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Frequently Asked Questions

 

click to read an answer, or scroll below to see all answers.  Please speak with the midwives to make sure website answers are up-to-date.

Finance

Will my insurance pay for a home birth?

Home birth with a CNM will receive some reimbursement on many plans.  I use a biller to make sure that you are reimbursed to the full extent of your out-of-network benefits.  I am not an in-network provider. The insurance biller is an expert at finding out what your personal insurance will cover.  To have them run a "Verification of Benefits" use this link to upload your insurance information. This will help you get the most accurate estimates of your coverage.  We are Tricare certified providers.

 

What does a home birth cost?

The midwifery package for a home birth includes prenatal care, labor, birth, birth assistant, initial newborn care and postpartum care (immediately after the birth, at home visits in initial days and later in the office).  This package costs $5800 when paid by 36 weeks.   Additional out-of-pocket costs associated with home birth are childbirth classes, a doula (especially recommended for first births) and birth supplies.

Can I use my HSA/FSA to pay for any of this?

Yes, home birth costs are allowable expenses for a health spending and flexible spending account.

 

Can I pay by credit or debit card?

If you pay by credit or debit card there is a 3% fee. Checks should be made payable to Fairfax Home Birth, LLC.

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Birth

Is home birth safe?

Yes, for healthy women with normal pregnancies it is safe to plan a home birth and if something about the health of mother or baby makes it no longer safe, we change our plan to a hospital birth.  Home birth is not for everyone, but it is a safe option for most women.  Studies continue to show the safety of home birth.  Home birth greatly reduces the incidence of c-sections (and with it, decreases risks for future babies and pregnancies) without compromising safety outcomes for mothers and their babies.  Statistics for Fairfax Home Birth are superior to national averages and can be found here.

 

Why do women choose home birth?

See "Why Home Birth?"

 
Do you attend water births?

Yes.  Over 40% of my client choose water births.  If you desire a water birth, and do not have a large enough tub at home then you should rent or buy a birth tub.  Please include this in your birth plan and discuss at prenatal visits.

 

Who will attend my birth?

In addition to me (and anyone else you invite), there will be one other trained attendant called a Birth Assistant at your birth. Many times our team also includes a student midwife who you will get to know in the office during your pregnancy

 

What is a birth assistant?

She is someone who attends your birth to assist the midwife.  Just as someone giving birth at the hospital would have both an OB (or CNM) and a nurse, a home birth client is attended by both a CNM (Alanna or Story) and a Birth Assistant.  This is not the same thing as a doula.  The birth assistant helps with labor and postpartum support, vital signs, charting, and is trained to assist the midwife in the event of an emergency.  Your birth package includes a birth assistant.  Meet our birth assistants

What if I can't decide if a home birth is right for me?

We encourage you to sign up for our free info session or a private prenatal consultation to find out more and ask questions specific to your situation.  Feel free to send a message to Alanna and Story.

 

Can I have a doula at my home birth?

Yes!  We encourage you to have anyone at your birth whom you want there.  It is wonderful for you to have the added support of a doula, whose sole job is your labor support.  Because she is not there in a medical role, a doula will not replace your birth assistant.

Does home birth leave a mess?

We do a very careful job of assuring that your birth does not leave any mess with the use of disposable underpads, plastic fitted sheets and lots of experience!  Before we leave, laundry is in the machine, trash is taken out, supplies are gathered up and a common thing to hear from dad is, "Wow, you can't even tell we had a baby here!"  But don't worry, we do leave behind the baby.  So there is that bit of evidence.  And that baby will leave a mess over the next 18 years but we take no responsibility for that.  

 

I live in a small apartment.  Can I still have a home birth?

Yes.  We need your home to have water, electricity and room enough for midwife and birth assistant.  Your apartment is probably larger than the typical hospital labor and delivery room.  As for noise, your baby will make far more noise for your neighbors over the next year than you make in a few hours of labor.  It is rare for a neighbor to hear anything from your labor.

 

How many people can attend my birth?

You may have whomever you wish at your birth.  If you are inviting your older child to the birth, you should have someone there (other than your main support person) who is responsible for the child's care.  You should prepare any people you invite by telling them that if you find you need more privacy for any part of labor you will ask them to leave.

