FORMS

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Question:

Is using a Certified Nurse Midwife safe?

Answer:

Yes! Certified Nurse Midwives are experts in women's health and focus on caring for you in the safest way possible. We know normal and variations from normal. We know when labor intervention is necessary and unnecessary. We know supporting you in an environment which is best for you is also best for your baby.  We hold space for you in professional and courteous way that allows you your best outcome. We prepare for and practice emergency drills regularly as well as keep up certifications in CPR, ALS, NRP and more than required continuing education.

Question:

What if I need an episiotomy?

Answer:

We know how to perform episiotomy but we never need to do it! We choose to let your body do it's best work without intervening unless there is a true emergency.

Question:

Is it worth having a Midwife? What is the cost?

Answer

Yes! Certified Nurse Midwives have lower rates of Cesarean Section as compared to their physician colleges. Research shows repeatedly that labor support from a Midwife yields shorter labors and lower Cesarean Section Rates. The recovery from Vaginal Birth vs. Cesarean Birth is smoother and faster.  Typical OB practices run like a factory with long office wait times and short visits which last 10 minutes, they make their income by seeing and delivering as many patients as possible. Our approach is different, we want to get to know you and allow you to enjoy your journey of pregnancy and birth in an unhurried and well informed way. The investment in Certified Nurse Midwife Care for pregnancy, home birth and postpartum care is only $8,000.00.  Many hospital bills are well over $35,000.00 with charges from multiple physicians and specialists potentially making the costs higher. 

Question: Is my health insurance going to pay for this?

Answer: We are a concierge practice and we are out of network with every insurance company.  Our billing is only a courtesy service. We require complete payment upfront for your pregnancy, labor and birth or pregnancy or labor or birth.  You may be eligible to be reimbursed for your care by your health insurance company, however, they may not reimburse anything at all and you are responsible for all of the costs incurred. We are out of network for all insurances. We do not accept Medicaid, we have provided services for Medicaid clients and they have never (no, not ever) paid for the services rendered. Our billing expert Melinda Doyle can answer to your questions. Please visit her website www.doylebilling.com and click the green button which says Check My Insurance. There is a small charge of $20.00 to verify your benefits with Doyle Billing which you will be required to pay. Please again understand we are a concierge practice and we are not in network with any insurance company. 

Question: I don't have medical insurance, how can I pay for care?

Answer: People often want care of a Midwife but they don't know how to pay for it. We know these services and valuable. We accept payment from family members, checks and credit and will develop a payment plan if needed. Please note ALL payments should be complete before 34 weeks. Most babies are born between 37 and 41 weeks. We require you to arrange for complete payment by 34 weeks. We limit the number of clients we accept monthly. In order to guarantee service you must pay to reserve your spot on our monthly roster. If you choose to move on to another person for care we may not reimburse you. We may give partial refunds if your care has to be turned over. We do expect that our time will be reimbursed. We reserve the time for you in our monthly birth schedule! 

Question: What about the birth certificate and social security number?

Answer:  We file the birth certificate with the state of Florida and with this you may request a social security number for your baby. To order a birth certificate for your baby go to www.floridahealth.gov you will be sent to vitalcheck.com from the states website if you order online. 

Question: Are there any state laws about home birth insurance coverage?

Answer: Yes, Florida Statute Number 627.6574, (see section 7)

Any group, blanket, or franchise policy of health insurance that  provides coverage for maternity care must also cover the services of  certified nurse-midwives and midwives licensed pursuant to chapter 4.

Why Home?

• You choose who is present at your birth.
• You choose how to birth, in any position, including in the water if that appeals to you.
• Your birth team comes to you when you are laboring with supplies and birth equipment.  
• Your birth team does the driving so you can relax into labor.
• You choose who is present at birth. Only those you welcome are present. 
• You use your own clean linens, towels, clothes and pillows.  
• We promote bonding with skin to skin contact and help with breastfeeding by keeping the baby and mom together.
• The midwives start the laundry after the birth. 
• During the birth you can eat and drink as you please. 
• After the birth you eat, drink, nurse shower and your baby is examined at home. 
• After a few hours the birth team finishes cleaning up and they leave you and your family tucked into your very own bed.
• The midwives follow up with you postpartum in your home.

