Most people have a question or two not covered here. Feel free to call, text, or email any questions, comments, or concerns so we can help you sort it out.
+ What is a Midwife? What kind of Midwife is Karen?
In the United States there are several pathways to midwifery education and training. Most pathways result in midwifery certification and qualify the candidate for licensing in her/his state or municipality. For more info on different kinds of midwives visit:Mana.org
Karen is a Certified Professional Midwife (CPM): A Certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of- hospital settings. Karen has been attending births since 1979, and has been a CPM since 1995. Want to know more about Karen?: Karen's Story
+ How Often Will I see you?
We see our clients at our office every four weeks until 28 weeks, every two weeks until 36 weeks when we will have a home visit at your home, and then weekly at the office until you have your baby. After your birth we return to your house at least 2-3 times and then you come see us in our office for your six week visit. We remain on call for visits at your home for 2 weeks after your birth and encourage you to call or text without hesitation with any concern; that’s what we are here for!
+ Do I have to Wait Until I'm Pregnant to Start Care?
We often meet with people before they are pregnant, so they can prepare for conception by making healthy changes in diet & lifestyle, and begin the midwifery relationship. As a small practice, taking 4-6 births per month, we encourage women to contact us as soon as they become pregnant to reserve a space.
+ I am due in a few weeks. Is it too late for me to start care with Woman Wise?
Often, later in pregnancy, women decide that the route of care they had initially chosen is not going to lead to a natural, woman & family centered birth. We assess each woman individually. Assuming that yours is a low-risk pregnancy, and that there is adequate time for preparation, we will certainly consider accepting you as a client.
+ What if there’s an emergency or a need to transfer into the hospital?
The general consensus is that midwives are experts in normal pregnancy and birth. In order to be a good candidate for a homebirth, you must have an uncomplicated pregnancy and be in good overall health. We believe that prenatal care is what you give yourself; we are with you throughout your pregnancy to provide support and guidance; we work as a team to keep you in optimal health. If, despite our best efforts, complications do arise, and the balance needed for a healthy homebirth cannot be restored, an individualized transfer of care plan is in place..
If, for health reasons, we need to transfer you out of our care during your pregnancy, we will be available to provide support through the remainder of your pregnancy, birth, and postpartum. If a transfer of care is needed during labor, we will make the necessary arrangements and accompany our clients to the hospital where we will remain as labor support for the birth & immediate postpartum period.
A homebirth is not our goal; our primary goal is a healthy mother and healthy baby. Thankfully, most planned homebirths, do happen at home! We come to births well-equipped to handle the rare unforeseen emergency, we carry emergency equipment, and we are trained and certified in Neonatal Resuscitation and CPR.
** I am happy to share a snapshot of my practice statistics, which includes rates of transfer, c-sections, VBACs, etc. when we meet for your consultation appointment. -Karen
+ What is Informed Choice?
As a family choosing homebirth and midwifery care, you will need to make a number of choices and decisions during your pregnancy, labor and birth, as well as for your baby. We want to equip you with the information you need to make informed choices. We believe that making informed choices involves weighing the benefits and risks of any decision or course of action while taking into account your intuition, personal experience, individual circumstances, advice and opinions of trusted sources, and evidence-based practice.
+ What do You Think About Waterbirth?
We love waterbirth! Warm water in labor can make an amazing difference for many women, and there’s some evidence that water can make a smoother transition for baby. We offer waterbirth tub rentals for a nominal cost. Another option is to purchase a personal birth tub,and we’re happy to refer you to websites for that. Our birth tubs come equipped with a disposable liner, compressor and pump for draining the water. We also offer original Aqua Doula heated birth tubs.
+ How do I Know If My Home us Suitable for a Homebirth?
Down the street in your neighborhood at any given time a birth could be unfolding. Sometimes when we slip out of a home in the early morning hours, leaving a new baby behind we are reminded of what birth could be here in America. Most homes are suitable for homebirth, even small apartments. Your neighbors will likely not know you've had a baby until you tell them. If you have any specific concerns please feel free to ask us, we also do a home visit at 36 weeks to become familiar with your space and make recommendations for birth.
+ Isn't Birth Messy?
The mess is a universal question, but the truth is that there is rarely a big mess. Families are often surprised (and relieved) to find that the midwives have left their homes as tidy as they were before the birth, and sometimes even tidier!
+ I Want my Children to be at the Birth. How Involved Can Our Family Be?
