Questions About Birth at Home with Big Valley Midwives
What is a Licensed Midwife?
A Licensed Midwife has met both the training and the educational requirements set by the California Medical Board. In California, Licensed Midwives has passed the comprehensive licensing exam held by NARM (North American Registry of Midwives) and is issued a license by Medical Board of the state of California to practice midwifery.
What does a Licensed Midwife do?
Big Valley Midwives provides comprehensive midwifery care for the childbearing year, including prenatal care, birth at home, breastfeeding support, postpartum, and well baby visits for the first 6 weeks. We also provide well woman care, including routine paps and labs, for our clients.
What is the care like with Big Valley Midwives?
Every mother, every family, and every pregnancy is unique. Big Valley Midwives provides individualized care to meet your needs and build an intimate relationship of trust. Appointments are scheduled to last about an hour so that you will have ample time to explore questions and concerns. In pregnancy, meet as often as you would meet with any other maternity health care provider: once a month until the 28th week of pregnancy, then every other week until 37 weeks, then weekly (or more often as necessary) until the baby arrives. We will monitor your progress through pregnancy and your baby's growth to make sure that all is normal. You will be offered all of the standard screening tests, labs and ultrasounds during your pregnancy with enough information about them to make an informed choice about whether or not you want to accept them.
When you are in labor, we come to you. We monitor your and your baby's health throughout your labor, birth and in the immediate postpartum. We stay until everyone is stable after the birth and all of your questions are answered.
We return about 24 hours, 72 hours and 7 days after the birth to check on everyone and are available by phone any time you have a concern in between. Postpartum visits are available at 2, 4, and/or 6 weeks as needed. We see our clients more often in postpartum than other types of maternity care providers because we feel that care during this time is important for the long term health of both you and your baby.
When you are in labor, we come to you. We monitor your and your baby's health throughout your labor, birth and in the immediate postpartum. We stay until everyone is stable after the birth and all of your questions are answered.
We return about 24 hours, 72 hours and 7 days after the birth to check on everyone and are available by phone any time you have a concern in between. Postpartum visits are available at 2, 4, and/or 6 weeks as needed. We see our clients more often in postpartum than other types of maternity care providers because we feel that care during this time is important for the long term health of both you and your baby.
How is Big Valley Midwives changing their care because of Covid-19?
We are essential health care providers so we are still working! We are still serving our clients on the usual schedule of prenatal care but we have had to make adjustments. As of this writing, the CDC recommends to limit in-person care to those appointments where a physical exam is an absolutely necessary component. We are working with our clients using the schedule developed by the Mayo Clinic as part of their OB Nest program. This schedule combines physical exams at specific times through pregnancy with telemedicine appointments where the main goal is education or counseling. We are still available to our clients as usual for any concerns that indicate a need for physical exam. Our seating arrangement in the office has always (unintentionally) promoted social distancing, and we are currently wearing masks for all extended in person care.
Currently we are asking people to bring only their partner into the office with them for standard prenatal care. We are trying to keep our visit a little shorter than the scheduled one hour so that people are not crossing the next in-person client in the hallway and to give us time to sanitize before they arrive.
We are asking all clients to limit their labor support to one person other than their partner and to have childcare in another location for any other children for the labor and the birth. This is because we are attempting in every way to limit all non-essential contacts, including in our personal lives, to reduce the risk to all of our clients.
Anyone can join you for telephone or video visits, and we look forward to a time when we can include all the members of the family in your care again!
Currently we are asking people to bring only their partner into the office with them for standard prenatal care. We are trying to keep our visit a little shorter than the scheduled one hour so that people are not crossing the next in-person client in the hallway and to give us time to sanitize before they arrive.
We are asking all clients to limit their labor support to one person other than their partner and to have childcare in another location for any other children for the labor and the birth. This is because we are attempting in every way to limit all non-essential contacts, including in our personal lives, to reduce the risk to all of our clients.
Anyone can join you for telephone or video visits, and we look forward to a time when we can include all the members of the family in your care again!
What areas does Big Valley Midwives serve?
We attend births throughout the Central Valley and Foothills.
The area we serve includes these cities and all the space between:
The area we serve includes these cities and all the space between:
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Do I need to have anything special for a birth at home?
Families are required to have a short list of supplies ready. The list of supplies are mostly things that are commonly gathered from your home or easily purchased. All families are also encouraged to arrange for a birth tub with a single use liner for comfort. We have a few types of tubs available for clients to borrow if they wish. The midwives will bring other supplies, including plant medicines, homeopathics, oxygen, and other emergency medicines and equipment to every birth. Nearly every tool available at a freestanding birth center is available to women birthing at home.
