Numerous studies demonstrate that home birth with a skilled midwife is just as safe as hospital birth, with fewer interventions. During your labor, we will closely monitor you and baby to make sure that everything is within the range of normal. If a medical complication develops that makes the birth higher risk, we are easily able to transport to a hospital setting, if necessary.

Does insurance cover homebirth?

Most PPO insurance plans will reimburse for homebirth midwifery care. I work with a skilled team of medical billers who will coordinate with your insurance company so that you can get reimbursement for the care that you receive. You can submit a “verification of benefits” request here to find out more about your specific coverage. Unfortunately, Kaiser and Medi-Cal clients are not eligible for insurance coverage for homebirth at this time.

Where do my appointments take place?

Prenatal care takes place in my lovely Albany office. I offer one home visit in the 3rd trimester. The first two weeks of postpartum care is provided in the comfort of your home. All appointments are scheduled for an hour in length.

Do I need to work with an OBGYN if I hire a midwife?

No. I provide all the care needed to see you through a healthy pregnancy, birth, and postpartum. Midwives can provide the same standard tests/screens that an OB would offer. Some of my clients choose to do concurrent care with an OB during pregnancy, but it is not required or necessary. In some cases, a medical complication may necessitate physician consultation or co-managed care.

Do you offer care to people planning a hospital birth?

Yes. Home birth is not for everyone: some people choose to birth in the hospital because they have a medical complication or risk factor that makes it a safer option, and some people simply prefer the hospital setting. I provide full prenatal care for those planning a hospital birth, and then go to the hospital with you when you are in labor, resuming postpartum care at home after the birth. Working with a midwife for a planned hospital birth gives you the best of both worlds: a more connected and holistic approach to your care, with the resources of the hospital setting.

Do you offer water birth? Is it safe?

Yes, many of my clients choose to labor and/or birth in water. Being submerged in water is studied to reduce discomfort in labor. Babies have an innate “dive reflex,” which means that they do not attempt to breathe underwater. This makes water birth a safe option for low-risk people.

How often will you see me for prenatal care?

I follow the same general appointment schedule as an OBGYN during pregnancy. This includes visits once a month until you are 28 weeks, then every other week until 36 weeks, and then weekly until you give birth. More frequent visits are offered if indicated.

Do you work with doulas?

I strongly encourage all first-time birthers to hire a doula as part of their support team! A doula is a non-medical support person who offers physical, emotional, and informational guidance to birthing people. While not required, doulas can be a wonderful addition to the team. You are also welcome to have as many or as few family members/friends with you at your labor and birth.

Do you offer the same prenatal tests/screens that I would get from an OBGYN?

Yes, I offer the standard of care in testing and screening during pregnancy and in the postpartum. Each test will be discussed in detail, and you will make an informed decision about which tests/screens you would like to have. We can do all routine blood work during our appointments, and bill the labs directly to your insurance. Any ultrasounds will be performed in a reputable ultrasound facility, and will also be billed directly to insurance.

Do you bring an assistant or second midwife to the birth?

There are always two licensed midwives in attendance for every home birth. Having two sets of skilled hands increases the safety of home birth, and means that there is more support available to you.

Who chooses midwife-led fertility care?

Emunah Midwifery provides services to anyone who needs respectful fertility care, but especially to those who’s needs are not being met in the mainstream system. This includes queer folks, trans and non-binary people, single people, people who experience size discrimination, “older” parents, non-traditional families, and those seeking a more holistic approach to health and fertility.

What is intrauterine insemination?

IUI is a procedure in which washed sperm is placed directly into the uterus, using a thin catheter (tube) that goes through the cervix. The procedure typically takes less than 2 minutes, and feels similar to getting a Pap. IUI is a safe and effective way to achieve pregnancy.

What is sperm washing and why is it necessary for IUI?

“Sperm washing” refers to the process where motile sperm are separated out from the other components in seminal fluid. Since IUI involves placing sperm directly into the uterine cavity, it’s important to remove bacteria, as well as prostaglandins that can cause uterine cramping. Additionally, removing the non-motile sperm and leaving only the healthy ones increases the chances of success. The washing process involves layering the seminal fluid over sperm-washing medium to create a density gradient, and using centrifugal force to separate out the healthy sperm. If you are purchasing sperm from a bank, you will need to get IUI-ready (washed) vials. If you are using fresh sperm (either from a known donor or a partner), your midwife will do the sperm washing at your home immediately prior to the IUI.

Does insurance cover fertility and IUI care?

