Upwards of 92-94% of pregnancies are low-risk, meaning that a majority of families are able to birth without complications. So much of Midwifery support is communication with supportive + holistic prevention strategies and informed consent. I use functional ranges as markers of health and have options for supporting your body as it changes throughout your pregnancy, birth and postpartum. I have many tools available to you including referral to other supportive providers in our community network, should you need additional support. In California, Licensed Midwives are able to care for low-risk families who are having singleton, vertex positioned (head down), babies between 37+0 and 41+6 weeks gestation. If your risk factors fall outside of my scope of care, I am still able to provide midwifery support to you for the continuum, working concurrently with medical providers as needed. 

Research articles on the safety of homebirth: 

• MANA Stats Project - Journal of Midwifery and Women’s Health 

•  Maternal outcomes and birth interventions- The Lancet, 2020

Supporting VBACs at home is something that I am passionate about especially being that the national average belly birth rate is near 30% in California and 45.5% and even higher in some areas of Mexico.  Practicing on the border includes providing care for many families who are seeking care outside of the access that is available to them. Current research shows that Vaginal birth After Cesarean is safest for those who are having a VBAC or VBA2C(vaginal birth after 2 cesarean births) with a low transverse incision. For families seeking a VBAC, I request previous surgical reports, medical histories, and an ultrasound towards the end of pregnancy to measure the previous uterine  incision site.

In the first week postpartum I will fill out all of the necessary documents for you to obtain the birth certificate for your newborn. As soon as the parents are ready to leave the home, but within 1 year, call the San Diego Vital Records Office (619) 692-5676, to make an appointment. This appointment typically takes about an hour. The birthing parent must attend the appointment, and they must have a valid form of identification such as passport, driver’s license, or military ID. If they have a passport from outside the USA, they must bring an appropriate visa if necessary. The parent will also need to bring paperwork from the Midwife including the Out-of-Hospital Birth Affidavit and the Midwife letter. A witness to the birth, the newborn, and the birthing parent, must be present for the appointment. The partner is not required to attend the appointment, unless they are the only other witness to the birth. If they would like to sign the birth certificate, they must bring identification as well.

If the parents are married to each other, the partner can be named on the birth certificate without being present (a witness is still required). If the parents are not married to each other, and the parents want the other biological parent named on the birth certificate, then the parents must sign paternity papers at the birth certificate appointment. The biological parent must be present.

When I arrive to support  you for labor and birth, I bring everything that is needed to safely care for you and your newborn throughout labor and birth. I will create mobile equipment stations so that wherever you feel comfortable to give birth, I can easily adapt with the necessary supplies.

- Equipment for monitoring maternal and fetal vitals, including doppler for monitoring the baby’s heartbeat in labor, blood pressure cuff, stethoscope, thermometer. 

- Basic supplies like lube, sterile and non sterile gloves, sterile gauze, sterile drapes, alcohol wipes, cotton balls, bandaids, sterile instruments, headlamp. 

- Newborn support including umbilical cord band, heating pad, weighing scale, measurement mat, resuscitation equipment, oxygen, pulse oximeter, bag valve mask, LMA, DeLee suction trap, goldenseal and oregon grape root powder, organic newborn hat, glucometer, eldon card, lab supplies.

- Maternal support including various herbal and homeopathic remedies, moxa and moxa based heating pads, IVs, IV fluids, electrolytes, chlorahexadine, antibiotics for GBS, oxygen, antihemorrhagic medications (herbal tinctures, yunnan baiyao, pitocin, methergine, cytotec and TXA), pulse oximeter, urinary catheters, postpartum sitz bath herbs, belly binder, lidocaine for suturing and suturing equipment.

- Another Licensed Midwife! You will have the opportunity to meet the Midwife who will be assisting your birth at the 36 week home visit and they will be called when you are in labor. Birth is always safer when there are at least two medical providers.

Absolutely, water is a powerful coping tool for labor! An inflatable tub, liner, potable hose, and shower adapter is included in the birth kit, if desired. It is also possible to use your home tub if you feel that you have enough space to be comfortable. Sometimes babies come fast and we don’t have time to fill the tub so this is something to keep in mind. I will share with you some tips on how to have a waterbirth if this is your vision. We will also do the dance of keeping the water at the right temperature. The water shouldn’t be too hot or too cold so we may need to remove water and replace it during the labor. After the birth, we can pump out the water to your plants or into the bathroom. 

