What is a Midwife?
Midwives are health care professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which results in confident, supported labor and birth. While there are different types of midwives practicing in various settings, all midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns.
Many midwives also provide preconception care and routine well-woman/gyn care.
The Midwifery Model of Care is a fundamentally different approach to pregnancy and childbirth than contemporary obstetrics.
Our model of care includes:
What areas do you serve?
We are currently serving most of Northeastern Ohio, although some limitations apply. Please email us to confirm coverage for your specific area. We are happy to provide referrals to other Midwives if we do not serve your area or if we are full.
What are the benefits of homebirth?
The latest research on planned home birth, released in 2014 by the Midwives Alliance of North America (MANA), found that among 17,000 families:
Better outcomes for babies: 97% of babies were carried to full-term, and weighed an average of eight pounds at birth. Only 1% of babies were transferred to the hospital after birth, most for non-urgent conditions.
Low rates of intervention: Only 4.5% of the 17,000 study participants required oxytocin augmentation and/or epidural analgesia.
This is much lower than average for the United States, where 26% have oxytocin augmentation and 67% have epidurals.
Low rates of cesarean birth: The 2014 MANA study also found that of the 17,000 planned home births, only 5.7% ended up birthing their babies via cesarean. This is compared to the national average of approximately 31% for full-term pregnancies.
High VBAC success rate: For low-risk individuals, the chance of having a vaginal birth after cesarean ranges from 68-87% when birthing outside the hospital.
Other benefits of choosing home birth with midwives:
Individualized care: All decisions about your care are made together with you. We will have thorough conversation about your needs, preferences, and values, your individual health, and the evidence regarding the options available to you. We respect you as the expert of your own body and your baby's primary care provider.
Continuity of care: Your midwife will follow you throughout the course of your prenatal, birth, and postpartum care. At every point in your parenting journey, you will see the familiar, comfortable, friendly face of your very own midwife.
Evidence-based care: We stay current on the research around pregnancy, birth, postpartum, and breastfeeding so that we can provide up-to-date information to assist you in your decision-making.
Your own environment: For many families, the comfort and security of your own home cannot be matched. You choose who attends your birth and who cares for you. You choose what to eat and drink. Walk, dance or sleep uninterrupted - it's your birth!
Incredible postpartum care: From the first minutes of your baby's life to your six week postpartum checkup, Ahava Midwifery provides attentive, personal support and education necessary for your baby's growth.
We help your family bond with your newborn, develop long-lasting breastfeeding or relationships, and heal your body in the postpartum.
Is homebirth safe?
Homebirth is a safe option for pregnant women whose pregnancies are without complications and are full-term at the start of labor. For some babies and parents who are at higher risk for complications, a hospital birth is a safer option.
To learn more about the safety of home birth, check out these studies:
Outcomes of planned homebirth after regulation in British Columbia.
Can I have a waterbirth?
Yes! Waterbirth is a lovely option for those who desire it. Many families choose to have birth tubs for comfort in labor, regardless of whether the family plans to have the baby in or out of the water. About 95% of our mothers choose waterbirth! The birth pool and all waterbirth supplies are included in our Global Midwifery fee.
Can I have a VBAC (Vaginal Birth After Cesarean)?
Most likely. Home VBAC has a high success rate - up to 87% - but there are some additional risks during labor, and some women are better candidates for home VBAC than others. Cesarean birth or other uterine surgeries leave a scar on the uterus, leaving some of the tissue weaker and slightly more prone to separating during labor. This is known as uterine rupture.
The risk of uterine rupture is 0.2% if you have had one prior c-section, wait at least one year for your uterus to heal before becoming pregnant, have a low transverse incision, and your reason for the c-section does not necessitate another - like breech or failed labor induction.
Additional c-sections, infections during healing, smoking, and possible anatomical reasons for c-section (ex: contracted pelvis) can increase your risk of uterine rupture.
Additionally, in order to have a VBAC birth with our practice, your place of labor/birth must be less than 30 minutes from a hospital with Labor and Delivery services.
We can discuss your prior birth experience and desire for VBAC during a free consultation.
Who will attend my birth?
During your labor, you will be with your midwife and anyone you invite to your birth. Our student midwife may be present during your care and birth. I value and respect your desire to know who will be at your birth and strive to make sure you have a chance to meet your entire birth team before labor time.
Can I have friends and family at my birth?
Yes! I truly appreciate the presence of loved ones who bring positive support and their love for you into your birthing space. We will need to meet everyone that you will be inviting to your birth, by 36 weeks gestation.
We can also offer support for setting boundaries when you desire privacy.
What do you do after the baby is born?