Unfortunately, most insurance plans do not include any fertility benefits. You are responsible for paying for any care provided by Emunah Midwifery, with payment due at the time of service. Some workplaces may offer fertility benefits, and I am happy to provide you with a superbill that you can submit for reimbursement. Any lab work can be billed directly to your insurance (with the exception of Kaiser members).

How many cycles does it usually take to conceive with IUI?

There is no easy answer to this question; everyone’s journey is unique. These statistics might help you get a sense of realistic expectations: For people under 30, the success rate is around 20-25% per cycle. For people aged 30 to 35, the success rate of IUI is typically 15-20% per cycle. People aged 35-40 have a 10% success rate per cycle. By their early 40s, the success rates drop to approximately 5%. These are statistics for people with no known fertility issues, who are using high-quality sperm. If you are impacted by fertility complications, your statistical chances of success will be lowered.

Can you prescribe fertility medications?

Medication management is outside of my scope as a Licensed Midwife. Some clients choose to get fertility medications prescribed through an MD, while still pursuing at-home IUI with Emunah Midwifery. We can discuss the risks and benefits of medications during a preconception consultation, so you have the information to make the best choice for your individual circumstances.

Postpartum Care and Postnatal Care with a Midwife in Berkeley, CA - Maternal Health - Homebirth

New parents celebrate the birth of their child supported by a Midwife in Berkeley, CA.

I have always said: that the biggest reason to hire a home birth midwife is for postpartum care. While there are indeed many reasons to hire a midwife for your pregnancy and birth, the difference between midwifery-led postpartum care and mainstream hospital-based postpartum care is night and day. I’ll be blunt: the US healthcare system has full-on neglected postpartum people, and the health consequences can be dire. But beyond the critical health assessments provided in those early days and weeks of your child’s life, the postpartum is a time of massive transition and vulnerability, and having consistent and attuned care during that period is so important. It lays the groundwork for an easy and connected parenting journey.

Mainstream Postpartum and Newborn Care

Let’s first take a look at how new parents and babies are cared for in the mainstream US healthcare system, and how outcomes compare to other countries with more robust postpartum healthcare and support services. In the US, it is typical to be hospitalized for around 24-48 hours after a normal vaginal birth (and 72 hours after a cesarean birth). After discharge, there are no routine OB visits or postpartum care until six weeks after birth. That six-week OB visit is typically allotted 15 minutes of time, and includes a talk about contraceptive options, a pelvic exam, and a vital signs check. That’s it. That’s all you get.

Care for Mother Vs. Baby

Meanwhile, your baby is receiving pediatric care, which typically includes 1-2 appointments in the first week, and checkups at 2 weeks, 4 weeks, and 8 weeks. At those appointments, they will weigh your baby, take vitals, do labs if indicated, and give vaccines per the CDC schedule. Most pediatricians have very minimal knowledge about breastfeeding/chestfeeding, so if this is something you want support with, neither your OB nor pediatrician will be able to offer much help or guidance.

Postpartum Care in the US vs. Other Countries

Compared to other countries in the global North, the U.S. offers much less routine postpartum care, and morbidities and mortalities are reflected in this deficit. In 2018, there were 17 maternal deaths for every 100,000 live births in the U.S. — which is more than double that of most other high-income countries. By comparison, in 2018 the maternal mortality ratio was 3 per 100,000 or fewer in in the Netherlands, Norway, and New Zealand[1]. (Note: the term “maternal mortality” refers to a death occurring during pregnancy or in the first year after giving birth. In the U.S., approximately one-third of maternal mortalities occur in the postpartum.)

No Routine Home Visits

The U.S. is one of the few high-income countries that does not provide routine home visits for postpartum families. In most European countries, it is standard practice for a nurse or midwife to do at least one home visit in the first week postpartum, regardless of whether the birth took place at home or in the hospital.

World Health Organization Recommendations

The World Health Organization recommends at least four health appointments in the first six weeks after birth[2], yet the U.S. health system only typically provides one postpartum appointment at six weeks. In a 2016 volume of The Journal of Obstetric, Gynecologic & Neonatal Nursing, in an article entitled “Postpartum Preeclampsia,” the author reports: “Indeed, 10% of maternal deaths from hypertension occur during the postpartum period, possibly because this may be beyond the window of routine care for new mothers.[3]” Preeclampsia is almost always manageable with proper medical attention, but when new parents are not receiving routine screening, many cases of postpartum preeclampsia go undetected, which can be fatal. Something as simple as a blood pressure check in those first weeks after a baby could be life-saving.

A new family gazes lovingly at their newborn infant representing a couple who could benefit from maternal health care in Berkeley, CA.