Homebirth is typically not as messay as you might think! The birth kit comes with different types of barriers to protect your home as well as hydrogen peroxide and alcohol to clean any spills that might happen. An early labor project that is done is what we call a bed sandwich- clean sheets on the bottom, a layer of plastic, then sheets you don’t mind getting possibly stained. After the birth, the Midwives will organize, start a load of laundry, and take out any garbage that was created, leaving you to snuggle in bed without worrying about any cleanup. 

The backup transfer plans is always discussed prenatally, at the start of our care together. Parents choose their preferred transfer provider in the event of a non-emergent transfer and the closest transfer provider in the event of an urgent/emergent transfer. We will also discuss which hospitals might be more supportive of your birthing vision should we need to transfer non-emergently. We work within functional parameters of health, so if something isn’t necessarily abnormal, we may still discuss supportive options to achieve as close to ideal as possible.

Midwives are autonomous and certified emergency responders. This means we perform NRP (neonatal resuscitation) and BLS (basic life support), without needing physician supervision. One of the most common reasons for non-emergent transfer is exhaustion, particularly for first time birthing parents. The foundation of care is always: Intention rest | Nourish | Hydrate!

Other common complications that arise in birth are a baby that becomes distressed in labor and excessive maternal bleeding postpartum. We bring all of the tools and medications necessary to support and initiate newborn breathing as well as to help prevent and stop excessive maternal bleeding after birth.

As a Licensed Midwife, I am considered an out of network provider in CA. Typically medical insurance will not cover the costs associated with medical care automatically, but usually cover the costs of lab work. Depending on your Verification of benefits, you may be able to get reimbursed a portion of the fee after your care is complete, which is considered after the 6-week postpartum visit. I work with STM medical billing who can submit a Verification of Benefits before the start care so you are aware of your insurance coverage, and who also advocates for reimbursement on your behalf, so you won’t need to follow up with your insurance provider. While there isn’t certainty about insurance coverage, it is always worth attempting to utilize it! The medical biller doesn't get paid unless you get reimbursed, and her fee is 10% of your reimbursement. The most success with reimbursement is through PPO and POS plans, and some success with HMO plans. I utilize a sliding scale, so if you qualify for Medi-Cal or other low income programs, your exchange will be discounted on the scale. Other available options are medical loans, payment plans, and barter for some services up to half of my fee for reciprocity of my support- so if financial exchange is giving you pause, don’t hesitate to reach out.

What is necessary for birth, is a comfortable space for birthing and a bathroom. I have attended births in tiny homes, shared spaces, RVs, etc. What I have found is that with an abundance of space, most families prefer being in a smaller birthing area of their home for intimacy. 

Lab work can be done by Woven Midwifery in the office or refer out to local labs, as desired. I offer alternatives to gestational diabetes screening options and swabs are performed by the client, as applicable. We cannot perform ultrasounds, but can refer to ultrasound providers, depending on your individual coverage plan.

Birth keeper’s are a vital way to be supported throughout the birthing experience and evidence shows that having this support has numerous benefits. I highly encourage birth keepers as part of the birthing team. Doulas, birth keepers, birth photographers, friends + family and extended community are always welcome. Some people prefer to birth alone or with their partner and midwives only, others make it a community event. If you are considering inviting someone into your intimate space, it is important that you are clear with them about your boundaries, what is helpful to you, and create agreements around their presence. Birth can bring up many emotions and those are brought in with the people you are inviting to this vulnerable space. The 36-week home visit is a great time for all those who will be present for the birth to meet and get to know each other, as much as possible.

Vulnerability takes time, trust, and care to develop. To hold space for families as they grow and acknowledge their experience as it unfolds is the medicine of Continuity of Care. As your Midwife, I walk with you through this vulnerability from preconception, birthing, and into parenthood. Yes, sometimes plans change and this is something that I hold space for, no matter the change. I value you and the precious story of your life, as it is uncovered.

Part of weaving in sustainable practices is utilizing electronic health care records. All of your medical history, prenatal and postpartum progress notes, contracts, consent forms, educational information and billing is all securely stored within our HIPAA complaint charting system, ClientCare. You can also communicate with me via the protected messaging system and I can send or request faxes through our paperless portal.