What do I need to know about Home birth in Philly?
An interview with Rachel Utain-Evans
What is a CPM and how do I find one?
CPM stands for Certified Professional Midwife, someone who specializes in out of hospital birth using the midwifery model of care. There are also a few CNMs (certified nurse midwife) in the area who do home births; CNMs also have a nursing degree and also practice in hospitals and birth centers. There are also “traditional/lay” midwives who are not certified.
You can find a midwife in your area by searching online or asking in your local parents group for referrals. Local birth sites, like Blossoming Bellies, can be a good source as well.
What questions should I be asking?
You might want to ask about what the prenatal appointments are like, what they involve, whether the midwife can draw blood for screenings, where she refers out for ultrasounds should they be necessary, etc. Does she work with assistants, when will they be present, and how many clients does she take on at a time? You can ask about what happens when you go into labor, how she prefers to monitor you and baby, what her procedure/decision process is like for home to hospital transfers, and whether she has relationships with particular hospitals. What do her newborn screenings entail, what is the postpartum appointment schedule and what does it include?
Most midwives will have a FAQ section on their website, and will be happy to schedule a consultation so you can meet in person. You should ask any questions you may have about your pregnancy, delivery, home birth, whatever you need to know to feel comfortable choosing where to birth. For us, we wanted to know what would be different, for better or worse, than our experiences delivering at the hospital. You may have specific questions from previous births, or general questions about how something works.
One of the best parts about home birth is that you get to choose your midwife and develop a relationship with her as your provider. She will be the one at your prenatal appointments, at your birth, and providing your postpartum care. So take your time and find someone you feel comfortable with.
How do I get started?
If this is your first pregnancy, maybe start by looking at some birth stories to get an idea of the variations of normal birth. If this isn’t your first pregnancy but is your first time considering home birth, take a moment to think about what you did or didn’t like from your past experience. Take time to sit down with your partner and figure out what you both need to feel comfortable. Talk to some other local parents about their experiences, and start setting up interviews. No matter where you’re considering giving birth, you shouldn’t settle until you feel educated in your options, and supported in your choices.
Does my insurance cover it?
More and more insurances are covering at least some, if not all, of the costs of a home birth. Most of our out of pocket costs got reimbursed by our insurance company. You can call your insurance company to ask what they will do, and when interviewing midwives you can ask how they handle/help with insurance claims. We actually found that the cost of our home birth was about the same as our deductible for our last hospital birth, if not a little less, and we were happy knowing the money was going straight to our midwife for the wonderful work she did with us. Most midwives also offer payment plans, and some work on a sliding scale.
What happens if there is a complication?
This is a great question for your midwife when you’re interviewing her.
The short answer is that birth is unpredictable, no matter where you have it, but most happen without complication. First, similar to if you wanted to be a patient of a midwife practice at a hospital or birth center, a home birth midwife will assess whether you’re a good candidate for home birth before accepting you as a client. Second, most naturally occuring complications can be caught by your midwife before they turn into emergencies. If she sees something developing prenatally or during labor that warrants hospital care, she’ll discuss it with you and recommend if/when transferring is necessary. You should feel comfortable discussing the possibility of an actual emergency with her ahead of time, and she can walk you through a scenario.
For us, the fact that we were able to form such a personal relationship with our midwife, and had such trust in her to give us the best care, took all the fear of “what if” out of the equation.
What is the best hospital in Philly to work with moms who are doing home birth?
Some home birth midwives have relationships at different hospitals, and this is a great question to ask when interviewing.
CPMs that serve the area
Rachel Utain-Evans is a Philly native, mama to 3 crazy wonderful kids, and professional family and birth photographer. Since 2011, she has been documenting the stories of new little ones being welcomed into their families, and creating images of those beautiful, little moments for parents to share with their children as they grow. http://rachelutainevans.com/