Q. What does “CPM” mean?
A. The credential CPM stands for Certified Professional Midwife. It is administered by the North American Registry of Midwives, a certifying agency created to evaluate the knowledge and skills of direct entry midwives. The CPM is the only credential available to maternity care providers which requires experience and competency in out-of-hospital birth. The CPM credential is used in the licensure process in most states that license direct entry midwives. CPMs work with healthy women having a healthful pregnancy and planning to birth outside the hospital. Certified Professional Midwives are experts in normal birth, unmedicated home or birth center birth, and recognizing and acting appropriately to transfer care if pregnancy or birth begins to fall outside the range of normal health.
Q. The fee for home birth midwifery care seems expensive. Can you explain the cost?
A. When compared to the cost of a normal, vaginal hospital birth, a home birth is a small fraction of that and is inexpensive for the amount and quality of care received. Here’s a rough estimate of our average time spent with a client:
- 12-14 hours/prenatal visits
- 2-24+ hours/ labor and birth
- 3-4 hours/ immediate postpartum
- 4-6 hours/ 4 individual postpartum visits
In addition to that, costs include on-call status of the midwife and assistants, access to a midwife by phone 24 hours a day, and the cost of driving to client’s homes.
Each birth is a once-in-a-lifetime event. Most people budget and plan for things they really want, because it is worth it to them. Birthing a child the way you want to is as important as the special things we expect to pay out of pocket for, like weddings, cars, engagement rings, and vacations.
Q. Having a baby seems like a messy affair! What do you do with the mess?
A. It’s actually not very messy at all! To get a good idea of how it works, read this article (which was written for The Birth Project, Issue II): Is Home Birth Messy?
Q. Will my insurance company pay for a home birth with a Certified Professional Midwife?
A. Maybe. Since a large majority of women have their babies in a hospital setting, most insurance companies don’t know how to process the rare home birth claim. If you call your insurance company with regards to midwifery care, most will tell you they won’t cover a home birth. However, some send reimbursement checks anyway. We can provide you with a receipt after 6 weeks postpartum for all services received (all prenatal care, birth, and postpartum). You may submit your receipt to your insurance company if you wish. Your insurance company may reimburse none, some, or all of the fee. Some clients have pursued their insurance company for explanation of refusal, and received reimbursement.
Q. I know pain relief medication is not used at home. How will you help me cope during labor and birth? What happens if I decide I want an epidural?
A. Because I practice midwifery and not medicine, I do not offer labor pain relief medication. Medications for labor pain carry risks that require hospital care. With a little self-education, childbirth preparation, and supportive encouragement, most women feel able to cope well during labor and birth at home. I trained first trained as a doula before becoming a midwife, and have years of experience supporting women in labor, offering words of encouragement, physical support, massage, and positioning ideas.
Being in your own familiar home provides a tremendous comfort to labor, and heat, cold, privacy, tub and shower, nourishment, closeness of loved ones, and ability to move around as you wish are the tools used to successfully cope with labor. Being in a normal environment helps keep labor and birth normal! If for whatever reason, a client decides she wants pain relief at the hospital, I will transfer care to the hospital and accompany you, serving as a doula, in the hospital setting.
Q. I’m thinking of having my older daughter and mom at the birth. Do many women invite people to their births?
A. One of the best things about having a home birth is being in control of your environment. You are welcome to invite whomever you would like to attend your birth. We will talk during prenatals about how to plan for child care at the birth, or other people attending. Most often, people want their homebirth to be a fairly quiet and private event with their partner, but many are comforted by the presence of another nurturing, supportive family member, or their older children.