What is the safety of out-of-hospital birth?

+ In 2014, the Journal of Midwifery and Women’s Health published research on the outcomes of 16,924 planned homebirths occurring between 2004-2009. This information was gathered by the Midwives Alliance of North America (MANA) Statistics Project and was used to examine the categories of complications experienced during planned home births, as well as the rates of morbidity and mortality among both infants and parents. The findings of the study revealed that:

• Among the 16,924 planned homebirths at the onset of labor, 89.1% gave birth at home

• The majority of intrapartum transfers were due to failure to progress

• 4.5% of individuals required Pitocin augmentation and/or epidural analgesia

• 1,054 individuals attempted a vaginal birth after cesarean (VBAC), 87% were successful

• Low APGAR scores (<7) occurring in 1.5% of neonates

• Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent

• Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000

• Breast/chestfeeding rates of 95% at 6 weeks postpartum

• Low cesarean-section rates of 5.2%

Overall, low-risk people in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.

Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D., & Vedam, S. (2014). Outcomes of care for 16,924 planned home births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery & Women’s Health, 59(1), 17–27. https://doi.org/10.1111/jmwh.12172

+ In Oregon, birth certificate data and vital record statistics evaluates the outcomes for planned community births by provider type, including unassisted births and births that involved a hospital transfer. Since being the only state that collects this information, we want to share it with birthing families to support decision-making.

Perinatal Mortality Rate per 1,000 Births of Community Births and Hospital Births in Oregon

(2012-2020)

• Hospital Births - 1.4 deaths per 1,000

• Licensed Midwives - 1.63 deaths per 1,000

• Traditional Midwives - 6.91 deaths per 1,000

• Unassisted Births - 11.52 deaths per 1,000

Oregon Center for Health Statistics (2022). Oregon Vital Statistics Annual Reports. 2012-2020 Tables 2-38, 7-19, 7-20

What happens if there is an emergency?

Birth doesn’t always go smoothly, and sometimes there are complications or emergencies that must be navigated. Being a licensed midwife, we are highly trained and skilled at identifying when a labor + delivery is normal, and when it is not. We remain up to date with evidence-based practice, attend workshops, and complete yearly continuing education units (CEU’s) to renew our license. We also carry a large amount of similar equipment that you may see in a hospital-setting, including:

• IV fluids

• Medications, including antibiotics and anti-hemorrhagics

• Oxygen

• Suturing supplies

• Resuscitation equipment for both the birthing parent and baby

We run practice-drills and routinely train with our equipment to ensure that any emergency in a home-setting is handled safely and smoothly. We attend peer-review with other midwives in a de-identified, confidential review of cases; It’s meant to provide the midwife with feedback, suggestions, and guidance, as well as accountability and continuing education.

Am I a low-risk candidate for homebirth?

We are committed to collaborating closely with you, striving to support your well-being throughout pregnancy and assist you in your desired birthing experience. However, specific pre-existing or pregnancy-related conditions might render an individual ineligible for homebirth. The most common of these include:

• Multiples

• Diabetes (Type I or II) currently requiring medication or insulin

• Previous classical T-incision during cesarean section

• Gestational Hypertension/Preeclampsia

• Active drug or alcohol use throughout pregnancy

• Other conditions that may impact the safety of an out-of-hospital birth

What Does the Investment for Homebirth Cost?

Our intention is to provide clarity regarding the expenses associated with our services, enabling families to make informed evaluations about the alignment of their individual budgets with midwifery costs.

Your investment for Global Maternity Care refers to routine maternity care including prenatal care, delivery and routine postpartum care is $6,000 total.

• $500 non-refundable deposit due at booking

• Remaining $5,500 due by 36 weeks gestation.

  • $300 discount for those who pay in full by 30 weeks gestation

Fees not included: Lab work, ultrasounds, any referred services, and birth kit. These items are separate from the Global Maternity Care fee. Additional fee for birth tub purchase.

Do You Accept Insurance?

Whether or not the insurance company decides to pay for services is strictly up to each individual plan. While we are not in network with any specific insurance companies, we do accept insurance and use an experienced billing company to file claims. Typically, labwork and ultrasounds can be billed through insurance. Clients will be given options for reduced-cost labs in the area, including Ulta Labs and Cash Clinical.

To run a verification of benefits (VOB), please contact Alisha at Earthside Billing for all of your insurance reimbursement questions.