FAQ

A Midwife is a trained birth professional who provides comprehensive care during the prenatal, birth and postpartum periods. Midwives are experts of normal natural childbirth.  There are many paths for midwives to gain education and training, including: traditional apprenticeship, nurse-midwifery training, national or state certification and state licensure.

A doula provides important physical and emotional support, as well as advocacy for laboring women in all birth settings. Doulas are a voice for the birthing mother and the guardian of her birth plan. The skill of a midwife and continuous support of a doula is a powerful collaboration that all women deserve.

Conventional approaches to obstetric care treat all births like a medical emergency that requires management. Choosing a midwife means a desire for a holistic and natural approach to birth — every woman should meet with at least once with a midwife during her pregnancy, even if she chooses to use an OB. All recommended testing would be the same — e.g., an ultrasound would be done at an outpatient referral site, just as with an OB. The needs and desires of the pregnant and laboring woman are the dominant focus in midwifery care. The normalcy of birth is respected and interventions are avoided.

• Prenatal visits with midwives are longer. Each midwife-mother relationship is completely individual and tailored to the new mother’s needs. Regular 30-minute prenatal visits focus on providing information and answering questions that a woman may have about pregnancy, childbirth and parenting. Other family members and partners are invited to attend, so they can also learn and support the new mother.
• Midwives provide active and consistent post-natal care. A midwife will talk with a new mother 24 hours after childbirth, then at 2 days, 10 days, 3 weeks, 6 weeks. This is a more frequent follow up schedule than with most pediatricians or OBs.
• Experience childbirth in a home-like setting. Many women do not feel comfortable giving birth at home, or amid the noise and technology of an institutional setting, like a hospital.

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Yes. Birth centers decrease the risk of cesarean section, episiotomies, infection and babies requiring resuscitation. Midwifery is completely focused on providing wraparound maternal health services, information and choices in a women-focused model of care.  Childbirth is a natural experience and midwives are trained to do everything possible for the safety of mother and baby. Specifically:

• Only women with low-risk pregnancies are eligible to give birth at the Marin Family Birth Center. Your midwife will review your health and any risks in her first meeting with you. (Risk factors can include high blood pressure or vaginal delivery after cesarean.)
• Many adjustments during childbirth are normal and can be managed without medical intervention. For example, one in six births involved the umbilical cord wrapped around the baby in some way. A midwife would gently remove it before it creates any danger.
• If something caused a concern, we would transport immediately to the nearest hospital facility. Often this can be done by car (which is more comfortable to the mother), but would be done in an ambulance if necessary. Marin General Hospital is the only county hospital with labor and delivery, and we have a transport agreement with them. Reasons to transport might include a drop or increase in the mother’s blood pressure, or an irregular fetal heartbeat.

Birth center deliveries are lower cost than hospital deliveries, and are usually as safe. A delivery at the Marin Family Birth Center costs approximately $8,000. We accept Medi-Cal, most private insurance, and offer flexible payment arrangements. For families with an out-of-pocket expense, a $250 deposit must be made to schedule a delivery at the birth center. Average costs for hospital deliveries are $9,000 to $12,000 for vaginal, and $15,000 to $25,000 for cesarean.

While a birth center cannot do a cesarean delivery, 90% of women do not need C-sections. Two-thirds of C-sections in the U.S. are for first time mothers, generally the lowest risk group. Read more about C-sections here.

For centuries midwives and birth attendants have used relaxation and comfort techniques to help provide women with pain relief. Gentle physical and emotional support are vital. Mothers cope with labor best when they are offered loving words, massage, warm baths, breathing techniques, visualizations and are encouraged to move when and how they feel most comfortable. Additionally, midwifery clients are reminded that the pain of labor is indeed manageable and an essential part of the hormonal exchange between mother and baby.

No, but pain management can be better in an out-of-hospital birth because of the flexibility for a woman to move freely and be in the position most comfortable to her. Gravity helps — laying on a bed can increase pain and length of labor, but at a birth center women are encouraged to walk, stand, sit or have a water birth if they choose. Instances of episiotomy are also dramatically less with midwives.

Women usually want to go home within four hours after delivery. By then the baby has had a well-child exam and the mom has had lactation support: the baby is healthy, eating and ready to sleep. The childbirth experience in a birth center can feel much more natural with quicker recovery.

Our midwives do 24- and 72-hour checkups with new moms. At these very personal visits, they can often see early signs of any difficulty nursing or post-partum depression.

Of the more than 2,000 certified midwives in the U.S., the Midwives Alliance of North America (MANA) offers this information on the 3 types of midwifery credentials:

• Certified Professional Midwives (CPM)
• Certified Nurse-Midwives (CNM) and
• Certified Midwives (CM).

The vast majority of direct-entry midwives in the U.S. are CPMs, who are seen as specialists in birth outside of the hospital, particularly in private homes and at freestanding birth centers. They are the only U.S. birth attendant whose education and clinical training focuses specifically and exclusively on out-of-hospital birth settings. Our CEO and the Director of our Marin Family Birth Center are CPMs and also Licensed Midwives (LMs) in California.

Certified Nurse-Midwives are dually trained in midwifery and nursing. Their training is hospital-based since the vast majority of CNMs practice in that setting. Certified Midwives have similar training to CNMs, conform to the same standards as CNMs, but are not required to have the nursing component. Most CNMs practice in clinics and hospitals, and can practice in any birth setting.

OBs receive extensive medical training, most of which is focused on surgery.
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Midwives receive extensive medical and nutrition training, to guide a woman and child through childbirth safely. OBs also receive extensive medical training, most of which is focused on surgery.

To become a California Licensed Midwife, candidates must complete a three-year post-secondary education program in an accredited midwifery school approved by the state board. These schools usually are accredited by the Midwifery Education and Accreditation Council (MEAC), whose accreditation mirrors that of the U.S. Department of Education (DOE) requirements, and satisfies Medical Board of California criteria. Upon completion of educational requirements, including clinical experience evaluation, the candidate also must successfully complete the comprehensive licensing examination administered by the North American Registry of Midwives (NARM).

• Medical Board of California
• North American Registry of Midwives
• Midwives Alliance of North America
• Midwifery Education Accreditation Council