Frequently Asked Questions
What is midwifery care like? How is it different from my OB?
The midwifery model of care is fundamentally different than the medical model. Midwives are the protectors of normal birth and specialize in care for the low risk, healthy woman or birthing person. Obstetric doctors are surgeons and specialize in high risk pathological pregnancy and birth.
Even in prenatal care midwifery is quite different than a visit to your OB. Our appointments generally last an hour, which allows plenty of time to ask all of your questions. We take the time to really understand what is going on with you, your baby, your family and your pregnancy. We offer resources such as reading suggestions, referrals to classes and other providers.
Another cornerstone of our care is informed choice - we offer the same standard of care when it comes to labs, ultrasounds, and procedures that you would get anywhere else, but shared-decision making is what sets us apart. We fully support and respect your decisions, knowing that you are the best and final expert on your body and your baby.
We are continuously keeping up to date on evidence based research, while maintaining perspective and remaining humble. Although we help guide your journey, you are in charge.
How do I know if I am a good candidate for out of hospital birth?
The majority of people are considered low-risk and a good candidate for out-of-hospital birth. To learn more about the safety of birthing out of the hospital, check out this research study conducted by the Midwives Alliance of North America (MANA), which confirms the safety for low-risk families who choose to birth at home with a Midwife.
In addition to desiring a natural home birth without pain medication and supporting physiology, the state of Louisiana requires the following criteria to be eligible for community midwifery care. We know many of the below is unacceptable and barriers to good midwifery care. We believe birthing families have the right to informed consent, shared decision making, and autonomy for where and with whom they birth… we are actively seeking for a change to these regulations.
Initial prenatal appointment with a local OB required by Louisiana to begin care. This OB does not have to “approve” of your choice to home birth.
No history of uterine surgery (Cesarean)
Head down single baby
Delivery between 37-42 weeks
Routing lab work: inducing anatomy ultrasound, STD screening, GBS screening, and gestational diabetes screening
Maintain normal low risk status throughout pregnancy and birth
However, you and your partner or person supporting you during pregnancy and birth’s mindset surrounding birth is key! If your philosophy is that birth is a natural event that sometimes needs medical assistance, you normally care for your self and family in that way, and you dont want pain medication during labor, home birth is probably your JAM!
What standard labs do you offer?
Complete blood count (CBC): Evaluates the cells that circulate in your blood, like iron and platelets.
Blood type and Rh factor: Determines your blood type and Rh factor (negative or positive)
Antibody screen: Tests for antibodies that attack red blood cells
Rubella Antibody titer: Screens for German Measles
Urinalysis: Evaluates components of the urine
Pap smear: Screens for cervical cancer
Genetic screening: Screens for fetal chromosomal abnormalities and neural tube defects
Carrier screening: Screens for maternal chromosomal abnormalities
HIV, Syphilis and Hepatitis B&C screening: Standard sexually transmitted infection (STI) screening
Gonorrhea and Chlamydia cultures: Screens for gonorrhea and chlamydia
Urine Culture: Screens for bacteria in the urine
Glucose screening: screening for Gestational Diabetes Mellitus
Thyroid and hormone testing: Screens the thyroid hormones, as well as additional hormones, if necessary.
Vitamin D: Evaluates Vitamin D levels
Vaginal Microbiome: Candida, BV, Trichomoniasis, etc.
Group beta streptococcus culture: Screens for presence of vaginal/rectal GBS
Unity Genetic screening (includes fetal sex, blood type, and genetic profile)
SpeakPeek Gender Blood Test
What are the costs, insurance information, and payments?
Please see the our investment page to learn more about cost of care, sliding scale, and payment options. For information about insurance reimbursement, check out the financial FAQ.
What do midwives bring to the birth and what do I need to buy?
Devotion Midwifery brings all medical equipment and labor support tools.
We require the purchase of a home birth kit which we have already compiled for you. We ask that this kit is purchased and delivered before our birth prep visit at 36 weeks. In addition to the birth kit, we recommend comfort items and snacks that you would normally desire.
How do you monitor the health of baby and mom during pregnancy?
The foundation of prenatal care is preventative care. We support you to make the healthiest and best choices possible to help keep your pregnancy low-risk. Additionally, we recommend standard of care lab tests and a mid-pregnancy (anatomy scan) ultrasound. We monitor the baby's heartbeat and growth throughout the pregnancy. We monitor your blood-pressure and other vital signs at every visit. Because our prenatal care is based on relationship, building and listening; we are often able to catch issues before they become major problems. We also believe that trust and intuition is a huge part of care. Talk with your midwife when you have concerns!
We recognize that pregnancy and birth are unpredictable and stay vigilant to any developing problems or concerns. If additional tests or consultations are needed, we have refer to other providers, imaging centers and labs.
How do you make sure we are safe and healthy during labor and birth?
During labor the midwives will monitor the baby's heartbeat frequently and discreetly. We work to keep you hydrated, fed, and rested while also checking vital signs regularly. We have a midwife and trained birth assistant, second midwife, or student at every birth. We follow our carefully researched and frequently re-evaluated protocols and practice guidelines to make sure you stay low-risk and safe for out of hospital birth. These are available upon request.
