frequently asked questions
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We understand there are a lot of questions when deciding the best option for your family. If you still have questions, we would love to hear from you!
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How does it work to have two midwives?
We believe in support, both for our clients and for each other. We attend all births together and rotate prenatal and postpartum visits so you get two midwifery perspectives. If one of us is detained due to sickness or attending another birth, you would be guaranteed to have one of us present at your birth and we would bring another midwife to assist us.
What is included in your fee?
We follow the OBGYN schedule with prenatal visits every 4 weeks until 28 weeks, every 2 weeks until 36 weeks and weekly until birth. All blood work and ultrasounds are covered by PPO insurance. If you have HMO, Medi-Cal or Kaiser insurance, we work with a low cost lab to keep these fees minimal for you or you can perform blood work for free with a provider in your network. We monitor you and your baby in the post partum period at your home on the day after the birth, day 3, and at 2 weeks. At 6 weeks after birth you come to our office for a final visit. Additionally, we provide unlimited herbal medicine and a lactation consultant as needed.
What is the difference between a Midwife and a Doula?
A Midwife is a medically trained primary care provider licensed by the medical board of California. A doula is a non-medically trained labor or postpartum support person, they are not trained to deliver babies or monitor the wellbeing of you and your baby. Doulas provide non-medical labor support.
Can I switch from seeing an OBGYN to a Midwife?
Absolutely! However, you and your baby must be "low risk" to safely birth out of hospital. Midwives are trained to screen for healthy women and babies to determine who meets this criteria. It is safe to birth out of hospital between 37 to 42 weeks when all lab work is normal, there has been appropriate fetal growth and vitals for both mom and baby are normal. If you become high risk at any point we will transfer your care to an OB and stay with you as an advocate for labor support in the hospital.
Can I still see a midwife if I am "high risk"?
Midwives are experts in normal physiologic birth. We are trained to identify and refer to OBGYNs when medical conditions or complications of pregnancy and labor risk you out of home birth. There are many myths of who is considered "high risk" which includes; being advanced maternal age (over the age of 35), having had a previous miscarriage, abortion, c-section, boarder line diabetes and having a high BMI. These are conditions we are trained to work with and can provide you with more information on staying in the "low risk" category. If you remain "high risk", we will transfer your care to an OB.
Is home birth messy?
After birth you will be left with one bag of garbage and one bag of laundry. We leave your house as clean as it was when we arrived. Births happen regardless of the space. We have attended births in small to large spaces, pools, tubs, hallways, beds, couches, floors, birthing stools, outdoors and on toilets! Babies come out wherever they want to! No landlord has the right to deter you from having a home birth.
We believe in support, both for our clients and for each other. We attend all births together and rotate prenatal and postpartum visits so you get two midwifery perspectives. If one of us is detained due to sickness or attending another birth, you would be guaranteed to have one of us present at your birth and we would bring another midwife to assist us.
What is included in your fee?
We follow the OBGYN schedule with prenatal visits every 4 weeks until 28 weeks, every 2 weeks until 36 weeks and weekly until birth. All blood work and ultrasounds are covered by PPO insurance. If you have HMO, Medi-Cal or Kaiser insurance, we work with a low cost lab to keep these fees minimal for you or you can perform blood work for free with a provider in your network. We monitor you and your baby in the post partum period at your home on the day after the birth, day 3, and at 2 weeks. At 6 weeks after birth you come to our office for a final visit. Additionally, we provide unlimited herbal medicine and a lactation consultant as needed.
What is the difference between a Midwife and a Doula?
A Midwife is a medically trained primary care provider licensed by the medical board of California. A doula is a non-medically trained labor or postpartum support person, they are not trained to deliver babies or monitor the wellbeing of you and your baby. Doulas provide non-medical labor support.
Can I switch from seeing an OBGYN to a Midwife?
Absolutely! However, you and your baby must be "low risk" to safely birth out of hospital. Midwives are trained to screen for healthy women and babies to determine who meets this criteria. It is safe to birth out of hospital between 37 to 42 weeks when all lab work is normal, there has been appropriate fetal growth and vitals for both mom and baby are normal. If you become high risk at any point we will transfer your care to an OB and stay with you as an advocate for labor support in the hospital.
Can I still see a midwife if I am "high risk"?
