Frequently Asked Questions

The word midwife comes from Middle English and means “with woman.”  Midwives are the time-honored guardians of healthy pregnancy and childbirth. They provide comprehensive prenatal care and education, guide labor and birth, manage complications, and care for newborns. Many midwives also provide preconception care and routine well-body reproductive (or gynecological) care.

California has two primary types of midwives: Licensed Midwives and Certified Nurse Midwives. Both provide maternity care, but their education, training, and typical practice settings differ.

• Licensed Midwives (LMs) complete a three-year, specialized midwifery education and clinical training program, or the equivalent thereof, and then must pass a national exam administered jointly through the North American Registry of Midwives (NARM) and the Medical Board of California. Their training focuses on providing maternity care in community-based settings (meaning in private homes and birth centers) and encompasses both standard medical management of pregnancy and childbirth, as well as traditional midwifery skills (such as herbal knowledge, hands-on bodywork, and holistic preventive care). They are licensed and regulated by the Medical Board of California and practice autonomously, without physician supervision. Many LMs are also Certified Professional Midwives, which is a credential awarded by NARM that emphasizes competency in community-based maternity care. LMs provide the majority of planned homebirths and birth center births in California.
• Certified Nurse Midwives (CNMs) are advanced practice nurses with a master’s degree in nurse-midwifery. Their training focuses primarily on hospital-based maternity care and rarely includes specific training in community or home birth. CNMs are governed and regulated by the California Board of Registered Nurses. Currently, CNMs are required to work under the supervision of physicians, meaning that most work in hospital settings.

Midwives and doulas play distinct but complementary roles in supporting families throughout pregnancy, birth, and the postpartum period. 

The midwifery model of care recognizes pregnancy and childbirth as normal and natural life processes. This model of care is rooted in the following: 

• A trusting and respectful relationship between midwife and birthing person that is egalitarian and non-authoritarian.
• Nurturing and monitoring the physical, psychological, and social well-being of the birthing person throughout the childbearing cycle.
• Individualized education, counseling, and prenatal care which promotes the birthing person’s well-being, autonomy, and self-determination.
• Therapeutic use of the human presence, including continuous hands-on assistance during labor and birth, as well as lactation and postpartum support.
• Minimizing technological interventions unless necessary for the health and well-being of the birthing person and baby.
• Collaboration and consultation with other health professionals to serve the needs of the birthing person and baby.

With in-home midwifery care, your Licensed Midwife comes to you, bringing the knowledge, equipment, and support needed to provide personalized primary care in the comfort and privacy of your own home.

Home-based midwifery care puts you and your family at the center of the experience, offering a more personal, convenient, and connected approach to care.

Benefits of midwifery care at home include:

• Client-Centered Care— You are at the heart of every decision. Your care is guided by your values, preferences, and needs—not by a one-size-fits-all approach. You remain an active, informed participant in your care, with your midwife serving as a trusted ally throughout your journey.
• Meaningful Family Involvement— Your appointments can naturally include your partner, children, and other loved ones. Family members can participate in ways that feel right for you, while everyday family routines continue with minimal disruption.
• Comfort and Convenience— No driving across town, waiting rooms, or packing everyone up to get out the door. Your midwife comes to you, making it easier to fit appointments into your day and care for your family’s needs along the way.
• A Relaxed, Personal Approach— Receiving care at home creates space for conversations to unfold naturally and for you to feel more at ease. This familiar setting encourages open communication, shared decision-making, and a collaborative relationship in which you feel heard, respected, and supported.
• Truly Personalized Attention— One-on-one, in-home care allows your midwife to get to know you and your family in a deeper, more meaningful way. By understanding your home environment, priorities, and unique circumstances, your midwife can tailor care to better support your individual needs.
• Continuity, Trust, and a More Empowering Experience— A strong, trusting relationship with your midwife is an important foundation for a positive pregnancy and birth experience. Continuity of care allows you to build that relationship over time, fostering confidence, open communication, and a greater sense of partnership. Receiving care in your own home adds another layer of familiarity and comfort, helping you feel supported in an environment where you can relax and feel at ease.

Research shows that homebirth with a professional midwife is a safe option for low-risk pregnancies. Large prospective studies have shown that rates of medical interventions are far lower for homebirths compared to births in hospitals, without any statistically significant increase in negative outcomes.