Is it safe to give birth at home?
The best, most comprehensive research available suggests that for a low-risk pregnancy (defined as a singleton, head-down baby born between 37 and 42 weeks), planned home birth with a trained, experienced midwife is as safe for both the mother and the baby as a planned hospital birth.
Women who plan to give birth at home are likely to experience lower rates of medical intervention, such as electronic fetal monitoring, cesarean birth, vacuum-assisted birth, and episiotomy. The overall rate of cesarean for families planning to birth at home is under 9% for women who have never given birth before, and under 2% for women who have previously given birth. The overall rate of urgent transfer from home to hospital is under 4%.
For more information on the safety of home birth, feel free to view the following links:
Women who plan to give birth at home are likely to experience lower rates of medical intervention, such as electronic fetal monitoring, cesarean birth, vacuum-assisted birth, and episiotomy. The overall rate of cesarean for families planning to birth at home is under 9% for women who have never given birth before, and under 2% for women who have previously given birth. The overall rate of urgent transfer from home to hospital is under 4%.
For more information on the safety of home birth, feel free to view the following links:
What if something goes wrong?
While most of our families birth at home, sometimes a situation arises in labor that requires a transfer to a neighboring hospital to complete the birth. Most home birth transfers into a hospital are non-urgent situations that allow families the choice to move into a hospital for access to interventions that may benefit them. Occasionally there is a true concern, or even an emergency which requires the services of a hospital or physicians without notice. During the first prenatal appointment, a plan is agreed upon for each of these situations, taking into account the location of the planned birth, the family's preferences, and their insurance coverage. Lucinda and Brooke are very experienced and skilled birth attendants. They bring emergency response medications and equipment with them to every birth. Typically there are indications in pregnancy when a mother or baby may need more advanced care at birth. If your health changes during your pregnancy or birth and it is no longer advisable to birth your baby at home, we will help you find a supportive and skillful provider. If we do need to transfer to the hospital during your labor, one member of our team will be available to be with you to provide labor support if your hospital policy allows it. We can resume postpartum care on our usual schedule once you are back home.
What can I do for pain?
For most women, labor is uncomfortable and contractions hurt. Midwives offer advice and comfort measures for pain relief, but not medicine. Often changes in position or activity help contractions become both more effective and less painful. Warm showers, heat packs, ice packs and massage can also help. Birth tubs are called the "midwife's epidural" as warm water and weightlessness are very helpful to relieve tension and pain.
Big Valley Midwives rarely transports into a hospital for pain management.
Big Valley Midwives rarely transports into a hospital for pain management.
Why do you recommend a birth tub?
We encourage water of all kinds for comfort in labor and for birth. Showers can be a useful comfort tool in labor but are usually limited by the capacity of the hot water heater. A warm tub is a great tool for pain relief! You can use your own bathtub or you can use a freestanding birth tub.
Big Valley Midwives offers a few types of loaner birth tubs and you can also purchase your own.
With any type of freestanding tub, we recommend single use liners. A liner is required for anyone who borrows one of our birth tubs.
Unfortunately, water immersion for labor pain relief and water birth are only available locally for births happening outside of the hospitals.
Please see our Water Birth Information page for a list of recommendations.
Big Valley Midwives offers a few types of loaner birth tubs and you can also purchase your own.
With any type of freestanding tub, we recommend single use liners. A liner is required for anyone who borrows one of our birth tubs.
Unfortunately, water immersion for labor pain relief and water birth are only available locally for births happening outside of the hospitals.
Please see our Water Birth Information page for a list of recommendations.
What about Vaginal Birth After Cesarean (VBAC)?
Big Valley Midwives regularly attends VBACs at home and is an advocate for all VBAC women, even testifying to the California Medical Board on multiple occasions in support of the right of women to choose a midwife attended VBAC at home. We encourage all women to know their options and we do not exclude women from home birth because they have had previous surgical births. Please see our VBAC resources for more information.
I'm in my third trimester. Is it too late for me to plan a home birth?
We usually welcome late transfers of care provided you are having a healthy pregnancy and if we have space in our calendar. We limit the number of clients we accept for each month so that we can provide exceptional care, but that doesn't mean we are always booked full! If you have decided you want a home birth or want to schedule an interview, contact us first to see if we have openings for your due month. We can help you request a copy of your prenatal care records before your first appointment.
