Christina Winton, CPM, LM, LLM
Frequently Asked Questions: Midwifery and Homebirth
Most people have a question or two not covered here. Feel free to call, text, or email any questions, comments, or concerns so we can help you sort it out.
How do I Know If I'm a Good Candidate for a Homebirth?
If you are a normal, healthy woman with a low-risk pregnancy; if you want to be engaged in all aspects of your pregnancy care & ultimately make the decisions that are informed and right for you, then you are a good candidate for a homebirth! Your midwives are there to support you with information and resources, but its up to you nourish yourself , research each decision, and find the path that’s right for you. This is your body, your birth, your baby. I believe there’s no place like home.
What equipment do you bring with you to a birth?
I bring a doppler for monitoring the fetal heartbeat during labor, equipment for monitoring maternal vitals, herbs, homeopathies, and various other supplies and equipment. I also carry oxygen and resuscitation equipment, I also offer birth chairs, and waterbirth tubs.
How much does it cost to use your services?
The global fee for my services is $5500. Flexible payment plans are offered to all clients, with the total fee due by 36 weeks. I never want issues regarding money and payment to interfere with our care-giving relationship. My work as a midwife is much more than a job, and the reality is that my fees allow me to be available and accessible to you throughout your entire pregnancy. I realize meeting the expenses will take planning for most families, and I am committed to working together to develop a clear and suitable payment plan at the beginning of your time in my care. I am a small independent practice and take a limited number of clients per month to ensure that I will be present for your birth! All clients are required to make a minimum $500 deposit by their first prenatal visit to ensure their place in our calendar unless other arrangements are made and agreed to.
I do ask that even if you are looking for insurance reimbursement that your fee is paid by 36 weeks. Napier Midwifery Billing is whom I refer clients to for help with insurance billing.
Discounts are often available for families that are eligible for Medicaid, and bartering may be part of that plan. In addition, I offer discounts for payments in full prior to 20 weeks and for repeat clients.
Do you accept insurance? Do you accept Medicaid?
The short answer is yes and no.
While I am not an in network provider with any insurance carrier, I do work with a billing service for insurance billing for those clients whose plan covers homebirth with an out of network provider. When we are filing a claim for insurance reimbursement, the global fee of $5500 is still due in full by 36 weeks. I cannot bill the global fee until after your birth.
As yet, Arkansas Medicaid does not reimburse for homebirth services.
For families with a Healthcare Sharing Plan, I can provide an invoice at the conclusion of care which the client submits. In most cases, healthcare sharing plans cover all of the fee for our services. If you are not currently pregnant you may want to consider signing up with a Health Sharing Plan. Examples are:
I don't have insurance, or my insurance plan doesn't cover homebirth. How can I pay for my homebirth? Do you offer a sliding scale fee?
I happily work with self-pay clients to find a way to pay for their care. As a small independent practice, I have a limited number of spaces each year for discounted fees. I strongly believe that finances should not be a barrier to having the birth you want. I can tailor payment plans to your budget and are open to barter arrangements*.
I accept cash, check, PayPal, & Venmo. There is a 3% fee for PayPal fees.
When bartering, there is no discounted fee, our barter arrangements are for the full fee of $5500.
I'd like to transfer care, but I am already late in my pregnancy; do you offer a discount?
Often, later in pregnancy, women decide that the route of care they had initially chosen is not going to lead to a natural, woman & family centered birth. I assess each woman individually. Assuming that yours is a low-risk pregnancy, and that there is adequate time for preparation, I will certainly consider accepting you as a client. I do offer a small discount when transferring care at or after 34 weeks, a $500 discount off the full fee of $5500 if you provide complete records of your current pregnancy. *No other discounts can be applied when transferring late to care.
Do I need to have an ultrasound?
Ultrasound can be a useful tool but is not routinely necessary in a healthy pregnancy. Some reasons an ultrasound may be recommended include uncertain dates, vaginal bleeding, possibility of twins, abdominal pain, decreased fetal movement, or if you have previously had a cesarean. Many clients planning a homebirth do decide to have a 20-week fetal anatomy scan done.
What about Doulas?
I welcome and encourage clients who want the extra support to find a doula, doulas can provide an extra layer of care, emotionally and physically, for the laboring mother, and can be a great addition to a birth team.
I Want my Children to be at the Birth. How Involved Can Our Family Be?
The short answer is that your family can be as involved as feels right to you! I enjoy having children present for prenatal visits and births. I think it's important for the whole family to have an opportunity to be a part of welcoming the newborn. I do recommend that you have someone just for your child(ren) who can be completely present and responsive to their needs and questions. Of course, it should be someone you are all comfortable with. There are wonderful books and materials for preparing children for the sights and sounds of labor and birth. Children are not yet socialized to fear birth, and whether they sleep through the night and wake to find a new sibling, or actively take part in welcoming the new baby, homebirth takes place within the natural rhythm of the family.
Isn't Birth Messy?
The mess is a universal question, but the truth is that there is rarely a big mess. Families are often surprised (and relieved) to find that the midwives have left their homes as tidy as they were before the birth, and sometimes even tidier!
What do You Think About Waterbirth?
I love waterbirth! Warm water in labor can make an amazing difference for many women, and there’s some evidence that water can make a smoother transition for baby. I offer waterbirth tub rentals for a nominal cost. Another option is to purchase a personal birth tub, and I am happy to refer you to websites for that.
What is Informed Choice?
As a family choosing homebirth and midwifery care, you will need to make a number of choices and decisions during your pregnancy, labor and birth, as well as for your baby. I strive to equip you with the information you need to make informed choices. I firmly believe that making informed choices involves weighing the benefits and risks of any decision or course of action while taking into account your intuition, personal experience, individual circumstances, advice and opinions of trusted sources, and evidence-based practice.
What if there’s an emergency or a need to transfer into the hospital?
The consensus is that midwives are experts in normal pregnancy and birth. In order to be a good candidate for a homebirth, you must have an uncomplicated pregnancy and be in good overall health. Throughout your prenatal care we work as a team to keep you in optimal health. If, despite our best efforts, complications do arise, a transfer of care plan is in place and we will work with you to find a provider who can continue your care. If, for health reasons, I need to transfer you out of my care during your pregnancy, I will be available to provide support through the remainder of your pregnancy, birth, and postpartum if that is what you desire. If a transfer of care is needed during labor, I will make the necessary arrangements and accompany you to the hospital where we will remain as labor support for the birth & immediate postpartum period.
A homebirth is not our goal; our primary goal is a healthy mother and healthy baby. Thankfully, most planned homebirths, do happen at home! I come to births well-equipped to handle the rare unforeseen emergency, I carry emergency equipment, my second/assistant and we are trained and certified in Neonatal Resuscitation and CPR.