While every birth is a little different (depending on if you, your partner, your child, or I catch your baby), at a typical birth I will wait for you to take your baby and bring them onto your stomach or chest, and for about the first fifteen minutes I will keep a close eye on your bleeding and your baby's adjustment to life outside the womb. After the placenta is born and the baby's cord is done pulsing, we ask you if you are ready to cut the cord and who is going to be the one to do it, and we help clamp and cut the cord.
We then make sure you have eaten and are hydrated, vitals are stable and the birthing area has been cleaned. We give you some space for family time, staying close by with an ear out for your needs and checking on you periodically. Whenever your baby is interested in nursing, I offer help with positioning and latch if you would like it.
After a thorough newborn exam and maternal postpartum exam, when your family is feeling comfortable and ready for a nap and I am satisfied that you and baby are healthy and stable, I leave. This will be no less than 3 hours postpartum.
I will then return in about 24 hours for your first postpartum visit. Subsequent visits are at 5 days, 2 weeks and 6 weeks postpartum- with additional visits if needed.
I will perform the Congenital Cardiac Heart Defect Screening, Newborn Metabolic Screening (PKU), other postpartum labs as needed , as well as complete and file the paperwork for the Birth Certificate and Social Security Card.
What equipment do you bring with you to births?
We are trained to carry and use equipment and medications to safely manage normal deliveries at home. The equipment and medicine that we are permitted to carry, varies by which state or country we are practicing in. This will be discussed in depth during the initial interview based on your location.
Some of the equipment we bring includes:
Monitoring equipment for you and your baby, including a fetal doppler, fetoscope, blood pressure cuff, several types of stethoscopes, thermometer, and much more!
Birth pool with sterile liner, hoses, water thermometer, air and water pumps.
Plastic drop cloth for under the birth pool
All disposable birth supplies- you will not need to purchase a birth kit-it is included.
Supplies for the newborn exam and any newborn procedures that you choose, including a scale, neonatal pulse ox monitor, measuring tape, erythromycin ointment, vitamin K.
Antihemorrhagic products to stop excessive postpartum bleeding and aid in placenta birth if needed.
Resuscitation equipment for baby and mother.
Suturing equipment and surgical glue to perform repairs if any tearing occurred, which is very rare in physiologic homebirth.
What happens if something goes wrong?
Midwives are trained to handle many complications at home and to know when a transport to the hospital may be necessary. One of the most common complications we handle at home is excessive bleeding from the uterus immediately after the baby is born, and we carry the same medications used in hospitals to stop the bleeding (when permitted by law), as well as very effective and proven antihemorrhagic herbal remedies.
The second most common complication in a homebirth is a baby who needs some help to take his or her first breaths. Every midwife at your birth is well trained in neonatal resuscitation. Again, in this scenario, we follow the same standards as the hospital.
Our most common reason for transporting a pregnant woman to the hospital happens during a very long labor where the mother nears clinical exhaustion. In this case, the hospital can provide additional measures such as IV Fluids and, an epidural, which are often the best tools to support sleep and enable a safe delivery after a very long labor.
There are of course rare unforeseen complications that can't be predicted even with the best care and monitoring.
Prior to becoming a homebirth client with our practice, we will meet and conduct a thorough risk analysis.
This process will also be completed several times throughout your pregnancy, to ensure that you remain a good candidate for homebirth.
We will also provide you with several extensive informed consent documents. These outline the risks and benefits of birthing at home for low risk women, and common tests and procedures in pregnancy and postpartum.
Do I need to see a doctor for my prenatal care?
In most cases, no unless you would like to. Midwives provide the same clinical components as doctors during prenatal care, such as listening to the baby, testing urine/blood and taking your blood pressure. We get to know you and your health, and address all your questions.
A large portion of our prenatal care is focused on good health and nutrition, as this will prevent many pregnancy, birth and postpartum complications.
While it is not usually necessary to also receive prenatal care with a doctor, some families may feel more comfortable establishing a relationship with an obstetrician in addition to their midwife. There are also some instances when your midwife will request that you consult with a physician, for example in the case of a potential complication.
We have a collaborative agreement with a homebirth supportive OB/GYN. He is available for telehealth consults as needed for second opinions or prescriptions. We also offer telehealth consults with a CNM. These services are included in your Global Midwifery Fee.
What about ultrasounds and lab work?
We provide lab order services: blood tests, urine tests, and infection swabs during regular appointments or in between if any concerns arise. We also provide referrals to medical imaging professionals in order to obtain ultrasounds as needed or desired. We have two trusted ultrasound providers that we have used for nearly 15 years. There are no tests available in obstetric care that we cannot provide you or help you access. Standard OB labs and ultrasounds are included in your Global Midwifery fee.
Does insurance cover midwifery care?
