IS HOME BIRTH SAFE?
Ample evidence supports the safety of home birth for healthy, low risk pregnant and birthing people planning to give birth at home with skilled providers. Overwhelmingly, the evidence shows higher rates of vaginal birth, lower rates of medical interventions (cesarean section, episiotomy, vacuum or forceps delivery, induction or augmentation of labor, epidural use and other pain medication, assisted ventilation for the newborn and NICU admissions) and a lower incidence of several labor complications (parental infection, meconium staining of the amniotic fluid, fetal intolerance to labor, severe perineal tears). The data suggests that there is a small increase in adverse neonatal outcomes for planned home births vs hospital births for first time birthers, but the absolute numbers reported in both birth sites are still very low. For people who have already given birth, research shows no difference in the health outcome for the parent or baby. (ACNM Clinical Bulletin #61)
The risks of home birth are primarily due to not being able to immediately access advanced / emergency medical interventions for birthers or babies, as one would have access to if they gave birth in the hospital. Even though the evidence shows the safety of out-of-hospital birth, there are times when complications arise that go beyond the scope of a Certified Professional Midwife. Most of the time, if complications arise, they do so slowly, providing ample time to transfer to the hospital. CPMs are equipped with training and medical tools to assess, monitor and provide emergency care at home while initiating a transfer to a hospital. Refer to the section below on transferring to the hospital for more information.
While our goal as midwives is always a physically, emotionally, and mentally healthy and safe birth, we also acknowledge that birth is an intense and unpredictable experience, and a 100% guarantee of safety is not possible no matter the birth location.
who can have a home birth?
Home birth is safe for healthy, low-risk, pregnant people. There are some preexisting medical conditions that would rule someone out of having a home birth. We’d be happy to talk with you to see if you’re a candidate for home birth care. Contact us!
You can have a home birth no matter what your living situation! We have attended home births in single family homes, small apartments, tiny homes, in collective houses and beyond!
What areas do you serve?
We serve clients who live within 1 hour from Plainfield, VT. This includes Washington, Chittenden, Lamoille, Orange counties, and parts of Caledonia, Addison, Franklin, Rutland and Windsor counties. Please contact us for more info.
what supplies do i need for my home birth?
The midwives bring all of the medical supplies to your home birth and are included in the total fee for your care. There are some items that you need to provide (either purchased new or gathered from around your house / borrowed from others). We will provide you with a birth supplies list in your third trimester. These are things like towels, baby blankets, wash clothes, cleaning supplies, trash bags, etc. If you need to purchase any supplies, the cost will usually not exceed $50.
CAN I STILL HAVE A HOME BIRTH if I previously had a cesarean birth?
Yes! Home Birth After Cesarean (HBAC), often called Vaginal Birth After Cesarean (VBAC), has the potential to be a triumphant and powerful healing experience! We are happy to provide care for families planning a HBAC. In the state of Vermont, pregnant people with a prior cesarean birth need to meet certain criteria to be considered low-risk and therefore appropriate for out-of-hospital birth. Please contact us to discuss these specifics.
Who attends your home birth?
Two midwives will always attend your home birth. The midwives, Emmy and Tessa, attend most births as a team. If one of them is off-call at the time of your birth, we will arrange to have another local CPM as our birth assistant. We do our best to plan this out ahead of time and will bring our CPM assistant to your 36 week home visit so you can meet them prior to your birth. In the case of an emergency (illness, family emergency, or two births happening at once) you will not get a chance to meet the birth assistant in advance. We apologize for this inconvenience and appreciate your flexibility in these rare situations.
what if I need to transfer to the hospital?
Most hospital transfers that occur are not due to emergencies. Many transfers occur for pain relief, exhaustion or the need for labor augmentation medications. In these instances, we discuss your options for a preferred hospital, make a plan and drive to the hospital in a private vehicle (without the use of an ambulance). The primary midwife will accompany you to the hospital, moving into an advocacy role, as the hospital staff take over the role of primary medical providers.
In the event of an emergency, we will stabilize the parent and baby until an ambulance arrives at the home to escort the clients promptly to the nearest hospital. The midwife will accompany the family to the hospital, usually in a separate car. CPMs are equipped with emergency medical training including CPR and neonatal resuscitation, and carry emergency supplies such as IV fluids, oxygen, medications to control bleeding and suture supplies.
Can i have a WATER BIRTH?
Yes! Research supports that water birth is safe for both the parent and the baby. Many people find that laboring in the water greatly increases relaxation and comfort and relieves muscle tension and pain. People can choose whether they want to use the tub only to labor in as a comfort measure or in the moment you can decide to give birth in the water.
We have birth tubs for you to borrow. Our kit includes the tub and liner. You need to purchase a lead-free hose and hose adapter. We provide all the clean-up associated with water birth.
How much does it cost to have a home birth?
Our full fee for prenatal care, home birth and postpartum care is $6000. Please see our payment and fees page for more information about sliding scale and payment plans. We are currently contracted with most major health insurance companies, including medicaid.
DO YOU TAKE HEALTH INSURANCE? MEDICAID?
We only accept Green Mountain Care (Medicaid). Those with Medicaid are still responsible for paying an out-of-pocket fee (the standard with all home birth care in Vermont) to cover unbillable services. The fee is $1800 - $3000 sliding scale.
For all other private insurance companies, we are considered out-of-network providers. Most PPO-type insurance plans will provide some amount of reimbursement for home birth midwifery care with out-of-network providers. For support in this process, we work with a medical biller who will run a verification of benefits at the start of your care to see how much your insurance might reimburse you for. If you have private insurance, you are responsible to pay out full fee by 36 weeks gestation. After your last postpartum visit, our biller will file a claim with your insurance company. You can expect the reimbursement to come 2-4 months after the claim is filed.
Other than home birth midwifery care, most insurance companies will not provide reimbursement or coverage for any additional services we offer. We’d love to see health insurance change to support client needs and necessary providers of all kinds.