In the U.S., low-risk birthing persons who planned a homebirth had a cesarean rate of just 5.2%, compared with a 31% cesarean section rate in the hospital. Homebirth is also associated with: dramatically lower rates of induction, episiotomy, infection, and preterm birth; reduced birth trauma; much higher rates of breastfeeding/ chestfeeding; and higher overall birth satisfaction..

You can learn more about the evidence on homebirth safety here or the following studies are a good place to start: 

• Outcomes of planned homebirths with CPMs in North America
• Outcomes of planned homebirth after regulation in British Columbia

These resources offer different perspectives and personal stories to help you explore whether homebirth feels right for you and your family:

• Why Choose Homebirth
• Born at Home
• Why Not Home?

Ultimately, questions of safety and risk are deeply personal. Each pregnant person and family must weigh for themselves the risks of birthing at home against the risks of birthing in-hospital, where unnecessary interventions and timetables, hospital-borne infection, and iatrogenic complications (meaning, caused by medical treatment) present their own dangers. You and your family must decide which set of risks feels safest to you and make the best choice for your situation.

What if there’s an emergency at home?

Licensed Midwives maintain certification in CPR/BLS for Healthcare Providers and in Neonatal Resuscitation (NRP) and are legally licensed to carry all medical equipment and medications necessary to safely manage low-risk deliveries and the most common concerns at home, including: fetal heart monitors (ultrasound Dopplers), oxygen, resuscitation equipment, emergency medications to stop bleeding, herbs, homeopathics, IV supplies, suturing equipment with local anesthetic, and more.

The excellent health of my clients combined with the high quality, preventive care I provide, mean that complications in labor and birth are rare. If a concern begins to develop, it is either addressed skillfully at home or we will discuss the need for transfer to a higher resource setting, as needed. In the case of a transfer of care, I ensure that your hospital provider has all the information needed and accompany you to provide support and guidance. 

Who can give birth at home?

Homebirth is an option for any pregnant person experiencing a healthy, low-risk pregnancy who desires to be supported and give birth outside of the medical setting, with minimal interventions, and who wishes to to take an active role in their health care. More than 80% of pregnant people are low-risk for complications for pregnancy and birth, so most are good candidates for midwifery care and homebirth.

Who is not a good candidate for homebirth?

There are certain conditions that rule out birth at home, as they create increased risks for both the birthing person and baby. These include high blood pressure, certain heart diseases and bleeding disorders, epilepsy, insulin-dependent diabetes, current alcohol abuse or drug addiction, cigarette smoking, uncontrolled asthma, kidney disease, liver disease, and significant mental health issues that might interfere with care.

Does insurance cover midwifery care?

Insurance companies and individual plans vary widely in their maternity care coverage, but many PPO insurance plans cover care with a midwife and birth at home at the out-of-network provider rate. You can contact your insurance provider’s Verification of Benefits department and ask if they cover midwifery services with a Licensed Midwife. I can also refer you to an excellent medical biller who, for a nominal fee, will verify your benefit coverage and help you get the maximum reimbursement.

Can I have a VBAC (Vaginal Birth After Cesarean) at home?

A previous Cesarean section does not automatically rule out having a homebirth. In fact, a VBAC at home is often statistically safer than a repeat C-section. This is evaluated case by case and depends on factors such as the type of surgical incision that was done, the number of previous c-sections, and the length of time between pregnancies. We would schedule a VBAC consultation to review your previous records and surgical report, as well as your pregnancy and health history, and then discuss your best options.

For general information about VBACs, go to:

• International Cesarean Awareness Network (ICAN)
• The VBAC Link
• VBAC Facts

Can I have a waterbirth?

Yes! Laboring in water can be very soothing and help ease the labor process, even if you are not planning on actually giving birth in water. People typically find that giving birth in water:

• Increases relaxation
• Decreases pain
• Increases the ability to move around and change positions
• Provides an increased sense of control
• Increases satisfaction with the birth experience

I have professional grade inflatable birth pools available for my clients to rent. The rental fee includes the pool, a disposable pool liner, air pump, thermometer, debris net, and sump pump. There are some additional supplies you must purchase. You need not clean the pool after birth—the birth team takes care of that for you.

To learn more about waterbirth, check out:

• The Evidence on: Waterbirth