The choice between midwifery care and obstetric care for low-risk pregnancies should be made based on individual circumstances and preferences. Midwifery care provided by Licensed Midwives can offer several advantages for growing families. See the following Research Study for more information

Personalized Attention:

• Midwives prioritize creating strong and trusting relationships with their clients. This results in individualized care tailored to the unique needs, preferences, and values of every member of the growing family. This relationship fosters a deeper understanding of the client’s concerns and goals to allow for more in-depth discussions and education

Holistic and Patient-Centered Care:

• LMs practice based on the midwifery model of care, which emphasizes holistic well-being and patient-centered decision-making.

• Clients and their families are actively involved in creating their birth plans, and midwives abide by these choices unless there is an emergency

Emphasis on Natural Birth:

• Midwives are experts in supporting and facilitating natural childbirth. They rarely use medical interventions and allow labor/birth to progress as naturally as possible

• Midwives are skilled in non-pharmacological pain relief methods, such as massage, hydrotherapy, and position changes, to assist in the birthing process

Support for Home Birth or Birthing Centers:

• LMs are also experts in providing care in the safe and supporting environments for home births or birthing center deliveries

Lower Rates of Medical Interventions:

• Research has shown that midwifery care is associated with lower rates of medical interventions like epidurals, inductions, and C-sections for low-risk pregnancies

• Midwives are skilled at recognizing and addressing complications; using interventions only when necessary

Lower Rates of Medical Complications:

• Some studies suggest that midwifery care is associated with lower rates of preterm birth and low birth weight, particularly for low-risk pregnancies

• Less frequency of pain medications, extensive perineal tearing, and NICU admissions

Postpartum Care and Lactation Support:

• LMs often provide extensive postpartum care, including support for nursing, guidance on newborn care, and monitoring the client’s physical and emotional well-being

• LMs typically offer more postpartum visits than a traditional OB care schedule. This allows for the client to have more support as needed throughout the postpartum period

Cultural Sensitivity and Inclusivity:

• Midwives are supposed to prioritize cultural sensitivity and inclusivity in their care, while respecting the diverse backgrounds and values of their clients and their families

• LMs are supposed to use individualized care to implement cultural beliefs or systems into a client’s pregnancy, labor, and/or postpartum as needed

Improved Outcomes

• Clients and families typically have greater satisfaction with pregnancy, labor, and birth experiences when supported by a Licensed Midwife

• Higher rates of successful nursing experiences, utilizing more support if the client

• Increased chance of successful vaginal birth after cesarean (VBAC)

• National hospital cesarean rates fluctuate between 30%-40% while cesarean rates with out-of-hospital midwifery care continue to be around or less than 10%.

Lower Costs:

• Midwifery care can be cost-effective compared to obstetric care for most families, especially when it comes to low-risk pregnancies. This can make high-quality maternity care more accessible to a wider range of families

• Midwifery care utilizes certain medical procedures only when needed, which avoids unnecessary spending and can reduce complications

Midwifery and obstetric care are two distinct approaches to perinatal care, philosophies, and practices. When families have the privilege of access to both options, the final decision often depends on their preferences, risk factors, and health needs. Some families choose both midwifery and OB care for a full-scope approach to maternity care, but this is not necessary for low-risk pregnancies.

Midwifery Care

• Rooted in a holistic, individualized approach for a stronger patient-provider relationship

• Emphasis on the natural process of childbirth, informed consent, and shared-decision making

• Providing comprehensive prenatal/labor/birth/postpartum care for low-risk pregnancies

• Recognizing emergencies or variations of normal, and consulting/referring/transferring to a higher level of care when necessary

• Some visits may be done in the home, while some visits may be in a midwifery office

• Generally caring for those planning to deliver at home or at a free-standing birth center. Some midwives also work in collaboration with obstetricians

• Education on alternative pain relief methods, like massage and hydrotherapy,

• Lower rates of medical interventions like induction, episiotomies, epidurals, IV pain medication, and cesarean sections

• Lower rates of various medical complications

Obstetric Care

• Typically utilizes a more medicalized approach

• Generally provide care for high-risk pregnancies and pregnancy related complications

