Question 1

Is homebirth safe?

Accepted Answer

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.

Question 2

Does insurance cover homebirth?

Accepted Answer

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.

Question 3

Where do my appointments take place?

Accepted Answer

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.

Question 4

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

Accepted Answer

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.

Question 5

Do you offer care to people planning a hospital birth?

Accepted Answer

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.

Question 6

Do you offer water birth? Is it safe?

Accepted Answer

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.

Question 7

How often will you see me for prenatal care?

Accepted Answer

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.

Question 8

Do you work with doulas?

Accepted Answer

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.

Question 9

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

Accepted Answer

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.

Question 10

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

Accepted Answer

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.

Question 11

Who chooses midwife-led fertility care?

Accepted Answer

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.

Question 12

What is intrauterine insemination?

Accepted Answer

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.

Question 13

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

Accepted Answer

“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.

Question 14

Does insurance cover fertility and IUI care?

Accepted Answer

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).

Question 15

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

Accepted Answer

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.

Question 16

Can you prescribe fertility medications?

Accepted Answer

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.

MEET THE MIDWIFE

El Tarver, LM, CPM