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What is a licensed midwife?

A licensed midwife is a trained professional who provides care to low-risk pregnant women seeking an out-of-hospital birth experience. Haven Midwifery supports women and their families in maintaining healthy pregnancies by offering individualized care, education and counseling throughout the childbearing cycle.

 Is midwifery safe?

Absolutely. Licensed midwives have a specific scope of practice that they follow. When the care required is outside the midwife’s scope of practice, the woman is referred to other health care providers for additional consultation or care. A number of research studies have consistently confirmed equal or better outcomes for midwife-attended versus physician-attended low-risk births. These studies point out that using a licensed midwife significantly lowers rates of interventions, such as induction of labor, artificial rupture of membranes, episiotomies, and cesareans.

 What happens if a complication arises in my pregnancy, at the birth or postpartum?

Birth is a natural human process and though the likelihood is small, a medical complication in pregnancy, birth or postpartum can arise unpredictably. That being said, dangerous deviations from normal usually have early warning signs which permit time to transport to the hospital. Licensed midwives are extensively trained to detect and manage complications. Further, licensed midwives carry all necessary equipment for infant resuscitation, oxygen and IV therapy, as well as, medications to control excessive bleeding after delivery. Licensed midwives can also suture 1st and 2nd degree lacerations.

 Do you offer your services to everyone?

Haven Midwifery offers free consults. It is at these consultations that the licensed midwife can determine if a woman is eligible for a an out-of-hospital birth. Factors that would risk a woman out of Haven Midwifery care are such things as heart disease, diabetes, history of seizures, kidney disease, asthma requiring steroids, HIV infection, sickle cell anemia, multiple gestation, or history of cesarean section with previous births. However, most women are low risk.

Do I need to see a physician during my pregnancy?

In general, no. The majority of midwifery clients do not need to see a physician during their pregnancy. However, if a woman develops a complication out of the midwife’s scope of practice, she will be referred to a physician. If the complication is severe and does not resolve, then the transfer of care and a hospital birth is indicated.

 What about lab work, ultrasound and other testing?

Licensed midwives can order most lab work, ultrasounds or other tests that a woman may need in pregnancy or postpartum. Blood draws and pap smears can be performed by the midwife at the clinic. You can opt for as many or few screenings, tests or ultrasounds as you like as long as you understand the risks and benefits of accepting or declining each. Licensed midwives practice informed consent, meaning a discussion with the client on the risks and benefits, and alternative choices of each procedure so a client can make an informed choice that they feel most comfortable with.

 Would I have access to pain medications during labor?

Currently, with the exception of local anesthetic for repairing small lacerations, no pharmaceutical pain medications are permitted at out-of-hospital births. However, licensed midwives are trained to help women use many non-pharmaceutical techniques to relax and manage the intensity of childbirth, water immersion being one of them.

 What equipment do you bring to a birth?

Licensed midwives must carry all of the necessary equipment and supplies for normal childbirth, as well as the equipment and supplies necessary to manage an emergency. They bring a blood pressure cuff and a hand-held doppler to measure mom’s blood pressure and baby’s heart rate, intravenous fluids and antibiotics (if necessary), anesthetics and suturing materials, several medications to stop excessive bleeding, oxygen for mom and baby, and tools (including a baby scale!) to assess the health of baby when he/she arrives.

 Does insurance cover midwifery services?

Most insurance companies do cover midwifery services in Washington state, however it depends on a woman’s individual plan. Licensed midwives may apply to become preferred providers under insurance companies but the process can take several months and sometimes, the insurance company opts to not contract with the licensed midwife. Insurance will be discussed at the consult and Haven Midwifery’s billing service can check what a woman’s particular policy covers. If a woman does not have health insurance, or has insurance that the midwife is not contracted with, an individualized payment plan can be set up. One thing is for sure, midwifery care and an out-of-hospital birth costs significantly less than care with a physician and a birth in the hospital.