Common Consultation Topics
Here you will find some of our most commonly discussed topics from our consultations. We are happy to go more in depth on anything we have touched on here, but we also recognize that by providing some of this information here beforehand that we open up a bit of time for deeper connection during our time together.
Our Philosophy & Care Attitude
We believe our female bodies were made to grow and birth our babies, that they do this well when supported well. We think the best service we can be to you is encouraging and providing space for that truth to express itself in your own birth.
We believe that as midwives our responsibility is to keep things normal as pregnancy and birth unfold, and acknowledge that sometimes that requires interventions. Interventions are handled with full disclosure of benefits, risks and alternatives. Our preference is to leave anything alone that is not threatening the definition of normal. A big part of the work we do together prenatally is building the trust and communication up in our relationships to make a smooth transition into the shared decision-making of labor and birth.
We offer and provide every client the practices and procedures that are standard in obstetrical care. As a practice, we have a high tolerance for parents refusing anything they wish after receiving appropriate informed consent. We also have a high tolerance for long labors in the absence of other complications.
Our background as doulas make us natural caregivers at births and we are most comfortable providing hands on support and reassurance during labor to keep the birthing mom progressing with optimal comfort. We include the partner whenever possible and work to establish him as the number one support person at birth, if he wishes.
We attend each birth together, providing 2 licensed midwives at your birth for the full duration. We feel this offers the maximum amount of support for families, but also helps birth run smoothly, providing more well-rounded care and increases safety and comfort.
Our Background & Experience
We both have Certified Professional Midwife (CPM) credentials earned at MEAC accredited midwifery schools through the North American Registry of Midwives, our national regulatory body. We are also Licensed Midwives (LM) through the Medical Board of California, the same regulatory body that licenses physicians in this state. We participated in the apprenticeship model of learning, and gained our midwifery skills through years as student midwives in local homebirth practices and birth centers. We both have backgrounds as doulas, childbirth educators and placenta specialists serving San Diego families since 2011.
Our Care Schedule
We see our clients for an initial office visit when they first come into care. We do a complete history, physical, prenatal exam and any necessary lab work. This appointment is typically 90-120 minutes long with subsequent visits lasting 45-60 minutes. From 4-28 weeks we see our clients every 4 weeks. From 28-36 we see our clients every 2 weeks. At 36-37 weeks we do a home visit prenatal where we all meet as a birth team, organize your birthing supplies and plan for the birth together. All visits after this are once a week until you deliver.
We go on-call for you at 37 weeks. We provide continuous phone support in early labor, arriving at your home for extra in-person support when you ask us to come.
We are licensed to attend your birth at home after 37 weeks and before 42 weeks. We do everything we can to ensure correct due date calculation for this reason. If you labor begins before 37 or after 42, we will accompany you to the hospital and remain with you for the birth.
If you require a transfer to the hospital during a labor at home, we also accompany you and remain with you through the birth. We cannot act as your primary caregiver in the hospital setting but become an advanced doula support for you, continuing to advocate, educate and support. The most common reason that women transfer from home to hospital is for prolonged labor requiring therapeutic rest. If emergent transfer for mom or baby is required, we initiate and coordinate the transfer with EMS and the closest hospital.
We remain with the new family for 4 hours after the birth, on average. We ensure mom and baby are stable, perform examinations on both, provide instructions for caring for both and remain reachable by phone 24/7. We return to check on the newborn and postpartum mom at their home on day 1, 3, 7 and week 2 and 4. We are licensed to care for the newborn up to 6 weeks but you may also see a pediatrician if you wish. We provide postpartum office visits at 6 weeks, 3, 6, 9 and 12 months. We find this extended postpartum care especially valuable during such a major time of adjustment in the family.
The Supplies We Bring
We bring 2 full stocked midwifery bags with us to every birth. Included in our medical equipment and supplies are: handheld Doppler, blood pressure cuff and stethoscope, oxygen and resuscitation for mom and baby, pulse oximeter, anti-hemorrhagic medications, IV fluids, suturing supplies including lidocaine to numb the tissue, vitamin k injection, and lab work supplies among many non-medical supplies.
We provide the kit of disposable supplies we will need for your birth. We will give you a list of household item you can gather for the birth.
Our fee is billed globally, which means regardless of the time and attention each family requires, the fee stays the same for all of our prenatal, labor, birth and postpartum services discussed here.
Our fee is $6,500. A deposit of $500 is due before the first visit. A discount of $500 is applied to payments made in full by the home visit. We offer payment plans as low as $500/ mo which can extend into the postpartum time. We work with an insurance biller for those wishing to go through insurance, to maximize reimbursement.
What Sets Us Apart
We pride ourselves on offering a service that is both needed and deserved. Some of the improvements we feel we are making to the midwifery model in San Diego are:
Hands on care from 2 midwives
Flexible payment plans
A full year of extended postpartum care
Emphasis on the parenting journey
Advocates for consent through complete information sharing
What you might ask us:
1. Are pharmaceuticals your go-to for treating issues in pregnancy or do you first use herbs, homeopathy and nutrients, diet and lifestyle changes, and/or body work?
2. What pregnancy conditions would risk me out of care?
3. What labor or birth circumstances would require a transfer?
4. Do you ever go out of town while you're on call?
5. What is your process around cervical exams? Do you require them? Do you do them at every birth? What if someone declines a cervical exam?
6. When labor is long and the mom is tired do you suggest a hospital transfer or let them come to that decision on their own? If you bring it up, how do you usually present the idea?
7. What is your protocol if my water breaks before labor begins? How long are you comfortable with me staying at home with ruptured membranes if there is no fever?
8. What do you see your role as at births? What do you usually do at a normal, straightforward birth?
9. Our insurance company is ________. What kind of reimbursement can we expect?
What we will ask you:
1. Why do you want to have your baby at home?
2. What is your vision for this birth?
3. What do you see the role of your midwives being?
4. How is the birthing parents’ responsibility different planning a homebirth instead of a hospital birth?
5. What are some or your ideas for coping with labor?
We look forward to meeting with you and discussing all of these topics, and more, in person! We are particularly excited about spending some time with you and getting to know you on a more personal level as well. It is a gift to get to connect with such amazing families, and we can't wait to meet yours!