Midwives are experts in normal physiologic birth. We are trained to identify and refer to OBGYNs when medical conditions or complications of pregnancy and labor risk you out of home birth. There are many myths of who is considered "high risk" which includes; being advanced maternal age (over the age of 35), having had a previous miscarriage, abortion, c-section, boarder line diabetes and having a high BMI. These are conditions we are trained to work with and can provide you with more information on staying in the "low risk" category. If you remain "high risk", we will transfer your care to an OB.
Is home birth messy?
After birth you will be left with one bag of garbage and one bag of laundry. We leave your house as clean as it was when we arrived. Births happen regardless of the space. We have attended births in small to large spaces, pools, tubs, hallways, beds, couches, floors, birthing stools, outdoors and on toilets! Babies come out wherever they want to! No landlord has the right to deter you from having a home birth.
prenatal |
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When do I make my first appointment?
We are happy to work with you as soon as you have a positive home pregnancy test or around 10-12 weeks. The earliest genetic screening and blood testing can be performed is at 10 weeks. Thinking of switching later in your pregnancy? We will work with you at any point in your pregnancy. It is never too late to begin midwifery care!
What is a prenatal visit like?
At your first prenatal visit we will review your medical history, discuss diet and any pregnancy discomforts you may be experiencing. We will discuss holistic and herbal support for your pregnancy. We will also perform any necessary blood work, screenings, tests and a physical exam as needed. Prenatal visits are 1 hour long which allows time to discuss pregnancy concerns, review or perform necessary blood work, screenings, and tests as needed. At every visit we listen to your baby's heartbeat and palpate for the position of your baby. Feel free to bring whomever you’d like to any of your visits, kids are welcome to join!
Can you tell the position of my baby?
At each prenatal visit we will palpate your belly to check for your baby’s position. Midwives are trained in the art of belly palpation which tells us the position of your baby based on what we feel, where your baby's heart beat is and where you report your baby's movements. If it is ever unclear we may refer you for an ultrasound to verify your baby’s position. We help your uterus to be in an optimal condition for birth. If your baby is not in a good position, we give you exercises to encourage them into a better position. A well positioned baby can lead to an easier, shorter birth!
What if my baby is in a breech position?
Midwives are trained in the art of fetal positioning and will help to turn your baby head down. At every visit, we monitor the position of your baby and discuss physical exercises to encourage your baby head down. If the baby remains breech closer to the time of your birth, we will help you to arrange birth options.
What if I am having twins or my baby is breech at the time of birth?
Midwives are not allowed to deliver twins or breech babies without a physician present in the state of California. In order to have a home birth you would need to hire a physician for the birth in addition to your midwife, which we will help arrange.
Are there required lab tests or blood work?
Blood work is a great way to know the health and wellbeing of you and your baby! We perform all routine blood work in the comfort of our office. We test to know your blood type and Rh factor, if you are anemic, how well your blood clots, if you have an infection or are at risk for Gestational Diabetes. We discuss genetic screening and perform this if you choose and discuss if you are at risk. We require one ultrasound, as studies show that outcomes for low risk pregnancies do not improve after 2 or more ultrasounds. However, we may advise additional ultrasounds if needed. We also review PAP smear and physical exam screening guidelines and perform one if you are due.
We are happy to work with you as soon as you have a positive home pregnancy test or around 10-12 weeks. The earliest genetic screening and blood testing can be performed is at 10 weeks. Thinking of switching later in your pregnancy? We will work with you at any point in your pregnancy. It is never too late to begin midwifery care!
What is a prenatal visit like?
At your first prenatal visit we will review your medical history, discuss diet and any pregnancy discomforts you may be experiencing. We will discuss holistic and herbal support for your pregnancy. We will also perform any necessary blood work, screenings, tests and a physical exam as needed. Prenatal visits are 1 hour long which allows time to discuss pregnancy concerns, review or perform necessary blood work, screenings, and tests as needed. At every visit we listen to your baby's heartbeat and palpate for the position of your baby. Feel free to bring whomever you’d like to any of your visits, kids are welcome to join!
Can you tell the position of my baby?
At each prenatal visit we will palpate your belly to check for your baby’s position. Midwives are trained in the art of belly palpation which tells us the position of your baby based on what we feel, where your baby's heart beat is and where you report your baby's movements. If it is ever unclear we may refer you for an ultrasound to verify your baby’s position. We help your uterus to be in an optimal condition for birth. If your baby is not in a good position, we give you exercises to encourage them into a better position. A well positioned baby can lead to an easier, shorter birth!
What if my baby is in a breech position?
