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Frequently Asked Questions
For clarity, the term “home birth” is used as any planned home birth attended by a qualified practitioner.
Q: What is the difference in maternity care between a doctor and a midwife?
A: Short answer, philosophy of care.
Most doctors use the Techno-Medical Model of Care which prevents and treats problems that may arise during pregnancy and labor with extensive use of diagnostic tests, monitoring and interventions. Most midwives use the Midwives Model of Care which treats and prevents problems that may arise during pregnancy and labor “individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support.” The Techno-Medical Model views pregnancy as an abnormal state with delivery of the baby as the cure. The Midwives Model views pregnancy as a normal body function with delivery of the baby as a continuation of this normal process.
Models of Maternity Care
Midwives Model of Care
Q: Is home birth legal in Louisiana?
A: Short answer, yes.
Midwifery became a legally recognized practice in Louisiana in 1985. We are licensed and regulated by the Louisiana State Board of Medical Examiners. The credential held is Licensed Midwife, not to be confused with a Nurse Midwife or any other advanced nurse practitioner. Louisiana midwives have a consistent set of training requirements and practice parameters set by both the legislature and the rules and regulations of the Board. As with other medical modalities, midwives report to the Board annually.
Read the full text of the Statutes, and Rules and Regulations in the following links. This information explains in detail how midwifery in Louisiana is regulated.
Louisiana Revised Statutes, Title XXXVII
Midwifery Rules & Regulations
Q: Is home birth safe in Louisiana?
A: Short answer, mostly.
To answer this question honestly, one needs to understand the standard against which a comparison is made. For example, are we attempting to answer whether the safety of home birth is compared to a birth at a facility (hospital, birth center, or both), or are we attempting to qualify any degree of harm in regard to interventions and morbidity. According to ACOG (American College of Obstetrics and Gynecologists), four standards are used in determining the safety of home birth in the United States,
1) risk status of the woman,
2) access to a qualified provider,
3) access of the provider to medical consultation,
4) ready access to a hospital for transport.
In meeting these four standards, home birth midwives in Louisiana
1) give care only to women who are assessed to be low or normal risk,
2) are qualified providers according to the State of Louisiana,
3) have access to medical consultation,
4) may or may not have ready access to a hospital. As a matter of travel time, rural residents may be 45 minutes or more away from the nearest medical facility.
Read the full text and follow the links provided within the ACOG Committee Opinion on Planned Home Birth.
ACOG – Planned Home Birth
Q: What if there is an emergency?
A: Short answer, it depends.
Most hospital transports are before they become emergencies. When a midwife is advising transport, it is usually a matter of the woman’s risk status falling outside the scope of what is safe for her and/or her baby. For most immediate emergencies, the midwife is trained and regularly practices the skills needed in providing care until transport is achieved.
Q: Do I really have to see a doctor first? A: Short answer, yes.
Actually, it is that midwives are required to have the physician diagnosis of uncomplicated pregnancy prior to taking on the care of a new client. The Louisiana State Board of Medical Examiners, our governing body, has written this specification into our Rules and Regulations as one of the measures, they believe, helps ensure the safety of home birth for you. It was written with the intent that the doctor/patient relationship would already be established in the event the midwife needs to collaborate or transfer care.
Q: What kind of midwifery training and experience does Rebecca Honeycutt have?
A: Short answer, the CPM credential.
There are three main credentials for midwifery that are usually recognized in the US;
- LM (Licensed Midwife),
- CPM (Certified Professional Midwife), and
- CNM (Certified Nurse Midwife).
The midwifery clinical experience component is comparable with all three with the exception of the CNM, which requires an RN (Registered Nurse) degree prior to entry to midwifery training. There is no distinction given to LM and CPM for receiving a formal accredited education or traditional apprenticeship. I was trained in the traditional apprenticeship modality, having to verify all skills learned in a hands on setting to NARM (North American Registry of Midwives), who issues the CPM, and I can give a current CV (curriculum vitae) upon request. Louisiana recognizes the CPM as meeting the criteria for LM. Continued education and experience are required for maintaining these credentials. I received my first license in September, 2018, and am specifically trained as a home birth or out of hospital birth midwife.
Louisiana State Midwifery License, the “LM”
Professional Midwifery Certificate, the “CPM”
Q: How much are midwifery fees?
A: Short answer, competitive.
There are many variables that go into the total midwifery fee including, but not limited to, lab work, supplies for the birth used by the family and midwife, medications used for Rh- mothers and the baby after they are born, any emergency supplies used, and unscheduled time for special needs that may arise. Expect a base fee of around 5,000.00 with some added expenses. Details are covered during the onset of care so that full disclosures are given and consents obtained in order that all parties involved know exactly what to expect concerning finances.
Q: Does insurance pay for home birth?
A: Short answer, rarely.
After deductibles are met, there is usually not much left for insurance to pay. What is available is usually in the form of third party reimbursement, meaning the client pays the fees in full and gets reimbursed by the insurance company after services are rendered. There are always exceptions, but that will depend upon the insurer and the policy.
Q: Does Medicaid cover home birth?
A: Short answer, it depends on the plan.
I am in network with Healthy Blue as a Medicaid provider. All other plans have requirements I do not meet, such as hospital privileges or a contract relationship with an OB who does. Open enrollment to change plans is from October through December. Some of my clients have been able to change their plan outside of open enrollment, others have not.
Healthy Blue pays the midwife only. The supplies and trained assistants will be the responsibility of the birthing family, and will start at a little over 500.00.
Q: What about water birth?
A: Short answer, it’s available.
Louisiana Rules & Regulations governing midwives state that water birth follows the recommendations put forth by ACOG (American College of Obstetricians and Gynecologists). ACOG’s current statement is that immersion in water appears to relieve pain, but there is insufficient data on the safety during birth. ACOG recommends that the mother labor in the water and get out before the birth of her baby unless the birth is being documented for research purposes. I participate in a statistic research project where I report the demographics and outcomes of the women I care for to Midwives Alliance of North America that meet the research criteria set forth by ACOG.
Read the full text and follow the links provided within the ACOG Committee Opinion on Immersion in Water During Labor and Delivery.
ACOG – water birth
Q: How do I get my family members to support my decision to have an out of hospital birth?
A: Short answer, you don’t.
The decision to use midwifery care and have a home birth takes time, consideration, and the path that leads a person to this decision are varied and personal. Whatever influences that affected a woman to go against her social norms for pregnancy care and birthing, she believes that she is doing best for her family. Well meaning family members also believe they are doing the best for her family by expressing their concerns. Even when presented with evidence, beliefs are slow to change. It is suggested to come to an understanding that your beliefs differ and have a mutual respect. If conflict persists, professional conflict resolution may be recommended.
Q: How can I get answers to questions I don’t see here?
A: Short answer, just ask.
There are a few ways to contact me with questions. My email address and phone number are on the Contact page, or you can text directly by using the SMS button at the bottom right of your screen. I look forward to hearing from you.