Racial Disparities in the U.S. Maternal Healthcare system

The maternal mortality rate in the U.S. is highly dictated by race. For Black birthers, the mortality rate is 37.1 per 100,000 births, compared to white birthers who have a mortality rate of 14.7 per 100,000 births. While there is much more to be said about healthcare disparities and race, it is clear that systemic racism is a major player in the maternal mortality crisis.

Midwifery-Led Postpartum Care

Midwives place high importance on the “fourth trimester;” the first 3 months of your baby’s life. This care is essential for physical health assessment, but it also includes so much more than that. Midwifery care in the postpartum is all about setting you up for success with nursing or baby feeding, bonding with your baby and attuning to their needs, getting proper nutrition, getting enough sleep, and tapping into the community and social resources. Not to mention, new parents typically have a ton of questions emerging in those early days and weeks, and having a midwife on-call, day and night, who picks up your calls at any hour and responds to your text messages is an invaluable resource.

Routine Postpartum Care From Midwives

The typical schedule of visits for homebirth midwives providing postpartum care is 3 visits in the first week, and additional visits at two weeks, four weeks, and six weeks. In my practice, the first two weeks of care is all done at the family’s home, as traveling for appointments in the first couple weeks can be disruptive to healing and bonding.

A mother snuggles with her older child and her newborn infant after giving birth with a Midwife in Berkeley, CA.

Care is Viewed as Interdependent by Midwives

A foundational difference that separates midwifery care from mainstream care is that the postpartum parent and newborn are viewed as an interdependent unit. In the mainstream model, the healthcare for the parent is fully separated from that of the newborn: the adult goes to the OB the child goes to the pediatrician, and the two providers are not coordinating or collaborating with each other to create an integrated health plan. In the midwifery model, we see the needs and wellbeing of the parent and child as intrinsically connected, and provide care that is centered on supporting and nurturing the entire family system.

Each visit tends to the physical, emotional, practical, and spiritual needs of the family. Since care is happening in the home setting, midwives are better suited to assess access to material resources like nutrition and safe housing, to assess relational health and familial/community support, and to tap into community and social resources for support.

Communication and Support Are Key Components of Postpartum Care with a Midwife

Postpartum appointments are scheduled for an hour in length, and often we go past an hour because there is so much to talk about. Typically, when I arrive at a family’s home for a postpartum visit, we will make tea and settle into the bedroom or living room. The conversation flows freely, and the parent(s) check in about how they are doing, both physically and emotionally. We spend a good amount of time talking about baby feeding, and often I’ll observe a feed and give suggestions or pointers based on what I’m seeing.

We talk about the mood in the postpartum:

How is the transition going?
How is your vitality?
What are you feeling?
Is there any anxiety or depression present?

We discuss sleep (for the whole family):

How many hours are you getting at a time?
What’s the quality of your sleep like?

We discuss community and familial support:

Are you having visitors?
Does this feel supportive or overwhelming?
Do you have support people helping out with meals, shopping, and household chores?
How can we mobilize your existing support system to better meet your needs?

For all of these areas (and more), we talk about strategies to optimize your well-being in ways that are most relevant to your circumstances, resources, and values. Midwifery is all about individualizing care to the specific needs of the family, rather than assuming everyone’s needs are the same.

Parents and their older child celebrate the birth of their newborn infant that took place with a midwife in Berkeley, CA.

The Inclusion of Physical Assessments of the Postpartum Parent and Baby

And of course, every appointment also includes a physical assessment of the baby and postpartum parent. For the adult, this includes checking vital signs; checking on the healing status of any tears or sutures from the birth; drawing labs, as indicated; checking in about postpartum bleeding; making sure the uterus is involuting (shrinking down to its pre-pregnancy size/position); and assessing for signs of infection. For the newborn, this includes a weight check to make sure they are gaining appropriately; checking in about their pees and poops; taking their vitals (heart rate, respiration rate, and temperature); assessing for jaundice; assessing the umbilical cord stump; and performing the Newborn Screening Test.

If you are ready to connect with a Midwife in berkeley, CA, and create a lasting meaningful bond with your caregiver, reach out today.

Postpartum families need ongoing and easily accessible care, that is tailored to their specific needs and circumstances, and that unifies the adult and newborn as a highly interconnected unit. Currently, this sort of care is only available to families who birth at home with a midwife, or those who privately hire a midwife to care for them in the first six weeks postpartum. My hope for the future of maternal and infant healthcare in the U.S. is that all families, regardless of their birthing location or economic status, receive appropriate and consistent care that tends to their physical and emotional well-being in the first year. This sort of care will help save lives, and will also create a foundation of confidence and greater ease for new parents.