Midwives are trained in the art of fetal positioning and will help to turn your baby head down. At every visit, we monitor the position of your baby and discuss physical exercises to encourage your baby head down. If the baby remains breech closer to the time of your birth, we will help you to arrange birth options.
What if I am having twins or my baby is breech at the time of birth?
Midwives are not allowed to deliver twins or breech babies without a physician present in the state of California. In order to have a home birth you would need to hire a physician for the birth in addition to your midwife, which we will help arrange.
Are there required lab tests or blood work?
Blood work is a great way to know the health and wellbeing of you and your baby! We perform all routine blood work in the comfort of our office. We test to know your blood type and Rh factor, if you are anemic, how well your blood clots, if you have an infection or are at risk for Gestational Diabetes. We discuss genetic screening and perform this if you choose and discuss if you are at risk. We require one ultrasound, as studies show that outcomes for low risk pregnancies do not improve after 2 or more ultrasounds. However, we may advise additional ultrasounds if needed. We also review PAP smear and physical exam screening guidelines and perform one if you are due.
birth |
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Who comes to the birth?
There will be two California Medical Board Licensed Midwives at your birth.
Is water birth an option?
Yes! You will need to purchase our water birth kit.
What equipment do you bring?
We bring the same equipment as a birth center or labor and delivery room in a hospital would have. This includes fetal monitoring equipment, oxygen, newborn resuscitation equipment, IV supplies, antibiotics, emergency anti-hemorrhage medications to stop bleeding, suturing supplies and medication to numb for suturing. We also bring herbal medicine and have a hospital transport plan arranged before birth. You will need to purchase a birth kit.
When do I call in labor?
We like to know if you are in early labor as this is a time for you to rest and establish a rhythm with your contractions. We will assess which phase of labor you are in by the frequency and length of your contractions. We will have you use a contraction timer APP so you can send the information to us as things progress. We will join you when you are in active labor, which is generally around 6 cm or more or when your contractions are 3 minutes apart. We will give you recommendations for positions to labor in including ways of coping and resting with contractions until we join you.
What medications and herbs do you carry?
We have been trained to use herbal, homeopathic and pharmaceutical medicines. We carry the same medications that are in a hospital labor and delivery room. We carry custom made herbal medicines specific to labor, birth and post partum.
What if there is a hemorrhage?
Midwifery care is about prevention. We monitor you closely prenatally to ensure you have good nutrition, no anemia and appropriate iron levels as these are the first line of prevention of hemorrhage. However, if a hemorrhage were to occur we bring the same medications as the hospital and use them as needed: Pitocin, Misopristol, Methergine and hemostatic herbs.
What if transfer to the hospital is necessary?
Most low risk people planning a home birth will have their baby at home. We are experts in normal physiological birth which includes identifying and responding to complications. Through careful monitoring and assessment of you and your baby's health during your pregnancy and labor, we determine whether you are low-risk to stay out of hospital. We keep in mind that part of the safety of home birth is utilizing the hospital when it is the safest thing to do. If your status changes to high risk, the hospital becomes a better setting for your care, we are with you every step of the way. Most transfers are due to a failure of labor to progress. It is very seldom that a transfer is an emergency. We will call ahead, provide records, and stay with you to facilitate your transfer of care and remain with you as a bridge between the hospital and you until you give birth. After your baby is born in the hospital, we will resume your care when you arrive home for the postpartum period and for any lactation support you need. While we do not have privileges in any hospitals, we make every effort to ensure hospital transfers are smooth, positive experiences, where you and your baby will be respected and will receive excellent care.
What do you do if the cord is wrapped around the babies neck?
This is by far the most common question we receive! About 1 out of 3 babies will have a cord wrapped around their neck when they are born. Midwives are trained in the art of hand maneuvers for birth, which includes slipping the cord over the baby's head to allow the birth of your baby's body without any problem. The cord has a protective mechanism called "whartons jelly" which allows for oxygen to continue to reach the baby when the cord is compressed in the womb or at birth. Your midwife is trained in other management options if the cord is too tight to slip over the baby's head.
What if the baby isn't breathing?
Approximately 90% of newborns will not require any help to begin breathing. A midwife is trained to recognize the 10% of babies who will need assistance, and are certified in Neonatal Resuscitation and Adult and Infant CPR. We bring all necessary equipment to your home, including oxygen, in the unlikely event that resuscitation is required.
What if the baby’s heartbeat stops?