Question:

Do I need a childbirth or lactation class? 

Answer:

Yes, if this is your first attempt for an unmedicated birth or first attempt at breastfeeding. Would you run a marathon without preparing? No way! Since pregnancy, labor and childbirth are one of the most important events of your life you should really prepare for it! Read until you feel informed. Learn until you feel like an expert. Spread the word when you've gained the knowledge!

Question:

Do you provide water birth services? 

Answer:

Yes! We love hydrotherapy and love to help you getting what you want! Water Birth is pretty cool to watch and experience first hand. If it feels right for you then its right for us! We have many, many years of experience with water birth. We do have a tub to share with you. You will have to purchase of a special disposable tub liner.

Working with Miami CNMs is personalized and unhurried. We strive to see every patient on time. Our prenatal care adheres to standard timing of visits but we are flexible.

We believe that pregnancy is a normal life process and that your body was made to create, grow, deliver and nourish your baby. We want to help you in this process. It is our responsibility to continuously evaluate your health and the health of your baby. This evaluation is by both you as the mother and by us as the Midwives.

Here is how we work with our clients….

We provide regular prenatal care on a routine basis. Routine prenatal care begins for most at 10 weeks. 

The usual schedule for prenatal visits is:

· Initial visit 10-12 weeks 

· Prenatal visit every 4-5 weeks from 12 weeks through 32 weeks.

· Prenatal visit every 2 weeks from 32-36 weeks

· Prenatal visit weekly from 36 weeks until delivery.

· Home visit 35-37 weeks.

· From 40 weeks through 42 weeks we will order special testing to watch the wellness of your baby. Induction of labor can be at 41 weeks but this is a topic for more in depth discussion.

· Postpartum visit 1-3 days after delivery in your home.

· Postpartum visit 6 weeks after birth.

· Laboratory Studies are as per standard of care and usually conducted at weeks 10, 15-20, 24-28 and 36 weeks.

We refer you for testing that we don’t offer. We do not provide in office labs or ultrasound. We refer to radiology facilities which have board certified radiologists in their office.

Our Certified Nurse Midwives have prescription writing authority.

We are available for our clients to ask questions 24/7 we ask that you try to keep your interactions to normal business hours when it’s a non-urgent situation. We define urgent as labor, preterm labor, bleeding at anytime in pregnancy, contractions, vomiting, diarrhea, leakage of fluid from the vagina (clear, brown, bloody, green, yellow) which could be a sign of preterm or full term labor. If you have questions about your dietary choices, vitamins, exercise routines, birth plans, doulas or anything which is non-urgent we ask that you write down your questions and we will happily discuss it at your visit.

Occasionally we are called to more than one home birth at a time. When this happens we rely on the other midwives in the community and we also help out other midwives in the community when they are overstretched. We do our best to avoid this situation by accepting a very limited number of clients each month. Additionally, we are human and things can happen such as illness, injury or emergencies, in this case we will ask for help from another midwife.

It is important to consider that based on your individual risk status, distance, patient load and timing we may not be able to serve you. 

We work with an OBGYN Dr. Spence to provide home birth services as a formal relationship is required by the state of FL.  We are friendly with many other LMs, CPMs, birth centers and OB/GYN groups.

We and kindly ask you to request your own medical records when you have decided to transfer care and as soon as possible. Once your records are complete please fax them to us at 786-373-1885.

Our Midwife takes off some part of summer so please discuss this with her, if possible, plan your pregnancy accordingly.

You will need some supplies for your home birth. Please click this link below to order your birth kit.

Additionally, you will need 5-8 towels in darker colors or older towels for after the shower or water birth and 5-8 cotton newborn receiving blankets (not muslin). You will need to place a waterproof cover on your bed to save your mattress if your water breaks!