse in a hospital setting. After that is completed, the student then returns to school for 1-2 years to get the midwife part of the training. Nurses are not autonomous. They must practice under a physician. Some states have Nurse-Midwives in the hospital setting only, some allow them to practice in birth-center settings and some allow them to attend home births. All of them have to have the authorization of a physician and are bound by hospital and insurance policies and procedures in their practices.
Are there laws regulating homebirth midwives?
Laws governing all midwifery practices vary from state to state. New Mexico has the honor of having some of the best midwifery laws in the US. That's good for you, the consumer and client, and good for the midwife practicing in this state. Midwives are required to carry basic emergency equipment and have the knowledge and skills to use them appropriately. In the Albuquerque area, we have physicians that are respectful of the home birth choice and are open to working with the midwives and the clients that may need their special kind of expertise.
Are your services covered by insurance?
It depends on your policy. Each insurance policy is designed with different needs in mind. Read your particular policy and look for specific terminology. Does it allow for a Licensed Midwife? A Certified Nurse-Midwife? No midwives, an OB or OB Specialist only? Does it mention homebirth by name? It's usually recommended that you call your insurance company and ask them exactly what they will cover before making a decision about your care provider. Sometimes, paying out-of-pocket is the only way to have a home birth. By doing your "homework" with the insurance company and during the selection of your care provider, you will be able to ensure having your birth your way.
What if I decide to have medication during labor?
The option of going to the hospital at any point in your labor is always available. Wanting something and needing something are two different things. No midwife is going to keep you at home against your wishes. However, going to the hospital will change your birthing environment considerably. A short discussion about the reality of what the hospital is prepared to do for you takes place prior to departure. We cover topics ranging from how long you might have to wait to receive any pain medication, how you will now be bound by hospital policies and procedures, and how you may need to stay for 24 hours or more after the birth, just to name a few.
Will I have to get a sonogram or ultrasound during my pregnancy?
Albuquerque Homebirth does not require a sonogram be done. We have access to an out-of-hospital sonography group if the need for one arises, or if the client desires a sonogram for assurance at any time during the pregnancy. Most sonograms cost about $300.00.
What are the benefits of using water during labor and/or birth?
Water removes 75% of gravity, which significantly decreases the amount of pain you experience during labor and pushing. It also allows you to be more relaxed and mobile, and because of that, shortens your labor. Being able to change positions frequently and easily allows the birthing woman to be more aware of how her labor is progressing and to feel a direct connection with what is happening. Water provides an increase in oxygen to the baby and the uterine muscles, decreasing the potential risks of fetal distress and prolonged, often ineffectual labor. Please visit some of the waterbirth sites listed on our waterbirthing links page to learn more about it. We also have waterbirth videos, books and handbooks in the lending library at our office for clients to borrow.
How long does the midwife stay after the birth?
We usually stay a minimum of three hours. During those three hours we monitor the mother, we have you eat, urinate and help with breastfeeding during that time. We also monitor the baby, for a minimum of three hours, and perform a thorough newborn exam and offer the State required tests to be done on all newborns. AHB also cleans up after the birth. By the time we leave, no one will know you had the baby at home by looking around the house; except there is the newborn in the bed with a proud Mama and family!
If, for any reason, the mother and baby are not doing just fine, we stay until the situation is resolved or go with one or both of you to the hospital, if the situation requires a trip to the hospital. Most do not.
What about the birth certificate? Social Security Number?
Your midwife will complete a "Registration Of A Live Birth" form and send it in within 10 days of the birth. One of the questions on the form is for assigning a social security number at birth. We can check"yes" or "no." If you choose "no," you must then register the child for a social security number by the age of sixteen. Approximately 4 to 6 weeks after the registration of the live birth form, you will receive a notice in the mail. You will return the notice with a fee (about $10) to receive the official, state-documented birth certificate.
What do I need to consider when choosing a care provider?
There are many factors that you should consider. We have a print out form (PDF) for you to use when choosing a care provider. If you have any questions regarding this form you can contact the midwife by email. Please click here for the PDF.
If you have a question for me not answered here, please email me.