 

What if I need to go to the hospital?

Transfer to the hospital is, of course, not something that a mother planning a home birth wants.  However, in your prenatal care, we always discuss our contingency plans.  Fairfax Home Birth is pleased to have both a CNM and an OB from Centreville OBGYN at Fair Oaks Hospital, nearly always available to receive our clients who transfer.  If you need to transfer during labor, we will nearly always be able to continue to support you for your birth at the hospital.

 

What is the most common reason that a woman would need to transfer to the hospital?

The most common transfers are non-emergent transfers for very long labors in which the midwife and couple together determine that a hospital intervention is needed or desired.  No arbitrary time limits are put on labor.  I am very comfortable with slow progress at a home birth if mother and baby are doing well.  Women who choose home birth do so because it is best for them and for their babies.  In the few cases where a woman chooses to transfer to the hospital, she does so because of some development that has caused her (with the input of their birth team) to conclude that in this case a hospital birth may be best for herself or her baby.  95% of our clients who planned home birth have a home birth and 97% of labors that began at home resulted in a home birth (as of 2022).

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Logistics

Will I need childbirth classes?

If you have not already had a natural birth, you should take childbirth classes to prepare.  They need to be classes, such as Bradley Method or Hypnobirthing, that are focused on natural childbirth.  Hospital-based childbirth education is usually not natural childbirth specific.  I would be happy to refer you to local teachers.

 

Where will I get my ultrasound?

We will refer you for ultrasounds to one of the many local radiology offices and they will send us the report.  For certain more medical situations you could opt to get an ultrasound with a Maternal Fetal Medicine OB.

 

How do I get a birth certificate and social security card?

I submit the appropriate forms to the Department of Vital Records for you to be issued a social security number and birth certificate.

 

What if two of your clients are in labor at once?

Alanna and Story each limit our client load to four or five clients per month to make it very unlikely that this will happen.  In the event that it does happen, you will already know the other midwife in the practice who would be available as back up. It is highly unlikely that both of us would be at births when you go into labor, but in that event, we have great relationships with several home birth CNMs in the area.

 

What is your home birth service area?

Our home birth service radius is Northern Virginia, 20 miles from Fairfax City (22030).  This includes portions of: Alexandria, Annandale, Arlington, Burke, Centreville, Chantilly, Clifton, Dunn Loring, Fairfax, Fairfax Station, Falls Church, Fort Belvoir, Fort Myer, Gainesville, Haymarket, Herndon, Manassas Park, Merrifield, Mount Vernon, Nokesville, Oakton, Occoquan, Reston, Springfield, Sterling, Woodbridge, and Vienna.

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Midwifery Care

What lab tests will I have during my pregnancy?

At your initial prenatal visit we will do a standard panel that checks for anemia, atypical antibodies, blood type, rubella immunity and infections. If you are due for a pap smear (cervical cancer screening) or desire genetic screening we will do those as well as any other labs that your medical history suggests.  At 28 weeks we will do another blood count (and an antibody screen if you have a negative blood type) and a screening for gestational diabetes.  At 36 weeks we will repeat your blood count if you've been anemic and do a test for Group B Strep.  Any additional laboratory testing is done as needed.  Read more about prenatal care.

 

Can you prescribe medications?

Yes, we are Certified Nurse Midwives, licensed to prescribe medication.  This also means that we are licensed to carry medications that could be needed at your birth for safety.  Some of these include oxygen, antibiotics, anti-hemorrhage medications, and lidocaine to numb if stitches are needed.

How often will my prenatal visits be and what do we do at them? 

See my page on prenatal care to learn about our model with a mix of private and group prenatal visits.

When does the midwife arrive in labor? 

Depending on the way your labor starts, I might come the first time you call me or I might speak to you for several hours while we wait for active labor.  I come to your house in active labor, earlier for mothers who have birthed before and later for first time mothers whose labors are longer.  For this reason, childbirth classes and doulas are a great way for first time mothers to be prepared to do well in early labor before we arrive.

What kind of postpartum care will I receive?

See my page on postpartum care.

 

Can I get my pap or other GYN services from you?

Yes!  See my page on GYN and Natural Family Planning services

 

 

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