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Frequently Asked Questions
The safety of Home and Birth Center Birth has been proven and successfully documented. We would be happy to discuss this in detail with you at your consult or initial visit. The research shows that home birth is very safe for healthy, low risk people. If you are interested in specific studies, please follow the links provided below for good resources on the safety of giving birth to your baby in your home or at a birth center.
This annotated bibliography provides citations and critical appraisal of original studies on home birth.
Results: Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age.
Discussion: For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.
Results: Of 15,574 women who planned and were eligible for birth center birth at the onset of labor, 84% gave birth at the birth center. Four percent were transferred to a hospital prior to birth center admission, and 12% were transferred in labor after admission. Regardless of where they gave birth, 93% of women had a spontaneous vaginal birth, 1% an assisted vaginal birth, and 6% a cesarean birth. Of women giving birth in the birth center, 2.4% required transfer postpartum, whereas 2.6% of newborns were transferred after birth. Most transfers were nonemergent, with 1.9% of mothers or newborns requiring emergent transfer during labor or after birth.
Discussion: This study demonstrates the safety of the midwifery-led birth center model of collaborative care as well as continued low obstetric intervention rates, similar to previous studies of birth center care. These findings are particularly remarkable in an era characterized by increases in obstetric intervention and cesarean birth nationwide.
Told through the lens of doctors, nurses, and midwives, Why Not Home? examines the latest evidence on risks and rewards of different birth settings. The film presents a balanced and accessible view on the latest research, along with moving personal stories of medical practitioners faced with big decisions for their own growing families. Viewers are challenged to move beyond preconceived ideas, and to envision a fresh future for maternity care in America.
RATIONALE – The best available evidence from North America and international studies demonstrates that midwife attended home births are associated with optimal labour and birth outcomes. Midwife attended planned home births in Canada are associated with fewer obstetrical interventions and no increase in maternal/fetal/neonatal mortality or morbidity compared to births planned to be in hospital.
Results – Medicaid beneficiaries enrolled at AABC sites had diverse socio‐behavioral and medical risk profiles and exceeded quality benchmarks for induction, episiotomy, cesarean, and breastfeeding. Among medically low‐risk women, the model demonstrated effective care variations including 82% attendance at prenatal education classes, 99% receiving midwifery‐led prenatal care, and 84% with midwifery‐ attended birth. Patient preferences were adhered to with 83% of women achieving birth at their preferred site of birth, and 95% of women using their preferred infant feeding method. Elective hospitalization in labor was associated with a 4‐times greater risk of cesarean birth among medically low‐risk childbearing Medicaid beneficiaries.
Conclusions – The birth center model demonstrates the capability to achieve the triple aims of improved population health, patient experience, and value.
Midwives Alliance of North America’s definition of a midwife is, Midwives are the traditional care providers for pregnant people and infants. Midwives are trained professionals with expertise and skills in supporting pregnant people to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide families with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a client-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes such as The Netherlands, United Kingdom and Canada. (Some words have been changed from Midwives Alliance of North America’s original definition to make the statement more inclusive).
We are Licensed Midwives and a Certified Professional Midwives. We are licensed by Washington State and overseen by the Department of Health. Northshore Midwives & Lactation Consulting provides full Prenatal, Birth and Postpartum (after birth) care for healthy people who are planning a Home Birth or a Birth Center Birth.
Conclusions: Midwives who were integrated into the health care system with good access to emergency services, consultation, and transfer of care provided care resulting in favorable outcomes for women planning both home or hospital births.
Main Results: Women who had midwife-led continuity models of care were less likely to experience regional analgesia, episiotomy, and instrumental birth, and were more likely to experience no intrapartum analgesia/anaesthesia, spontaneous vaginal birth, attendance at birth by a known midwife, and a longer mean length of labor.
Conclusions: Most women should be offered midwife-led continuity models of care and women should be encouraged to ask for this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications.
“STEP 1: Offers all birthing mothers unrestricted access to birth companions, labor support, professional midwifery care. ACCESS TO MIDWIFERY CARE – Use of midwives was associated with:
- Increased length of prenatal visits, more education and counseling during prenatal care, and fewer hospital admissions.
- Less need for analgesia and/or epidural anesthesia and increased use of alternative pain relief methods, as well as more freedom of movement in labor and intake of food and drink.
- Decreased use of amniotomy (membrane rupture), IVs, electronic fetal monitoring; fewer inductions and augmentations of labor; and fewer injuries of the perineum (tissue between vagina and anus) as shown by fewer episiotomies, fewer rectal tears, and more intact perineums.
- Fewer cesareans overall, including fewer emergency cesareans for fetal distress or for inadequate progress in labor, and more vaginal births after cesareans (VBACs).
- Fewer infants born preterm, low birthweight or with complications such as birth injury or requiring resuscitation after birth, and more infants exclusively breastfeeding at 2-4 months after birth.”
The largest research study in the US on waterbirth published in the Journal of Midwifery and Women’s Health, found that being born underwater did not confer any excess risk to the baby. Babies born underwater were no more likely than those not born in water to have a low five-minute Apgar score, or require hospitalization or neonatal intensive care (NICU) admission. We also found no evidence that water birth is associated with neonatal death; on the contrary, in our sample of 6,534 babies born in water, there were no cases of death that could be attributed to being born in water. This indicates that, for low-risk people whose labors proceed normally, water immersion is generally a safe pain management option.
Home Birth is not messy. Our staff is meticulous about keeping your home clean. We start your laundry and remove any garbage resulting from the birth process. When we leave, your home will look as it did before the birth.
Northshore Midwives & Lactation Consulting is a preferred provider for most major insurance companies. Please call the office for questions you may have regarding your individual plan and we will direct you to our midwifery billing specialist. Our billing specialist will contact and bill your insurance directly for your Prenatal, Birth and Postpartum care.
Also see our Insurance and Billing Page
The most common reason that we transfer to the hospital during labor is for non-emergent reasons such as a very long and exhausting labor. There are fewer situations that can be more urgent. The Midwives at Northshore Midwives & Lactation Consulting are highly skilled healthcare providers, who are trained to recognize, and resolve, any issue quickly or to initiate help when needed. We have plans in place for every possible scenario. When you come for a consult or initial visit, please write down all your questions and we will go each one in detail.
Northshore Midwives & Lactation Consulting has strong working relationships with obstetricians and perinatologists at our local hospitals. Should a situation arise during your Prenatal, Birth or Postpartum care that increases your risk, your midwife will consult with one of these physicians or transfer your care to one of the local hospitals. If transfer to a physician is needed, our existing relationships with these providers improves the transfer interactions significantly.
Northshore Midwives recommends having a Doula at your birth. Studies have shown that Doulas are a valuable addition to your birth team. These studies indicate that women who use Doulas are less likely to need pain medication, are less likely to have interventions such as cesarean-section (c-section), are more likely to have shorter labors and are generally happier with their birth experience. Midwifery care in and of itself positively impacts these results, adding a Doula to the team provides even greater benefits. Learn more about Doulas.