Due to having low-risk clients with healthy, low-risk pregnancies, our transfer rate is very low (7%) . We are trained to identify risk factors and transfer to the hospital before complications become true emergencies. We carry medications such as pitocin, IV fluids, oxygen, and resuscitation equipment that allow us to manage complications at home. As a maternity healthcare provider in the state of Louisiana, we also train and certify in Neonatal Resuscitation and CPR every 2 years.
During your care we discuss the reasons why we might transfer to the hospital and what happens during a transfer. We have relationships with our community hospitals and facilitate a smooth transfer of care in the small percentage of births where it might be necessary.
How will I cope with labor?
One of the benefits about having a midwife for your unmedicated birth is that we have helped hundreds of people do this. We have trust in you, your body and your baby, and we have skills to help. If there is one thing we know, it is that you can cope with the discomfort of normal labor. We do ask that all first time home birthers take childbirth education class and or hire a doula so that you are more prepared and confident.
Women have been doing this since the beginning of time. We find that the “mind over matter” philosophy really does ring true. The mental state, ability to relax and or overcome is greater than the physical sensation. We truly believe your body was meant for birth, and support the physiology while breaking into the psychology that may get in the way.
Your midwife also will deliver the birth pool to your home at 36 weeks. We LOVE “aquadurals” and encourage using water as a coping tool. Additionally, we bring birth balls, peanut balls, TENS units, Birth Slings, and our heart and hands to fully support you.
Lastly, we always encourage hiring a doula. They are professionals for supporting the physical and emotional “labor” of birth. Doulas and Midwives go together like Peanut Butter and Jelly!
Do you offer VBAC?
Short answer, no. In the state of Louisiana home birth midwives are not allowed to attend VBAC clients at home in Louisiana. We do offer midwifery prenatal care package for $2500 with plans of birthing in the hospital. Alternatively, we can offer VBAC at home or hotel in Mississippi. Contact us to discuss this option.
We know this is unacceptable and a barrier to good midwifery care. We believe birthing families have the right to informed consent, shared decision making, and autonomy for where and with whom they birth… we are actively seeking for a change to these regulations.
What if we have to transfer?
The midwfery model of care highly focuses on preventative measures, which means transfer rates are usually low. If higher level of care is needed during the pregnancy this may be temporary, like a consultation, or permanent like being risked out of care for a medical reason. In the event of a transfer during labor, a midwife will accompany you to the hospital until delivery as your doula (even if you already have one) and complete all standard postpartum visits.
Sometimes, we need the hospital, and it’s important to recognize that need before it becomes emergent. Leila has a 7% transfer rate which is similar to the national average of 10%. this means we don’t just transfer for no reason and sabotage your birth, and we also don’t put you or your baby at unnecessary risk.
It’s also important ot note that the number 1 reason for transfer is not a medical emergency, or even pain relief… It’s exhaustion. So please listen to your midwife when we ask you to rest, hydrate, and eat in early labor. It’s a marathon, not a sprint.
Can I switch to Devotion Midwifery if I am already in care with another provider?
Absolutely! We take transfers as far as the third trimester. However these is not a “Late to care” discount. We often find that the energy it takes to build a relationship in such little time is just as much as a full pregnancy with our care.
Please schedule a phone consultation to discuss details.
When should I start prenatal care?
We love to see you starting in the first trimester, specifically by your 12th week gestation. This will give us plenty of time to build a trusting relationship. If you are currently being seen by another practice, we will facilitate transfer of records and can establish you into even into the third trimester. Per Louisiana state law, you must see a Louisiana OBGYN prior toe the start of care with a Licensed Midwife and beet low risk criteria. Therefore, we often find that people wait to come into care until that visit is complete around 12 weeks. However, the earlier the better as evidence shows that the midwifery model of care prenatally reduces poor outcomes, inductions, gestational diabetes, preeclampsia, cesareans, and poor birth experiences.
Can I eat and drink in labor?
Yes! We encourage it. Your uterus is a muscle, it would be a disservice to not allow you to refuel as you work hard to birth your baby.
What if I tear?
Leila is fully trained and experienced in laceration repair and carries all legal medication to make the experience more comfortable.
Who can come to my birth?
You can have whoever you want at your birth, its YOUR birth. Some people like to give birth in complete privacy, while others want their mom, sisters, cousins, a doula, a photographer, oh and their kids too! However, We encourage each person you invite to have a specific role in supporting you and your birth goals.Simply consider if you feel ok pooping, being naked, and crying in front of them. Additionally, we strongly believe that the people who are present at your birth should align with your values. There is no room for placing their fears on you in this pinnacle time.
Who files the birth certificate? What about the newborn screenings?
Your baby's birth certificate information will be submitted and instructions will be provided on how to obtain the birth certificate. The Newborn Metabolic Screening and Congenital Heart Defect Screening are offered at the first postpartum visit.
We will perform weight checks at every postpartum visit, ensuring adequate weight gain and timely referrals, as necessary.
Can we do delayed cord clamping?
We do not clamp or cut the cord until you are ready, or unless there is an indication to. Many times this does not occur until approx. 2+ hours after the first when we are completing the newborn exam.
Can I have a doula?
Yes! We love doulas. Check out the evidence on doula care. https://evidencebasedbirth.com/the-evidence-for-doulas/