Consultation

Plan on our consultation to be approximately 2 hours. This takes place in your own home and will be your first opportunity to meet with me, ask questions, and see if my care and services are right for you and your family. I will also take this time to determine if you and your family are good candidates for a home birth. I want to know how you envision your prenatal care and birth, answer your questions, and share with you my expectations of home birth clients (mostly eat well and be well!). Consultations are always free of charge.

Initial Prenatal Appointment

Your first prenatal visit will be approximately 90 minutes. Your health history will be reviewed (you are given this paperwork at your consultation), a physical exam will be completed, and you will have the option of a Well-Woman exam to include a Pap Smear as well. A full obstetric prenatal blood panel will be drawn and I will call you with any abnormal results. If lab results are normal, your blood work will be reviewed at your next appointment.

Prenatal Appointments

Most of your prenatal appointments will take place within the convenience and comforts of your own home, and occasionally my home office (where your other children are welcome of course with plenty of toys to play with). I am also able to schedule appointments in the evenings and on weekends for families whose partners do not have the ability to attend during normal business hours. Lasting a minimum of 60 minutes, prenatal visits consist of physical evaluations for Uterine Size, Weight, Urine Test, Blood Pressure, Pulse, Fetal Movement, Fetal Heart Rate, Fetal Presentation, Edema (swelling), and review of diet, herbs, supplements and any other information applicable to your week of gestation. Any labs necessary will also be drawn at these appointments; there is no need to send you to a separate location for this service. We will also discuss your emotional well-being, physiological changes, and preparations your family has been making. Prenatal appointments will occur every 4 weeks until 32 weeks gestation; bi-weekly appointments at 34 weeks and 36 weeks, weekly appointments from 37 weeks to 41 weeks (if you haven’t had your baby yet), and twice weekly from 41 weeks until your baby is born.

Your Birth

I am at home with you throughout your labor, birth, and 4 hours postpartum as you and your baby are quietly evaluated. Suturing is done if necessary, breastfeeding assistance is provided, and thorough postpartum instructions are reviewed with you and your family. I will do a thorough newborn examination and will give you the necessary paperwork you may choose to take to your family doctor or pediatrician. We will be staying in contact by phone until our first postpartum visit 24 hours later.

Postpartum Appointments

After the birth, you will have in-home appointments at 24 hours postpartum, 1 week, 3 weeks, and 6 weeks postpartum. I will occasionally call to check in on you and the baby in between postpartum appointments and remain on call for you as well.

Ultrasounds

Ultrasounds are not normally required within my practice, although some families opt to have one. You may choose to have an ultrasound at an OB/GYN office, Radiology Center, or if you choose to have an ultrasound for personal purposes only, you may find it desirable to go to a local women’s imaging center. Although rare, there are some occasions in which a diagnostic ultrasound may be called for. We will of course discuss these incidences in detail should they apply to you.

Fee for Services

Your $3,500 fee covers all of your prenatal and postpartum appointments, your labor, birth, Aqua Doula© birth tub rental, and midwife’s assistant at your birth. In addition to the fee for services, you will need to purchase your birth kit (approximately $60) as well as a new, unused hose that you will use to fill your birth tub. Fees for any lab tests will be billed directly to your insurance if you have a PPO or paid directly to me if you are already an out-of-pocket client. Should you choose to have an ultrasound at an OB/GYN office, Radiology Center, or we determine that an ultrasound is necessary, that cost will be billed to your insurance by the service provider or must be paid directly to that provider if you do not have insurance. If you choose to have an ultrasound for personal purposes only, you may find it desirable to go to a local women’s imaging center and pay out-of-pocket. As always, I have an extensive library of books, DVD’s, and CD’s loaned freely to clients and other mothers in the community, and I am on call 24 hours a day, 7 days a week when you have questions and/or concerns.

Out-of-Pocket

Without PPO insurance, your out-of-pocket fee for services is $3,500. You may choose to pay for your care in payments of check, cash, or credit card. Payments via credit card will include a 3% fee of the amount billed at that time. A non-refundable $500 retainer is due at your Initial Prenatal Appointment, with a minimum $300 payment due per appointment thereafter. Any remaining amount must be paid in full by 37 weeks of pregnancy. If you are a potential or present client experiencing a true financial strain and cannot afford the fee for services within the time limits provided, please let me know as soon as possible. You may be creative and offer an alternative financial, bartering, or goods ‘in return for services’ contract that can work for both of us.

Insurance Billing

With PPO insurance, your out-of-pocket fee for services will be $1900 prior to the birth. After the birth of your baby, I will bill your PPO insurance as an Out-of-Network provider. Depending upon your percentage of covered maternity benefits with an Out-of-Network provider, your insurance will pay me that percentage (usually 60-80%) of what they deem "usual and customary" for maternity care by a midwife minus any remaining deductible you may not have met for the year. Our billing service will find out what your specific coverage is, how much of your deductible you have remaining, and the approximate reimbursement we can expect so there will be no major surprises to you after the baby is born if you have a remaining out-of-pocket balance owed. Any remaining amount owed is due by your 6 week postpartum visit. I do not pass my service fees on to you for the use of an Insurance Billing Company to facilitate my reimbursement.