Home birth questions, answered

Both are trained midwives, but their training prepares them for different settings. A Certified Professional Midwife (CPM) is certified by the North American Registry of Midwives and trained specifically for the unique demands of birth at home. A Certified Nurse-Midwife (CNM) is a registered nurse with a degree in midwifery, and most CNMs train and practice in hospitals.

A CPM's home birth focus shapes the care you get:

• Hands-on experience at home births. Out-of-hospital births are a required part of CPM training, so home is familiar ground, not an exception.
• Expertise in unmedicated, physiologic birth. Supporting labor with movement, position, water, and patience rather than routine interventions.
• Prepared for the unexpected away from a hospital. Watching closely for early signs of trouble, handling emergencies with the oxygen, newborn resuscitation equipment, and bleeding medications I bring, and arranging a calm transfer when a hospital is the safer place.
• Care that comes to you. Prenatal and postpartum visits in your home, with the same midwife from your first visit to your six-week checkup.

Kentucky licenses CPMs as Licensed Certified Professional Midwives (LCPMs). I'm an LCPM, licensed in both Kentucky and Tennessee.

A Certified Professional Midwife (CPM) is a medical professional trained for routine care of mother and baby during pregnancy, labor and delivery, and postpartum. A doula is a non-medical support person who offers emotional, physical, and informational support.

Yes. I'm a Licensed Certified Professional Midwife (LCPM) in Kentucky and a licensed midwife in Tennessee. I'm also certified as a Certified Professional Midwife (CPM) through the North American Registry of Midwives.

Yes. Kentucky passed a law in 2019 creating the Licensed Certified Professional Midwife (LCPM) license, so Certified Professional Midwives can legally attend home births in the state. I'm an LCPM licensed by the Kentucky Board of Nursing, and I'm also a licensed midwife in Tennessee.

These are good questions to bring to any consultation:

• Are you licensed, and in which states?
• How many births have you attended, and in what settings?
• Which hospital do you transfer to, and how often do transfers happen?
• What emergency equipment and medications do you bring?
• Who attends with you, and who covers if you're unavailable?
• What's included in your fee, and what isn't?

I'm glad to answer all of these at your free consultation.

For a healthy pregnancy, planned home birth with a trained midwife is a great choice, and midwives' outcomes show it. In a national study of nearly 17,000 planned home births attended by midwives (MANA Stats, 2014), about 94% of mothers had a vaginal birth, and 98% of babies were breastfeeding at six weeks. Home birth also brings real benefits for you and your family:

• Room for birth to unfold. Labor is supported to progress on its own, without routine medical interventions.
• Labor in your own space. Move, eat, rest, and use water as you like, surrounded by the people you choose.
• No car ride in labor. Your midwife comes to you, so you can settle in and let labor unfold.
• Uninterrupted time with your baby. Skin to skin, the first feeding, and the first hours together, without separation.
• A midwife who already knows you. The person at your birth is the same one you've seen all pregnancy.

We screen for risk at every visit, and if anything changes we talk it through together and adjust the plan.

Most transfers are calm and non-urgent, such as a long labor or a wish for pain medication. I come with you, bring your records, and stay as your support. Your birth plan includes your nearest hospital and the route there.

• Equipment for checking maternal vitals
• Doppler and fetoscope for listening to baby
• Oxygen and newborn resuscitation equipment
• IVs and medications to manage bleeding, as permitted under my license
• Suturing supplies and newborn exam tools

As early as you can, ideally in the first trimester. I take a limited number of families each month, and I don't accept new clients after 28 weeks.

I attend births in Louisville, Jefferson County, and surrounding counties, including Bullitt (Shepherdsville), Henry (New Castle), Nelson (Bardstown), Oldham (La Grange), Shelby (Shelbyville), Spencer (Taylorsville), and Trimble (Bedford) counties. If you're not sure whether you're in range, just ask.

My well woman care is perinatal, meaning it covers pregnancy and the postpartum period. Perinatal visits are open to all families, whether you're planning a home birth or birthing in a hospital or birth center. If you're not birthing at home, these visits let you receive some of your care at home. For annual exams and care outside of pregnancy, I can refer you to a trusted local provider.

When labor starts, call or text me and we'll talk through how things are going. I come to you in active labor with a trained birth assistant. While you labor, I listen to your baby's heartbeat regularly and check on you, and you're free to move, eat, drink, rest, and use the birth pool.

After your baby is born, we stay for a couple of hours to watch your recovery, help with the first feeding, do a full newborn exam, and tidy up, so you can rest in your own bed.

Yes. Use of a birth pool is included in my home birth package when one is available. The Water Birth Supply Kit is not included and is sold separately in my shop. Many families find that warm water eases pain and helps them relax, whether they labor in the pool or give birth in it. I keep watching you and your baby closely the whole time, and if anything calls for it, we move out of the water.

Your home birth package includes use of a birth pool and most birth supplies. At your 36-week home visit we'll walk through your space and your personal supply list, and you'll receive a Home Birth Supply Kit. Most families also gather a few things from home:

• Towels and washcloths
• Trash bags and a laundry basket
• Snacks and drinks for labor

Yes. You decide who is present. Many families have older children nearby with a dedicated helper.

Doulas are welcome and encouraged, especially for first-time moms. A doula gives you constant physical and emotional support, so I can focus fully on caring for you and your baby.

There may be moments during labor or birth when I ask some attendees to step away for a little while, for the comfort and safety of you and your baby. It's usually brief, and I'll welcome everyone back as soon as it makes sense.

We usually stay 1 to 2 hours after birth to make sure you and your baby are recovering well. We tidy up, help you settle in, get breastfeeding started, and go over your postpartum instructions and questions.

My postpartum visits come at 24 hours, 3 days, 1 week, and 6 weeks, with the early visits in your home. For you, I check bleeding, healing, blood pressure, and how you're sleeping and feeling emotionally. For your baby, I check weight and feeding, do the newborn screenings, and help with latch and breastfeeding. Every visit has time for your questions.

My home birth package is $5,000 and covers prenatal, birth, and postpartum care, plus a birth assistant, use of a birth pool, and most supplies. A $500 deposit holds your spot. Many families find it comparable to their out-of-pocket costs for a hospital birth.

Some insurance plans may cover part of home birth care, but I don't currently accept insurance or Medicaid. Some plans will reimburse you for home birth services, and I can give you an itemized receipt to submit. I do accept HSA and FSA payments. Payment plans are available, with the balance due by 36 weeks.

All prenatal, birth, and postpartum care listed on the Services page, a prenatal physical exam, standard labs, a trained birth assistant, use of a birth pool for water birth, most birth supplies, on-call time from 37 weeks, and text and phone access to me. Special labs and ultrasounds are billed separately.