• Handling complex-medical conditions outside of pregnancy that may require specialized monitoring and/or care during pregnancy

• Trained to perform surgical procedures like cesareans

• Prenatal/Postpartum visits are done at the doctor’s office; deliveries are in hospitals, where medical equipment facilities are more easily accessible for emergency situations

• May involve medical interventions such as continuous fetal monitoring, IV pain medication, labor augmentation medications, internal fetal monitoring, epidurals, and elective cesareans

OBGYNs (Obstetricians-Gynecologists), Licensed Midwives (LMs), Certified Nurse Midwives (CNMs), and Doulas are all healthcare professionals who provide reproductive health care; each having different training, qualifications, and scopes of practice.

OBGYN (Obstetrician-Gynecologist):

• OBGYNs Undergo medical school and residency to become specialists in obstetrics and gynecology; providing medical care for patients throughout pregnancy, childbirth, postpartum, and general gynecological care

• OBGYNs handle both low-risk and high-risk pregnancies, manage complications, and perform surgical procedures such as cesareans

• OBGYNs attend deliveries in hospitals, with visits in clinics or private practices

Licensed Midwife:

• LMs receive a minimum of 3 years worth of specialized training that consists of both rigorous formal education and thousands of hours of clinical experience to provide midwifery care for low-risk pregnancies and births, and must successfully complete the North American Registry of Midwives (NARM) examination after graduation prior to obtaining a midwifery license through the Florida Department of Health. This pertains specifically to Florida LMs and may vary per state

• LMs offer prenatal/postpartum care, oversee the safety of labor/birth, and manage uncomplicated pregnancies

• LMs can order certain tests, prescribe medications, and provide certain non-invasive medical procedures as long as they are performing within their scope of practice.

• LMs focus on natural childbirth but are trained to recognize emergencies or variations of normal, and consult/refer/transfer care to medical doctors when needed

• LMs in Florida are able to stay up-to-date with required continuous education to maintain and renew their licenses every 2 years, utilizing new advancements and updated evidence-based practice to optimize the standard of midwifery care. They are also required to maintain certifications in Newborn Resuscitation and CPR, with renewal every 2 years

• LMs practice in homes and free-standing birth centers. This may vary by state

Certified Nurse Midwife (CNM):

• CNMs are advanced practice nurses (APRNs) with backgrounds in nursing and midwifery, holding master's and/or doctoral degrees in nurse-midwifery, and are certified through the American Midwifery Certification Board (AMCB)

• CNMs provide various healthcare services, including prenatal care, childbirth attendance, postpartum care, and family planning. They can also manage gynecological conditions and prescribe medications with collaboration from an OB

• CNMs may practice with OBs or independently with continued training

• CNMs may practice in hospitals, clinics, homes, free-standing birth centers, and private practices. They are licensed to practice in all 50 U.S. states but state laws may vary

Doula:

• Doulas provide emotional, educational, and physical support to families during pregnancy, childbirth, and the postpartum period. They do not have medical training, do not provide medical care, and do not perform clinical procedures

• Doulas offer non-medical, continuous support, including comfort measures, encouragement, and advocacy

• Doulas work in various settings, including hospitals, birthing centers, and homes, to support the family’s emotional and physical well-being

• Doula support in labor leads to improved outcomes, see the following from Evidence-Based Birth

There are several different factors that contribute to the eligibility of midwifery care for clients with previous cesareans, such as the reasoning and method of cesarean, the length of time between pregnancies, number of cesareans, general health history, and more. These factors dictate whether a Trial of Labor after Cesarean (TOLAC) can be facilitated at home or should be carried out in a hospital setting. Visit https://vbacfacts.com/ for more information on VBACs. Contact Us to get scheduled for a FREE Consultation for more information.

Yes, depending on the practice and circumstances surrounding the pregnancy and general health history. Mother of Thousands Midwifery does not accept pregnancy transfers after 35 weeks to ensure adequate time for establishing a strong provider-client relationship. We STRONGLY recommend having your pregnancy records prepared in advance to ensure a smooth transition between practices.