While we do not accept insurance directly at this time, PPO insurance companies will often reimburse for midwifery services at the out-of-network or sometimes the in-network rate. We work with an insurance billing company to help you get the best reimbursement, if you have private or employer provided insurance. Families will pay out of pocket and then seek reimbursement from their insurance company, with the assistance of our biller.
Further details will be outlined in your financial and insurance agreement documents, if you hire our practice.
We also have experience working with Healthshare companies and offer discounts to members of some companies. Please email for details.
Healthsharing companies will typically reimburse you for the majority of our Global Midwifery Fee, less your personal/family yearly responsibility. We are also able to bill some of the Healthshare companies directly without out-of-pocket payment from you. This will be discussed in your interview if applicable.
If you have a FSA or HSA, we can typically accept this directly as payment via the debit card or checks that the account provides you with.
What is the cost and do you offer a payment plan or discounts?
Please contact us for our current Global Midwifery Fee that covers all in-home professional care, labs, ultrasound and additional benefits listed below.
Repeat clients are always offered a generous discount, significantly reducing the Global Midwifery fee.
When you hire our practice, there is a minimum deposit due of $1800. To ensure you have personalized and attentive care, we only accept a very limited number of births per month.
Your deposit places your due date on our calendar and initiates full care with our practice.
Due to our low volume practice and many repeat clients, we are nearly always 100% booked and frequently have to turn interested referred families away. If you think that you may want to use our services, call us as soon as you confirm pregnancy.
We will schedule a no cost consult and together determine if we are the right fit for your family.
After hiring our practice and paying your deposit, the remainder of your Global Midwifery fee is then divided up and paid monthly, at your prenatal appointments, with the total balance due prior to or at the 36 week prenatal appointment.
Alternatively, we offer extended financing through United Medical Credit. Please ask for an application if you are interested in extended financing.
We strive to keep our Global Fee as affordable as possible. Each year we invest in significant continuing education, equipment, government fees, physician collaboration fees, practice overhead and added benefits for our clients. We also pay our students for their work learning within our practice. In order to account for inflation, remain sustainable and offer the highest quality of care, we typically increase our global fee by 10% yearly. In excellent economic times with low inflation, we forgo the 10% yearly increase.
Each client that pays the full Global Midwifery fee is contributing to Ahava Care. Ahava Care is not for homebirth, but provides education, prenatal/postpartum care, and essential supplies to very low-income and homeless families.
With this said, we are sensitive to the financial difficulties many families are currently experiencing. If you believe we are the right practice for your family, and cannot afford our Global Midwifery service, please have an honest conversation with us. If you are a good candidate for our practice and we have an opening for your due date, we will do our best to help find a solution that is mutually beneficial.
-Prenatal appointments are conducted at your home, lasting 30-60 minutes. If your prefer, visits are also currently available in our office. These appointments are scheduled monthly until the 36th week of gestation, after which they occur weekly until the birth. This schedule may be adjusted to meet specific client needs.
- Optional Sneak Peek Fetal Gender Test at 6+ weeks.
- Standard prenatal laboratory panel at 10 weeks or at the commencement of care. Additional labs such as Anemia panels, Thyroid panels and Vitamin panels can be included based on your individual needs.
- Group B Strep (GBS) test.
- Gestational Diabetes (GDM) screening.
- Organic Fresh Test for GDM screening.
- 3rd trimester lab panel at 34-36 weeks gestation.
-RhoGAM if needed.
- Urinalysis as needed.
- One ultrasound in first and third trimester, if desired. This includes early dating ultrasound and 3rd trimester 3D/4D and/or Biophysical Profile. Written physician report is included for diagnostic scans.
- One Anatomy Ultrasound between 18-22 weeks, with written physician report.
-Nutrition and supplement plans.
- Midwife availability “on call” 24/7 for your birth starting from the 37th week.
- All necessary disposable birth supplies and birth kit.
- Birth Pool and water birth supplies, if desired.
- Support from a Primary Midwife and an assistant/student Midwife.
- Comprehensive labor, birth, and immediate postpartum care for both mother and baby.
- Photos of labor and birth, when feasible.
- Postpartum home visits for mother and baby approximately 24 hours, 3-5 days, 2 weeks, and 6 weeks after birth.
- Newborn PKU and CCHD screening.
- Assistance with the filing of the birth certificate and social security card paperwork.
- Lactation support up to 8 weeks postpartum.
- Telehealth consultations at no additional cost with our collaborative homebirth supportive OBGYN, or CNM if necessary. This is typically used if you need a second opinion or prescriptions in pregnancy, labor or postpartum.
- Secure messaging and chart access via your EHR portal.
- Access to hundreds of nutritional supplements for the entire family at wholesale prices- for life!
-Assistance in submitting your health insurance claim for possible reimbursement.
birth@ahavamidwifery.com
Phone: (330) 295-3933
HIPPA Compliant Fax: (888) 518-2224
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