Questions About Birth at Home with Big Valley Midwives
If you are interested in planned home birth, please read through these questions to learn about Big Valley Midwives and how to schedule an interview.
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, a Licensed Midwife has passed the comprehensive licensing exam held by NARM (North American Registry of Midwives) and has been issued a midwifery license by the California Medical Board.
What does a Licensed Midwife do?
Big Valley Midwives provides comprehensive midwifery care for the childbearing year, including prenatal care, planned 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 45 minutes so that you will have plenty of time to explore questions and concerns. In pregnancy, you will be offered a maternity care schedule personalized to meet your needs. First time parents typically have appointments once a month until about the 28th week of pregnancy, every other week until 36 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 labs and ultrasounds during your pregnancy with enough information to make informed choices about them.
When you are in labor, we come to you at your home. We monitor your and your baby's health throughout your labor, birth and in the immediate postpartum. We stay 2-4 hours after to ensure everyone is stable after the birth and all of your questions are answered.
We return about 1 day, 3 days, 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 at your home. We monitor your and your baby's health throughout your labor, birth and in the immediate postpartum. We stay 2-4 hours after to ensure everyone is stable after the birth and all of your questions are answered.
We return about 1 day, 3 days, 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 has Big Valley Midwives changed their care because of Covid-19?
Big Valley Midwives is serving clients on the usual schedule of prenatal and postpartum care. We require everyone who enters our office to wear a mask over their mouth and nose for all office visits regardless of vaccination status. People may bring their partner or one support person into the office with them for standard prenatal care. Children are not currently permitted in our office.
For a long period of time, the CDC recommended limiting in-person care to those appointments where a physical exam is a necessary component and using telemedicine to provide other care. We have been using the schedule developed and researched by the Mayo Clinic as part of their OB Nest program for low risk, healthy pregnancies. This schedule combines physical exams at specific times through pregnancy with telemedicine appointments where the main goal is education or counseling. We have always been available to our clients as usual for any concerns that indicate a need for physical exam. Telemedicine has worked so well for some of our appointments that we expect to keep it as a valuable option.
Our seating arrangement in the office has (unintentionally) promoted social distancing and we are trying to keep our visit a few minutes shorter so people are not crossing the next client in the hallway as they arrive.
We are not asking anyone to wear masks in their own home during their labor, but anyone present for labor support or childcare that does not live in the home already is required to wear a mask.
If a client or family member in the home is symptomatic or confirmed with active infection, appointments will take place by telemedicine for the duration. Infection with Covid in labor has increased risks for sudden changes in health status and we do not consider this to be low risk for a birth at home. If you or a member of your household is symptomatic or confirmed with active infection your care will be transferred to your hospital of choice. Postpartum care will resume once the active infection phase is over.
Both of the midwives are fully vaccinated and looking forward to a time when this will not be relevant. Since the beginning of this policy, these measures have protected us from multiple exposures and helped to keep us available to our clients for their appointments and births. By extension these measures have protected all of our clients and their families from us exposing them unintentionally.
For a long period of time, the CDC recommended limiting in-person care to those appointments where a physical exam is a necessary component and using telemedicine to provide other care. We have been using the schedule developed and researched by the Mayo Clinic as part of their OB Nest program for low risk, healthy pregnancies. This schedule combines physical exams at specific times through pregnancy with telemedicine appointments where the main goal is education or counseling. We have always been available to our clients as usual for any concerns that indicate a need for physical exam. Telemedicine has worked so well for some of our appointments that we expect to keep it as a valuable option.
Our seating arrangement in the office has (unintentionally) promoted social distancing and we are trying to keep our visit a few minutes shorter so people are not crossing the next client in the hallway as they arrive.
We are not asking anyone to wear masks in their own home during their labor, but anyone present for labor support or childcare that does not live in the home already is required to wear a mask.
If a client or family member in the home is symptomatic or confirmed with active infection, appointments will take place by telemedicine for the duration. Infection with Covid in labor has increased risks for sudden changes in health status and we do not consider this to be low risk for a birth at home. If you or a member of your household is symptomatic or confirmed with active infection your care will be transferred to your hospital of choice. Postpartum care will resume once the active infection phase is over.
Both of the midwives are fully vaccinated and looking forward to a time when this will not be relevant. Since the beginning of this policy, these measures have protected us from multiple exposures and helped to keep us available to our clients for their appointments and births. By extension these measures have protected all of our clients and their families from us exposing them unintentionally.
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. We have a few types of birth tubs available for clients to borrow if they wish. The midwives will bring a birth tub liner, disposable medical supplies, plant medicines, oxygen, other emergency medicines and equipment to every birth.
Is it safe to give birth at home?
The best, most comprehensive research available suggests that for a person having a low-risk pregnancy (defined as a single, 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 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%.
Women who plan to give birth at home 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%.
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 an emergency which requires the services of a hospital or physicians without notice. During prenatal care 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 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 skillful provider for a hospital birth. If we do need to transfer to the hospital during your labor a member of our team will be available to provide labor support if the hospital policy allows and you do not have a suspected or confirmed Covid infection. We can resume postpartum care on our usual schedule once you are back home or through the active infection period.
What can I do for pain?
Labor is typically 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 or you can 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.
Big Valley Midwives offers a few types of loaner birth tubs or you can 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.
What about Vaginal Birth After Cesarean (VBAC)?
Big Valley Midwives regularly attends VBACs at home and is an advocate for VBAC availability. Lucinda has testified 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 do not exclude women from home birth because they have had previous surgical birth. 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 do accept late transfers of care 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 with your due date and location to see if we have openings for your due month. We can help you request a copy of your prenatal care records before your interview.
How much does it cost?
Our fee is $5600. An $1100 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).
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).
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 an $1100 discount 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. After clients complete care with Big Valley Midwives 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 contract.
The insurance reimbursement process can take a long time after your care is complete.
For more information about coverage, contact Brooke at brookemyung@gmail.com.
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. After clients complete care with Big Valley Midwives 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 contract.
The insurance reimbursement process can take a long time after your care is complete.
For more information about coverage, contact Brooke at brookemyung@gmail.com.
How do I hire Big Valley Midwives?
We are currently holding interviews via FaceTime or Zoom. If you have a partner they are required to be present with you to interview us.
Interviews are more engaging when families have questions that are personal and important to them. You and your partner should read through the questions on this page before scheduling an interview.
If you are interested in having comprehensive midwifery care for a planned birth at home with Big Valley Midwives, you can contact us at (209) 521-7981 or by email at 209midwife@gmail.com to schedule an appointment.
Interviews are more engaging when families have questions that are personal and important to them. You and your partner should read through the questions on this page before scheduling an interview.
If you are interested in having comprehensive midwifery care for a planned birth at home with Big Valley Midwives, you can contact us at (209) 521-7981 or by email at 209midwife@gmail.com to schedule an appointment.
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.