Is home birth safe? A number of studies show the safety of home birth for low risk women with a healthy pregnancy. The New England Journal of Medicine published a study in December 2015 showing there is no increased risk for low risk mothers birthing at home than if they were in the hospital. The Journal of Midwifery and Women's Health published a study based on data collected by the Midwives Alliance of North America Statistics Project that shows homebirth is a valid option for may women. This companion article explains how the data was collected. The British Medical Journal published a study showing lower incidence of intervention in homebirth with Certified Professional Midwives. Here is a link to a list medical literature showing the safety of homebirth. Another great resource in understanding the data and why doctors and nurses are choosing to give birth at home is the movie Why Not Home. The Why Not Home Discussion Guide is also very helpful.

Who can have a homebirth with your practice? In short, low risk women carrying a single baby in a head-down position with no preexisting or current complications or history of cesarean. Pregnancy is a normal physiologic process and most pregnant people can have a healthy pregnancy without complications. Midwives use prenatal care to continually assess and evaluate risk status. Many risks can be lowered or avoided by good nutrition and healthy lifestyle choices. Women who have any of the following conditions would not be good candidates for homebirth: insulin dependent diabetes, severe preeclampsia, chronic high blood pressure, gestational diabetes that requires medication to control, and preterm birth.

Should I see an OB as well? You are welcome to see an OB throughout your pregnancy, but it may not be necessary. However, some clients plan an appointment to establish care with a doctor who would be willing to be involved with transfer, should that become necessary.

Service Area/Locations Served: North and Central Alabama counties: Bibb, Blount, Chilton, Cullman, Etowah, Jefferson, Lawrence, Limestone, Madison, Marshall, Morgan, Shelby, St. Clair, Talladega, Walker, and Winston

Should I hire a doula? You are absolutely welcome to hire a doula. A trained doula can focus completely on supporting you during labor and be a wonderful source of education and resources. I do provide some labor support but my primary focus is on monitoring the well-being of the laboring mother and baby. I highly recommend first time parents hire a doula.

What if complications develop during labor? Birth usually works beautifully but I recognize the necessity of being prepared if the unexpected occurs. The majority of home to hospital transports are not emergencies but things such as for non-progressive labor or the water being broken for too long before birth. If transfer to a hospital becomes necessary, I go with you to the hospital providing your records to the staff and providing labor support throughout your birth. I will stay with you until after baby is born and you have a successful nursing session. We can resume your postpartum care when you return home.

What equipment and supplies are needed for birth? Many supplies needed for birth are probably readily available in your home, such as towels, washcloths, bowl, paper towels, trash bags, etc. However, there are some things that are good to have on hand for a homebirth. I have complied a custom birth kit with Precious Arrows. The kit is about $40, with the option of adding other items at discounted rate. If you are planning a waterbirth you will also need to purchase a pool liner, hose, adapter and a few other things.

What if I tear? I will do all I can to help you ease your baby out and support you. I can repair 1st and 2nd degree tears at home and use a local anesthetic. Repair of more extensive tears should be performed by a doctor in the hospital. If transfer becomes necessary, I will go with you (if possible), to support you and provide your records to the hospital.

What if we change our minds? Birth works best when the mother feels safe and comfortable. For some, the place they feel safest is in the hospital. If at any point you decide that you would like to change plans for a homebirth, or you are not comfortable with my care, I want you to feel free to make the choice that is best for you. I hope that if you are unhappy with my care, you will tell me so we can work things out. If we are not able to reach an understanding the North American Registry of Midwives had a grievance process that you can turn to. (For information, contact the North American Registry of Midwives, 5257 Rosestone Drive, Lilburn, GA 30047. Or phone 888 842-4784.)

What are the benefits of homebirth/midwifery care? This brochure on the Midwifery Model of Care is a great introduction to what midwifery care is. Four concepts that I see as the foundation of midwifery are parental education, informed decision-making, personal connection, and knowledgeable, evidence-based care. During a homebirth, you are in your own comfortable environment and have the freedom do whatever makes you the most comfortable. You choose when and how to move, when and what to eat and drink, what positions to be in, who you want to be there and so on. Your birth team will provide support and care throughout your birth in whatever position you choose, including in the birth pool. When baby is born you have immediate skin-to-skin contact and all care for the baby can be done while he/she is right with you. Routine interventions such as IV access and continuous monitoring are avoided.

Is homebirth legal? What about Alabama laws? Homebirth is legal, even in Alabama! On January 18, 2019, I was the first Certified Professional Midwife to be issued a license by the Alabama State Board of Midwifery. To read the law and rules related to midwifery in Alabama you can visit the Alabama State Board of Midwifery.

What is the cesarean rate for my practice? What is the transfer rate for my practice? Below are my practice statistics from 2019-2021

Total births: 140                                  Homebirths: 119 (85%)
Hospital Births: 13                              Waterbirths: 77

Prenatal Transfer:  5  (3%)

Intrapartum Transfer: 7 non-emergent transfers (5%), 6 preterm labor (4%) Total:  (9%)

Postpartum Transfer: 5 (4%)

Transfer for Perineal Laceration Repair: 3

Newborn Transfer: 5 (4%)

Cesarean Rate: 14 cesareans (10%)

20 Clients gave birth for the first time (17%)
78 clients gave birth out of hospital for the first time, most had their first unmediated birth (66%)
21 clients who had received midwifery care in the past (18%)

29 repeat clients (clients I assisted with a previous pregnancy/birth) 24%

95 Clients with no perineal lacerations or a 1st degree laceration, not requiring sutures (80%)

18 Clients with 2nd degree lacerations (15%) No clients had 3rd or 4th degree lacerations.