Midwifery Care Arlington + Boston Area Homebirth Services
Home birth is not only a unique experience, but includes a unique relationship. Unlike providers who are only able to see you for 10 minutes at a time, we spend our time prenatally really getting to know each other, information sharing, and fostering trust and respect. This allows us to create the safest and most fulfilling and empowering birth possible. This care continues into the postpartum period to allow an easy transition into life with an infant.
Certified Professional Midwife is an accreditation given by the North American Midwifery Association (NARM). The requirements for receiving the CPM credential include birth support, extensive skills test, and a written exam. NARM requires 20 births as “active participant” and 20 births where you are the “primary” midwife. All such events must be done under supervision of an experienced midwife and must primarily take place in out-of-hospital settings. The skills test includes a practical exam given by a qualified instructor. The written exam is a strenuous six-hour exam covering a vast array of midwifery related topics.
At Birthwise, where I trained, the requirements for graduation included 10 additional “active participant” births to the national requirement, bringing the overall total requirement to 50 births. Our studies and training also emphasized the ability to conduct thorough and conscientious well-woman exams.
The CPM certification is the only midwifery accreditation that requires out-of-hospital experience. We are generally considered to be the experts in normal (non-hospital) healthy birth.
Prenatal midwifery care
Once you chose me as your midwife, we would have our prenatals in your home or in my office. Discussions will focus on optimizing nutrition, methods for maintaining a healthy pregnancy, and any physical or emotional issues that may arise. I assess that your baby is growing healthy with a strong heartbeat using a fetoscope, a measuring tape, and my hands. I make sure you are staying healthy by monitoring your blood pressure and watching for anything concerning.
Prenatals are roughly 60 minutes and are every four weeks until 28 weeks, then every 2 weeks until 36 weeks, then weekly until your baby comes! If you’ve been coming to my office I will do a homevisit at around 36 weeks where you will meet the other midwife who will attend the birth as my assistant. This prenatal is fun and you’re encouraged to invite anyone else who may attend the birth.
I can draw blood work and order ultrasounds. It’s important to me that you have a full understanding of any lab work we do and have an opportunity to ask questions or decline these tests. If the idea of blood draws are concerning to you, I’m happy to find a way to make you as comfortable as possible.
Midwifery care for your home birth
At 37 weeks you are considered term and I go on-call for you. When you think something may be starting, call me! Keeping you comfortable and well rested in early labor is the best way to have a smooth active labor. Once you get into a more “active” pattern with your contractions, the assistant and I will join you in your home. We track vital signs and monitor both you and your baby’s heart rate. We also aim to offer comfort and emotional support to you and additional family members involved. Once the new baby has arrived, we will stay with you for a few hours until everyone in your home feels secure, has been fed, and happily tucked in for a nap. We also make sure to leave the place as clean or cleaner than when we arrived!
In the event that we no longer feel a homebirth is safest, or you request a transfer, I will accompany to the hospital. I will stay with you as a birth support person the whole duration of your labor and birth and will continue to give you postpartum care as soon as you return home from the hospital.
I bring a couple medium sized duffles for my equipment to every birth with the addition of a birth stool if desired. One bag carries an oxygen tank and resuscitation bag for mother and baby. Another holds a doppler for listening to the babies heartbeat, equipment for monitoring the mother’s vital signs, instruments for cutting the cord and suturing. I carry herbs, homeopathy, medication for postpartum bleeding, and local anesthetic. Most of what I bring to a birth is not used but I am trained to use all my equipment and it is important to be prepared for any and all unexpected stages of a birth.
Homebirth is not as messy as people think. In the birth kit that you will order there are two large plastic bags. Once the birth is complete one bag is filled with any garbage and then discarded while the other is reserved for linens to be washed. This is typically the extent of the mess and we as midwives strive to make sure the house is as clean or cleaner than when we arrived.
Anyone you want! One of the wonderful aspects about choosing to give birth at home is that it focuses on the family unit. Anyone you feel comfortable with is welcome to join. When small children are present, we recommend having a designated care taker so that the laboring mom and her partner are able to focus on the birth. Occasionally if a midwife senses that labor progression might benefit from a quiet, uncrowded atmosphere, she will encourage giving the laboring mom some space but it is up to the mother to decide.
This is the first question that most parents ask themselves, and are asked by their friends and family, when considering a home birth. Midwives are the experts in healthy pregnancy and birth. During the prenatal period the midwife conducts regular assessments making sure their clients are fit home birth candidates. In labor, midwives are trained to watch for complications long before anything becomes a true emergency. They are also trained to deal with complications such as postpartum hemorrhage, stalled and long labors, as well as neonatal resuscitation. However, if a true emergency occurs we will not hesitate to call 911 or take the woman straight to the nearest hospital. There is almost always time to get to a hospital. In the event of any transfers, emergent or non-emergent, the midwife will go with you to the hospital.
For more information on the safety of home birth, please visit the resources page.
Midwifery care postpartum
After your baby is born, my care doesn’t stop! I come by frequently to make sure you and baby are adjusting well to each other and recovering from the birth.I will return the day after the birth, sometime between 3-5 days after that, at one week, then at the two week mark and finally at six weeks. In these visits I’ll be assessing you and your babies health and wellbeing, monitoring babies weight, and helping you with any breastfeeding challenges. During this last appointment I can also provide a well woman exam for you, including a pap smear.