We monitor fetal well being throughout labor at the same interval as the hospital so we know your baby's wellbeing prior to birth. If there are any signs of fetal distress heard in the heart rate, we will transfer to the hospital prior to the birth. If the baby were to be born needing assistance, both midwives are trained and certified in Neonatal Resuscitation, infant and adult CPR and BLS and re-certify every two years as well as routinely practice their skills on a regular basis.
Do you carry pain medication?
No, but we are trained to help manage labor through emotional and physical support which including labor positions for optimal fetal positioning, and holistic support. Many find relief in laboring/birthing in the water, as this allows the muscles to relax and the body move freely. When a person is emotionally prepared and allowed to listen to their bodies intuition, birth progresses manageably and with ease. We offer warm perineum compresses during pushing to help ease your baby out and prevent tearing.
How long do you stay after the birth?
We stay for 3-4 hours after the birth and leave when all are stable. We regularly check you and your baby's vital signs, clean up, give you something to eat, help you to the shower, perform a full newborn exam, assist in breastfeeding/ chestfeeding and give you post partum instructions. We then visit you 24 hours later, again on day three, at two week and six week where we will continue to monitor the wellbeing of you and your baby.
What are the standard injections given to my baby at birth?
Injectable Vitamin K is standardly given in the hospital. We offer the option for injectable or oral Vitamin K and will provide you information to help decide what is right for your baby. Hepatitis B is also routinely given at brith in the hospital, which we do not offer. You can get this from your pediatrician if desired.
When do I see a pediatrician?
You will need to select a pediatrician prior to birth. We will provide a resource of pediatricians that are home birth, breastfeeding and delayed vaccination friendly. If all is normal we recommend that your baby be seen by a pediatrician within the first two weeks of life, sooner if anything abnormal presents. Your pediatrician will provide a hearing test and all vaccinations if you choose. We continue to monitor your baby through 6 weeks post partum.
Do you provide a Birth Certificate?
When the baby is born the parents must register by law with the Department of Vital Statistics in Downtown LA within the first year. All requirements can be found at the Los Angeles County’s Public Health website. We will provide you with the necessary paperwork.
There will be two California Medical Board Licensed Midwives at your birth.
Is water birth an option?
Yes! You will need to purchase our water birth kit.
What equipment do you bring?
We bring the same equipment as a birth center or labor and delivery room in a hospital would have. This includes fetal monitoring equipment, oxygen, newborn resuscitation equipment, IV supplies, antibiotics, emergency anti-hemorrhage medications to stop bleeding, suturing supplies and medication to numb for suturing. We also bring herbal medicine and have a hospital transport plan arranged before birth. You will need to purchase a birth kit.
When do I call in labor?
We like to know if you are in early labor as this is a time for you to rest and establish a rhythm with your contractions. We will assess which phase of labor you are in by the frequency and length of your contractions. We will have you use a contraction timer APP so you can send the information to us as things progress. We will join you when you are in active labor, which is generally around 6 cm or more or when your contractions are 3 minutes apart. We will give you recommendations for positions to labor in including ways of coping and resting with contractions until we join you.
What medications and herbs do you carry?
We have been trained to use herbal, homeopathic and pharmaceutical medicines. We carry the same medications that are in a hospital labor and delivery room. We carry custom made herbal medicines specific to labor, birth and post partum.
What if there is a hemorrhage?
Midwifery care is about prevention. We monitor you closely prenatally to ensure you have good nutrition, no anemia and appropriate iron levels as these are the first line of prevention of hemorrhage. However, if a hemorrhage were to occur we bring the same medications as the hospital and use them as needed: Pitocin, Misopristol, Methergine and hemostatic herbs.
What if transfer to the hospital is necessary?
Most low risk people planning a home birth will have their baby at home. We are experts in normal physiological birth which includes identifying and responding to complications. Through careful monitoring and assessment of you and your baby's health during your pregnancy and labor, we determine whether you are low-risk to stay out of hospital. We keep in mind that part of the safety of home birth is utilizing the hospital when it is the safest thing to do. If your status changes to high risk, the hospital becomes a better setting for your care, we are with you every step of the way. Most transfers are due to a failure of labor to progress. It is very seldom that a transfer is an emergency. We will call ahead, provide records, and stay with you to facilitate your transfer of care and remain with you as a bridge between the hospital and you until you give birth. After your baby is born in the hospital, we will resume your care when you arrive home for the postpartum period and for any lactation support you need. While we do not have privileges in any hospitals, we make every effort to ensure hospital transfers are smooth, positive experiences, where you and your baby will be respected and will receive excellent care.
