Common Questions
Is Home Birth Safe?
Home birth is safe for well-prepared, healthy women experiencing normal pregnancies. We limit our clientele to low-risk childbearing women. State law prohibits us from attending high-risk births at home. We do not attend known breech births (baby not head down), multiple gestation, or vaginal birth after more than one cesarean. If you have had a cesarean birth, we may accept you so long as you can provide your operative report showing you had a low transverse cesarean and that you will have a spacing of at least 18 months between births. Other high-risk conditions, such as preeclampsia, gestational diabetes requiring medication, as well as many chronic diseases, such as hypertension, Type 2 or Type 1 diabetes, are inappropriate for home birth. If you're not sure if you are a good home birth candidate, please contact us, and we can talk about your unique situation in more depth. Most hospital transfers are for non-emergency reasons. A typical home birth to hospital transfer would be for a first time mother having a long and difficult labor, where she has opted to get an epidural for pain relief. This is almost always why we transfer to the hospital. Every once-in-a-while, we will encounter an emergency at a home birth. If that happens, EMS will be notified, and we will continue care until you have been received by a hospital-based provider. After you are discharged from the hospital, we can continue your postpartum care as planned.
What is a midwife?
​Midwives are the experts in the care of women throughout their lifespan. We believe in shared decision making and providing evidence-based informed choices for our clients. Midwives, depending on their certification, have different training, education, and experience. Certified Professional Midwives (CPMs) are trained and practice only in the community birth setting (home and freestanding birth centers). The CPM is the only midwifery credential that requires experience in out-of-hospital (community) birth, and specifically in home birth. They are trained and educated in a variety of ways, but their training includes a clinical apprenticeship with an experienced midwife. Their education, experience, and competency are evaluated and they are board certified by the North American Registry of Midwives (NARM). In Wyoming, CPMs are licensed by the Wyoming Board of Midwifery. Certified Nurse-Midwives (CNMs) are registered nurses who also have a masters degree in midwifery. CNMs mostly care for families in hospitals, but they can also provide community birth care. CNMs are board certified by the American Midwifery Certification Board (AMCB). CNMs in Wyoming have full practice authority, meaning they can provide care within their scope of practice without a requirment of physician supervision or collaboration. They are licensed as Advanced Practice Registered Nurses by the Wyoming Board of Nursing.
What's the difference between a midwife and a doula? If I hire a midwife, do I also need to hire a doula?
A midwife is a trained clinical provider. Midwives provide comprehensive prenatal care, labor management, postpartum care, and normal newborn care. We are not doctors, but we can provide most of the care obstetricians provide, but unlike doctors, we do not perform surgeries or care for high risk people. Doctors are experts in high risk care and surgery, while midwives are the experts in physiological birth for healthy people. Doulas are professional labor support people. Their function is to provide emotional, physical, and information support during pregnancy, birth, and postpartum. They are an extra layer of support that many people find helpful regardless of whether they are working with a midwife. We highly recommend a doula for your first birth, mainly because first-time mothers are more likely to have long labors and more likely to transfer to the hospital during labor so they can get pain relief. The doula can continue to support you at the hospital once you are under the care of the physician.
How many births have you attended?
Our midwife, Kim Pekin, has attended over 500 births at home and in freestanding birth centers. She has also attended over 100 births in the hospital. She has successfully managed complications such as postpartum hemorrhage, shoulder dystocia, unexpected breech birth, and neonatal resuscitation. She is an experienced and trusted midwife with almost 20 years of experience in providing midwifery care. In her work as the Clinical Director and owner of two nationally-accredited freestanding birth centers in Virginia, she supervised the midwifery care of thousands of families.
How many clients do you take each month?
We prefer to keep our practice small so we can deeply focus on building relationships with our clients and attending to their needs, while balancing our personal needs for self care and family time. With this in mind, we generally do not attend more than two births per month. This also reduces the possibility that we will have more than one person in labor at a time. If that were to happen, we have a network of midwives we can call upon to help us. If we are "full" for the month, we can refer you to one of those other wonderful midwives, and they may be able to help you. We know how important it is that every woman have the opportunity to have a midwife assist her with her births, and we will do all we can to connect you with a midwife if we cannot serve you ourselves. There are very few midwives in Wyoming, and we hope to change that by training new midwives to expand our workforce.
Do you attend waterbirths?
Yes! We love waterbirths! We have special fetal dopplers that are waterproof in case you decide you want to give birth in water. Many homes have tubs that will work for waterbirth, but we also have several styles of portable birthing tubs you can rent if that will better suit your needs. The cost to rent a tub varies depending on the model and features.
How much does a homebirth cost?
​Our global fee for home birth is $6500. This includes a $500 non-refundable registration fee when you come into our care. This fee holds your spot on our calendar for the month you are due. Half of the remaining fee is due at 28 weeks and the other half is due at 36 weeks. The global midwifery care fee includes all prenatal care, home birth, baby care, and postpartum visits. It also includes our birth assistant. Medications, lab testing, ultrasounds, portable birthing tub rental (if desired), or services rendered by other providers are not included in our global fee. Fees are not prorated if you receive some of your prenatal care from another provider, and the global fee is non-refundable once you reach 36 weeks. You will receive a detailed financial agreement, including refund policies, if we decide to work together. We do not bill insurance. If you have health insurance, we can provide you with an itemized bill you can submit to attempt reimbursement on your own. Generally, if your plan covers CNM care and home birth, you can expect your insurance company will provide some reimbursement. Billing insurance is a cumbersome process, and after years of battling insurance companies for insurance reimbursement, we made the decision to move to a self-pay model. Every insurance plan is different and we cannot guarantee they will cover any of the cost of your care. However, insurance companies generally will pay for lab testing and ultrasounds, and they should cover care at the hospital should we need to transfer there for any reason.