Answering Your Questions
What kind of training and experience do you have?
Diane took a state-approved course in midwifery through the Association of Texas Midwives and completed an apprenticeship of at least 18 months with an approved preceptor. During that apprenticeship, she had to attend at least 30 births, and be the primary midwife for an additional 20 births under the supervision of that preceptor. She also had to complete a certain number of other clinical skills as well. To maintain licensure in Texas, we are required to take 10 hours of continuing education classes each year. Since becoming a licensed midwife in 2007, Diane has attended more than 400 births.
Do you do VBACs?
Before agreeing to do a VBAC, we will require a copy of the surgical report on your c-section. Both the outer and inner incisions must be low transverse. We will also look at the reason(s) why the cesarean was done. We prefer that you live within 15 minutes of a hospital (or be willing to use the birth center in Mount Pleasant).
Do you do waterbirth?
Yes! You can rent or buy a birth tub from various places online or you can borrow one from me, or use a deep garden tub if you have one. Once the baby is born, we immediately bring him or her out of the water into your arms. We have specific written guidelines for the setup and use of a birth pool.
Do you accept insurance?
We can file insurance claims with most companies, however, only a few are easy to get reimbursement from. At your consultation or first prenatal, insurance eligibility can be checked for a $30 fee. This will give us an estimate of what portion of my fee you will be responsible for. We ask that you pay that estimated portion, and then we will file a "global" bill with your insurance company after your last postpartum visit. There will be a separate claim for any "extras" and for services for your baby. Once the claims have been completely processed, you may owe more or you may be due a refund.
If you prefer, we will gladly give you the detailed billing receipts that you need to file reimbursement claims with your insurance company yourself. Most companies have a form that you fill out and fax or mail to them to file a claim for health care that you paid for out-of-pocket. You may be able to get reimbursed for your expenses more quickly with this method. Our insurance biller will also do this for you for a small fee. We are also happy to work with Christian sharing plans (they are a pleasure to do business with and we highly recommend them!).
Most insurance companies (even those that won't pay for a licensed midwife's services) will at least pay for the lab work that is done and for a sonogram. If you have any questions about insurance, please ask at your consultation.
Do you accept Medicaid?
Medicaid will not pay for a home birth. Medicaid will sometimes cover a birth center birth, and almost always covers necessary lab work and sonograms. The birth center is enrolled as a Medicaid facility and Diane is enrolled as a provider, however, that doesn't guarantee that they will pay for all of your care. You will need to pay for care that Medicaid doesn't cover, but we won't ask you to pay more than the Medicaid rate for our services.
What areas/towns do you serve?
We serve the entire northeast Texas area -- Texarkana and New Boston, Mt. Pleasant, Mt. Vernon, Winnsboro, Daingerfield, Linden, Atlanta, Marshall, Jefferson, Longview, Gilmer, and all points in between.
Due to the number of clients in our practice, we are unable to do home visits for prenatal care and postpartum care, other than the home visit we do at 2-3 days after the birth.
Is home birth safe?
When the mother has cared for herself well during her pregnancy and she is at low risk of developing complications, AND she is served by a well-trained birth attendant, then yes, home birth is safe. Of course, there is nothing that is perfectly safe, not even a hospital birth. Do your research. Studies have shown that home birth for a normal, healthy woman, pregnant with a single baby is just as safe as birth in the hospital.
How do you deal with complications at birth?
There are a few things that could go wrong that would constitute a true emergency. We have specific medications and training to be used in these situations and would immediately transport the mother/baby to the closest hospital while giving emergency care, or we would give care until EMS arrived to transport the mother/baby. Most complications are non-emergent. The most common reason for non-emergency transfer to the hospital is "failure to progress."
What if I need something for the pain?
If you really feel that you need pain medication during labor, you will need to be transferred to the hospital. All pain medications have side effects for you and the baby that necessitate medical supervision and care. However, remember that during a home birth you are able to move around, eat, drink, bathe, and rest where you are most comfortable. You are not confined to a room or a bed and you can work with your contractions. You might just surprise yourself and find that the contractions are manageable under these circumstances!
What if someone goes into labor at the same time as I do?
Yes, this does happen rarely. It depends on where both of you are in your labors. We always try to have at least two people at a birth, so one might be able to leave to check on the other person if they are nearby. Or, more likely, we would call another midwife to go check on the other person and attend the birth if one of us couldn't make it. We do try to limit the number of clients that we take so that this sort of thing doesn't happen. Our clients are always welcome to arrange a meeting with any of the back-up midwives.
Do you work with any other midwives in this area?
We have backup arrangements with a couple of other midwives in the area. You are welcome to arrange a time to meet them if we have vacation time planned or some other reason we might not be at your birth. We also frequently have apprentices who assist in giving care during prenatal visits and births.
What do you think are the greatest benefits of midwifery care and home birth?
The individualized care and time spent in education about normal pregnancy and birth that you receive from a midwife are invaluable. There are also a lot of immediate and long-term benefits for both mother and baby from having a natural birth when the process is respected. These include better bonding, more successful, long-term breastfeeding, healthier babies, less trauma, lower chance of c-section, and often smoother and shorter labors.
We are here to answer any questions you may still have. Contact us for more details or to schedule a free consultation today!