What do you do if the cord is wrapped around the babies neck?
This is by far the most common question we receive! About 1 out of 3 babies will have a cord wrapped around their neck when they are born. Midwives are trained in the art of hand maneuvers for birth, which includes slipping the cord over the baby's head to allow the birth of your baby's body without any problem. The cord has a protective mechanism called "whartons jelly" which allows for oxygen to continue to reach the baby when the cord is compressed in the womb or at birth. Your midwife is trained in other management options if the cord is too tight to slip over the baby's head.
What if the baby isn't breathing?
Approximately 90% of newborns will not require any help to begin breathing. A midwife is trained to recognize the 10% of babies who will need assistance, and are certified in Neonatal Resuscitation and Adult and Infant CPR. We bring all necessary equipment to your home, including oxygen, in the unlikely event that resuscitation is required.
What if the baby’s heartbeat stops?
We monitor fetal well being throughout labor at the same interval as the hospital so we know your baby's wellbeing prior to birth. If there are any signs of fetal distress heard in the heart rate, we will transfer to the hospital prior to the birth. If the baby were to be born needing assistance, both midwives are trained and certified in Neonatal Resuscitation, infant and adult CPR and BLS and re-certify every two years as well as routinely practice their skills on a regular basis.
Do you carry pain medication?
No, but we are trained to help manage labor through emotional and physical support which including labor positions for optimal fetal positioning, and holistic support. Many find relief in laboring/birthing in the water, as this allows the muscles to relax and the body move freely. When a person is emotionally prepared and allowed to listen to their bodies intuition, birth progresses manageably and with ease. We offer warm perineum compresses during pushing to help ease your baby out and prevent tearing.
How long do you stay after the birth?
We stay for 3-4 hours after the birth and leave when all are stable. We regularly check you and your baby's vital signs, clean up, give you something to eat, help you to the shower, perform a full newborn exam, assist in breastfeeding/ chestfeeding and give you post partum instructions. We then visit you 24 hours later, again on day three, at two week and six week where we will continue to monitor the wellbeing of you and your baby.
What are the standard injections given to my baby at birth?
Injectable Vitamin K is standardly given in the hospital. We offer the option for injectable or oral Vitamin K and will provide you information to help decide what is right for your baby. Hepatitis B is also routinely given at brith in the hospital, which we do not offer. You can get this from your pediatrician if desired.
When do I see a pediatrician?
You will need to select a pediatrician prior to birth. We will provide a resource of pediatricians that are home birth, breastfeeding and delayed vaccination friendly. If all is normal we recommend that your baby be seen by a pediatrician within the first two weeks of life, sooner if anything abnormal presents. Your pediatrician will provide a hearing test and all vaccinations if you choose. We continue to monitor your baby through 6 weeks post partum.
Do you provide a Birth Certificate?
When the baby is born the parents must register by law with the Department of Vital Statistics in Downtown LA within the first year. All requirements can be found at the Los Angeles County’s Public Health website. We will provide you with the necessary paperwork.
holistic gynecology |
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Is this covered by insurance?
We accept most PPO insurance plans. Unfortunately, we do not accept HMO, Medi-Cal or Kaiser. We accept cash, personal check, venmo and credit cards.
Why would I want to come to you?
Our personalized exams are 1 hour with no wait time. We review your medical history, discuss any issues or concerns and perform a PAP smear and blood work as needed. All blood work is performed in comfort of our office. Our pelvic exams are gentle, respectful of survivors of abuse, gender affirming and focused on self empowerment. Herbal medicine and the option for referrals to specialists as needed.
Do you work with trans / gender non-conforming / queer folks?
We are committed to serving people of all races, genders, ethnicities, and economic backgrounds. We operate a body positive, sex positive, queer, transgender and gender affirming practice.
We accept most PPO insurance plans. Unfortunately, we do not accept HMO, Medi-Cal or Kaiser. We accept cash, personal check, venmo and credit cards.
Why would I want to come to you?
Our personalized exams are 1 hour with no wait time. We review your medical history, discuss any issues or concerns and perform a PAP smear and blood work as needed. All blood work is performed in comfort of our office. Our pelvic exams are gentle, respectful of survivors of abuse, gender affirming and focused on self empowerment. Herbal medicine and the option for referrals to specialists as needed.
Do you work with trans / gender non-conforming / queer folks?
We are committed to serving people of all races, genders, ethnicities, and economic backgrounds. We operate a body positive, sex positive, queer, transgender and gender affirming practice.
