Our clients are looking for something more in their maternity care than what standard obstetrics has to offer. They want to be active participants in the care for themselves and their babies, not silent bystanders in a system that makes all decisions for them. At Midwife Louisiana, LLC, you are informed about your body, your pregnancy, your baby and your options. We make decisions regarding all of these together. Typical midwifery care can look like this:
Louisiana and Arkansas
are unique in that the rules governing midwives require the pregnant person see an obstetrician, or an OB, prior to starting midwifery care. This physician evaluation will document a positive pregnancy test and an initial health assessment. The midwife will then request the records from this appointment to confirm that the pregnancy is low to normal risk pregnancy. Now we are ready to begin midwifery care.
Our initial visit
will be lengthy. Allow at least two to three hours for initial paperwork, time for questions about the OB’s records, a nutritional assessment, a complete physical exam, if desired, information and education pertinent to you and your pregnancy, a well check on you and your baby and time to address your questions and concerns. Family members are encouraged to participate.
Prenatal appointment schedules
follow the same as an OB’s;
- every month until 28 weeks gestation
- every two weeks until 36 weeks gestation
- every week until delivery
Midwifery care offers the same screens, tests, and ultra sounds that you would expect from any healthcare provider. All appointments are in the safety and convenience of your home.
Other prenatal visits will last approximately 30 minutes to an hour, based on your circumstances and needs. They may last longer. You are encouraged to talk. Tell us about the births of your other children. Tell us your hopes for this birth. Tell us your concerns and fears. Tell us what you are learning about pregnancy and home birth. This helps us to be better midwives for you.
In between visits, your midwife is available by text during regular business hours for non urgent questions and concerns.
As for labor,
I have a team. I usually get there first for an assessment. My primary assistant, Lisa, is a student midwife, and with your permission, will be participating in your care under my direct supervision. She is trained in basic emergency skills, and can assist me as many urgent events would require two people to manage efficiently. My secondary assistants, either Jasmin or Ashley (whoever is on call), keeps us both on target for things that are time sensitive and provides accurate charting. All of the assistants are doulas. We mainly stay just outside whatever room you are laboring in until you reach transition and need more help to cope with the exception of checking on the baby every 30 minutes or as needed. Most labors are intimate, with the laboring person and her chosen support. We will discuss all general procedures and your preferences, such as being mobile, eating and drinking, birth positions, water for labor and birth, delayed cord clamping, newborn eye ointment, vitamin K and so much more before you are due. We stay a couple hours after you and baby are stable while maintaining the balance of preserving your precious golden hours. We clean up, make sure you have eaten something delicious and fortifying, and are comfortable before we leave.
Your postpartum care
is very intensive starting with a phone call at around 12 hour after the birth of the baby. There is a postpartum visit the next day to check the well being of you and the baby that includes a congenital heart screen for the baby. and a heal stick test that takes a small blood collection from the baby to screen for 28 metabolic disorders. We are on standby the first week for common postpartum issues like abnormal bleeding and breastfeeding. At one week we check in to make sure you are adjusting to motherhood and troubleshoot any problems. We have a similar well check at two weeks. A four week check is optional, based on your needs.
I file the birth certificate. At your request, I apply for your baby’s social security card. You get a copy of your birth summary, the newborn exam and the well checks the baby receives for your Pediatrician. You have secure online access to all you records and may download them at anytime.
The six week postpartum visit is always bittersweet. It marks the finality of our midwifery relationship. There is usually reflection and feedback to help us know how we can do better as midwives. A PAP smear will be offered, when appropriate.
Basic Midwifery Investment
is 5,000. When payment is received in full by 36 weeks, you receive a 10% discount (4,500.). Depending on your method of payment, their may be other costs.
When You Have Private Insurance
your portion will be determined by your insurance plan. You are responsible for deductibles, co pays and other portions that your plan does not cover. If the amount paid by your insurance company plus your deductible and other portions equal less than 5,000, you are responsible for the remaining balance. I am not an in network provider with any private insurance companies. Therefore, you can expect to have to call your insurance company for preapproval of payment for midwifery services. I will provide a template for the phone call. The template includes a script for asking the insurance company to pay for my services as though I were an in network provider.
As of 2023, insurance companies that provide maternity coverage in Louisiana must pay for midwifery care. However, the wording of the law is Certified Nurse Midwife OR Licensed Midwife. Meaning, if the insurance provider covers nurse midwives, they do not have to cover licensed midwives.
Licensed midwives have historically had a difficult time getting reimbursed by private insurance companies. Its a complex system to navigate. We can look at your benefits and make a decision that works best for you.
When You Have Public Insurance ( Medicaid)
The basic midwifery investment above is all inclusive, meaning it pays for everything. However, Medicaid only pays for midwifery services and prenatal tests and screens. Things not covered by Medicaid are the assistants (around $400), disposable supplies (around $30) and, if desired, waterbirth supplies (around $85).
At this time, Midwife Louisiana, LLC is only in network with Healthy Blue. Open enrollment to change insurance providers is in October through December. If your time of seeking midwifery care falls outside open enrollment, contact me to see how to change your plan to Healthy Blue since your current insurance provider does not cover the care provider you are seeking .
More on Payment and Billing
If you are unable to pay in full by 36 weeks, we can work out an interest free payment plan. If you need addition help, see if Gift Certificates or bartering (trade) are a suitable option for you. Former client have been able to get a portion, and sometimes all, of their services gifted to them through gift certificates. Others have bartered .
You will receive an invoice and receipt according to the terms agreed upon (self pay, insurance, barter). You can make monetary payments online through a link in the invoice, or pay by cash or check.
What other midwifery care questions do you have? Use the SMS button at the bottom right of your screen to text the midwife.