Pregnancy care often begins in the second half of the 1st trimester, normally between 10-14 weeks in pregnancy; however, Mother of Thousands Midwifery may accept pregnancy transfers until 35 weeks. During this visit, we get to know each other, review your full health history, establish a plan for your care, and listen to the baby's heartbeat if the baby allows. A full set of labs are collected at the end of your visit, and any necessary referrals, ultrasound scripts or medication prescriptions may also be issued at this time, if needed.

LMs bring medication to keep home birth safe including IV fluids, antibiotics, antihemorrhagic medications, lidocaine for suturing, neonatal vitamin K injection and neonatal erythromycin eye ointment; along with emergency equipment such as oxygen and equipment for resuscitating your baby if necessary. LMs also bring medical supplies including equipment to take vitals on you and baby, herbal and homeopathic remedies, sterile medical tools for clamping the umbilical cord and suturing as needed, and spare supplies in case we need to use more than what is provided in your Home Birth Kit.

It's crucial for LMs to work within the established guidelines to ensure the safety and well-being of clients and their babies. Because midwifery care is generally for low-risk pregnancies and various non-emergent pregnancy-related conditions, there are specific circumstances where the transferring of care to an OB or a specialist may be recommended or required in Florida (other states may vary).

Disqualifying medical conditions prior to current pregnancy:

• Type 1 or Type 2 Diabetes

• HIV+ or AIDS diagnosis

• Previous Cesarean with Classical Incision

Requires transfer to an OB or Hospital with NICU during pregnancy, labor/birth, postpartum:

• Syphilis, HIV+ or AIDS diagnosis

• Pregnancy with confirmed fetal anomalies

• Gestational Diabetes that requires medication

• Preeclampsia or HELLP Syndrome

• Placenta Previa

• Placental Abruption

• Uterine Abruption

• Preterm Labor (before 37 weeks)

• Fetal Distress

• Thick Meconium Present with ruptured membranes in labor

• Baby born with fetal anomaly

• Active genital herpes outbreak at onset of labor

• Intrauterine Growth Restriction

• Cord Prolapse

• Retained Placenta

At this time, Mother of Thousands Midwifery is out of network with all insurance companies. However, your insurance should cover whatever labs and ultrasounds your policy includes since these services are billed directly through the lab or imaging service. Payment plans are available throughout prenatal care but must be paid in full by 35 weeks. See the ‘Offerings’ tab for more information on Payment options.

It's important to check whether your health insurance covers midwifery care. Some insurance plans may cover a portion of the costs associated with midwifery services, while others may provide full coverage. Contact your insurance provider to understand what is covered under your plan. As a fully licensed and insured medical provider, you are likely to have our services applied to your deductible at minimum. To find out what your insurance plan will cover you can call your insurance representative and ask what your coverage is for an out-of-network provider providing home birth services and midwifery care. You may also request to obtain a gap exception, which allows your care to be billed at in-network rates. If a gap exception is denied, your care will be billed as out of network. Remember if you begin your pregnancy in one year and deliver in the next year, that your deductible(s) (both in and out of network) will need to be satisfied each plan coverage year regardless of the provider you choose and the place you plan to deliver.

If your insurance policy includes out-of-network insurance benefits, a third party billing may be able to assist in receiving reimbursement for your midwifery care. Typically, third-party billers require you to first fill out a verification of benefits (VOB). VOBs outline what is covered under your specific insurance plan as it pertains to homebirth Midwifery and/or out-of-hospital birth. Unfortunately, this doesn't typically tell you at what rates they will reimburse you. Insurance companies or share plans will only start the process of reimbursing you once you've "completed care," which is defined as two completed postpartum visits. Once the third-party biller sends the necessary documents summarizing your care to your insurance carrier, the insurance company decides how much will be reimbursed to you for payments you had already made towards your care. Reimbursements are not guaranteed, and Mother of Thousands Midwifery is not responsible for deviations from the insurance coverage described within the VOB form. Third party billers will likely charge a small percentage once the insurance company has paid.

Contact Us to request a FREE Consultation for more information

Contact Us to request a FREE Consultation for more information