The short answer is that your family can be as involved as feels right to you! We enjoy having children present for prenatal visits and births. We think it's important for the whole family to have an opportunity to be a part of welcoming the newborn. We recommend that you have someone just for your child(ren) who can be completely present and responsive to their needs and questions. Of course, it should be someone you are all comfortable with. There are wonderful books and materials for preparing children for the sights and sounds of labor and birth, and we have many of these for you to borrow. Children are not yet socialized to fear birth, and whether they sleep through the night and wake to find a new sibling, or actively take part in welcoming the new baby, homebirth takes place within the natural rhythm of the family.
+ Will Students be Involved on my Care and at My Birth?
Yes, Karen is committed to the importance of growing more midwives; to that end, she has always worked with students & apprentices and firmly believes in the concept of “each one,teach one.” Students will be a fluid part of your care and you will absolutely meet anyone who would be at your birth well ahead of time. All student midwives or birth assistants who work with Karen are certified in neonatal resuscitation and CPR and are required to take Birth Emergency Skills Training courses, at least every three years.
Karen is a clinical preceptor for the Birthwise Midwifery School in ME, and has served as a faculty preceptor with the National College of Midwifery in NM for 5 students over the past 16 years.
+ What about Doulas?
We welcome doulas; doulas can provide an extra layer of care, emotionally and physically, for the laboring mother, and can be a great addition to a birth team.
+ What Tests are required If I Have my Care with Womanwise?
Homebirth midwifery care is a shared responsibility between you and your midwife. Though we are able to provide you and your baby with all the screenings and tests that are standard of care we do not require them. On the flip side, having a natural, healthy homebirth does not preclude you from accessing any testing or screening you desire. We work closely with you so that if a situation arises where further testing would be useful we can advise you.
**For uninsured clients, we offer discounted lab services
+ Do I need to have an ultrasound?
Ultrasound can be a useful tool but is not routinely necessary in a healthy pregnancy. Some reasons an ultrasound may be recommended include uncertain dates, vaginal bleeding, possibility of twins, abdominal pain, decreased fetal movement, or if you have previously had a cesarean. Many clients planning a homebirth do decide to have a 20-week fetal anatomy scan done.
+ What equipment do you bring with you to a birth?
We bring a doppler for monitoring the fetal heartbeat during labor, equipment for monitoring maternal vitals, herbs, homeopathics, and various other supplies and equipment. We also carry oxygen and resuscitation equipment, emergency medications to stop bleeding, IV supplies, and suturing equipment with local anesthetic. We also offer birth chairs, and waterbirth tubs.
+ How much does it cost to use your services?
Please feel free to contact Karen about WomanWise fees. The fees for homebirth vary widely across the country and WomanWise fees are in line with local midwives fees. The global fee for our services is $4200.
We are a small practice and take a limited number of clients per month to ensure that we will be present for your birth! All clients are required to make a minimum $500 deposit by their second visit to ensure their place in our calendar. Unless other arrangements are made and agreed to, all fees must be paid in full when we go on call for you at 36 weeks.
+ Do you accept insurance? Do you accept Medicaid?
The short answer is yes. While WomanWise is not an in network provider with any insurance carrier, we do work with SLB billing services for insurance billing for those clients whose plan covers homebirth with an out of network provider. As yet, CPMs in MD, DE & PA are not recognized providers with Medicaid, so Medicaid does not reimburse for our services..
For families with a Healthcare Sharing Plan, we provide an invoice at the conclusion of care which the client submits. in most cases, healthcare sharing plans cover all of the fee for our services.
+ I don't have insurance or my insurance plan doesn't cover homebirth. How can I pay for my homebirth? Do you offer a sliding fee scale?
WomanWise happily works with self-pay clients to find a way to pay for their care. As a small independent practice, we have a limited number of spaces each year for discounted fees. We believe that finances shouldn't be a barrier to having the birth you want. We can tailor payment plans to your budget and are open to barter arrangements. Potential clients who are receiving assistance (food stamps, WIC, Medicaid) may qualify for a reduced fee. For those in financial need we offer a sliding fee scale ranging from $2800 - $4200; together we can determine the fee that will work for you.
We accept cash, check, and credit card/HSA payments with Square.
+ How do I Know If I'm a Good Candidate for a Homebirth?
If you are a normal, healthy woman with a low-risk pregnancy; if you want to be engaged in all aspects of your pregnancy care & ultimately make the decisions that are informed and right for you, then you are a good candidate for a homebirth!
Prenatal care is what you give yourself! Your midwives are there to support you with information and resources, but its up to you nourish yourself , research each decision, and find the path that’s right for you. This is your body, your birth, your baby.
We believe there’s no place like home.