How much does it cost?
Our fee is $4500. An $800 deposit is due when you hire us. The remaining balance must be paid in full by your 37th week in pregnancy. This fee includes comprehensive prenatal care, labor and birth care, postpartum and well baby visits until six weeks of age.
We accept most forms of payment: cash, check, debit/credit card, Health Savings Account (HSA), Flexible Spending Accounts (FSA), and even Paypal.
Requested labs and ultrasounds happen in other facilities, and fees for those services are not included in our fee.
We accept most forms of payment: cash, check, debit/credit card, Health Savings Account (HSA), Flexible Spending Accounts (FSA), and even Paypal.
Requested labs and ultrasounds happen in other facilities, and fees for those services are not included in our fee.
Do you accept Medi-Cal?
We are not Medi-Cal providers. We do offer a $900 discount (20%) for families on Medi-Cal who live within 30 minutes of downtown Modesto.
Do you accept my Anthem/Blue Shield/Kaiser health insurance plan?
What about my healthcare cost share plan?
We do not contract with any insurance plan, all clients are self- pay and all fees reflect a pre-paid discount.
We do help our families utilize the benefits of their insurance or health share plan.
When clients come into care, we can help them to determine the details of their coverage and provide instructions for them to apply early for the best insurance benefits possible. When clients complete care with Big Valley Midwives about 6 weeks postpartum, they are given an itemized receipt of the services they received and payments made.
We provide needed support to help you submit your receipt with your plan's Member Reimbursement Form and support you in the follow-up process.
Most private health insurance plans allow coverage for part of our fee. The actual amount you might be reimbursed is entirely up to your plan contact.
The insurance reimbursement process can take a long time after your care is complete.
We do help our families utilize the benefits of their insurance or health share plan.
When clients come into care, we can help them to determine the details of their coverage and provide instructions for them to apply early for the best insurance benefits possible. When clients complete care with Big Valley Midwives about 6 weeks postpartum, they are given an itemized receipt of the services they received and payments made.
We provide needed support to help you submit your receipt with your plan's Member Reimbursement Form and support you in the follow-up process.
Most private health insurance plans allow coverage for part of our fee. The actual amount you might be reimbursed is entirely up to your plan contact.
The insurance reimbursement process can take a long time after your care is complete.
We are happy to talk with you about your insurance benefits. We can also contact your insurance provider to check your insurance benefits for a planned home birth with Big Valley Midwives. For more information about coverage, contact Brooke at brookemyung@gmail.com.
How do I hire Big Valley Midwives?
As home birth providers, you have the opportunity to interview us before you make the decision to seek care with us. We want to be assured your questions are answered. If you are interested in having a birth at home with Big Valley Midwives, you can contact us at (209) 521-7981 or by email at 209midwife@gmail.com. A phone call can answer many questions and help you decide if you want to arrange an interview.
Due to the current circumstances, we are doing interviews via your favorite videoconferencing: FaceTime, Zoom, Hangouts, or other.
Due to the current circumstances, we are doing interviews via your favorite videoconferencing: FaceTime, Zoom, Hangouts, or other.
How do I become a midwife?
In the state of California, there are two pathways to become a midwife:
A Licensed Midwife is a midwife issued a license to practice midwifery by the California Medical Board. To obtain this license, the midwife must complete an approved three-year educational program (click here for a list of approved programs) and pass the North American Registry of Midwives (NARM) exam.
A Certified Nurse Midwife is a registered nurse who is certified to practice midwifery by the California Board of Registered Nurses. To obtain this certification, the nurse must complete a post-baccalaureate midwifery program for nurse midwives (click here for a list of approved programs) and pass the American Midwifery Certification Board (AMCB) exam.
Big Valley Midwives is dedicated to training excellent midwives, but we are not currently accepting midwifery students.
A Licensed Midwife is a midwife issued a license to practice midwifery by the California Medical Board. To obtain this license, the midwife must complete an approved three-year educational program (click here for a list of approved programs) and pass the North American Registry of Midwives (NARM) exam.
A Certified Nurse Midwife is a registered nurse who is certified to practice midwifery by the California Board of Registered Nurses. To obtain this certification, the nurse must complete a post-baccalaureate midwifery program for nurse midwives (click here for a list of approved programs) and pass the American Midwifery Certification Board (AMCB) exam.
Big Valley Midwives is dedicated to training excellent midwives, but we are not currently accepting midwifery students.