Frequently Asked Questions

It is fantastic that you are considering a home birth, but sometimes there are questions.  Here are some commonly asked questions that can give you a little more information.

Basic Midwifery Care:

1.     When should I start prenatal care? 

You can start your care whenever you feel ready to start care.  I always encourage people to start care when they begin thinking about having a baby.  There are so many things you can do to help encourage a healthy pregnancy prior to a positive pregnancy test.  If you are already pregnant, the sooner the better.  Boosting your health and helping to combat possible pregnancy discomforts will help you gain knowledge, confidence, and a great respect for your body and all it is doing to help your baby grow.

2.     How often will I visit with my midwife?

You will see your midwife every month at the beginning, from your first visit until 28 weeks.  After 28 weeks you will see your midwife every two weeks until 36 weeks.  After 36 weeks, you will see your midwife every week until your baby is born.  

3.     Do you require specific tests during pregnancy?

You will be able to fully participate in your care! I am able to offer all of the same testing you would receive at a doctor's office.  The choice is up to you!  I will explain the risks, benefits, and discuss the type of results that each test will provide.  You will have the ability and opportunity to do some research, discuss it over with your loved ones, ask questions, and then make your own decision.  Whatever decision you make will be fully supported by your midwife.

4.     Will you use a fetal scope in place of a Doppler if requested?

Absolutely, in fact I prefer to use a fetal scope.  Doppler carries the same kinds of risks to the baby as ultrasound does.

5.     What is your experience with herbs, homeopathy & alternative medicine?

I have had a formal introduction and education in herbs, homeopathy, and alternative medicine.  I have received several classes throughout my educational experience in midwifery school and had three years' experience with them throughout my preceptorship with my instructors. I will generally offer this route of treatment before offering any routine pharmaceuticals.

6.     Do I have to have a homebirth to use your services?

No.  I also provide prenatal care and support to women exploring hospital birth options.  There are three ways to receive care when deciding if a hospital birth is the right option for you.

     ·Receive prenatal care and postpartum care: You will receive all routine prenatal care, testing, and support up until labor ensues. Once in labor, you will have the option to labor at home with or without a doula (separate fee applies for the use of a doula) and once ready can head to the hospital.  Once there you will assume care with the on-call physician.  The on-call physician will provide all care at the hospital.  Once discharged, your midwife would provide the remainder of your postpartum care.

     ·Receive prenatal care with assistance of midwife: This option would allow you the ability to receive all routine prenatal care, testing and support up until labor ensues.  Once in labor, your midwife would join you.  When you determine it is time to head to the hospital, your entire birth team including your midwife would transport to the hospital.  Your midwife would assume the role as a doula. The on-call physician will provide all care at the hospital.  Once discharged, your midwife would provide the remainder of your postpartum care.

     ·Receive prenatal care: You will receive all routine prenatal care, testing, and support up until labor ensues. Once in labor, you will have the option to labor at home with or without a doula (separate fee applies for the use of a doula) and once ready can head to the hospital.  Once there you will assume care with the on-call physician.  The on-call physician will provide all care at the hospital.  Once discharged, you would follow up with the physician on-call that delivered your baby in their office.

7.     What is your experience with home births after caesarean (HBAC)?

I have worked in practice where I have had about 40% HBAC.  Out of the 40% of mothers who were HBAC, 80% of them had a successful HBAC, 10% had a successful VBAC in a hospital setting, and 10% of them had a repeat C-section.

8.     Do you require a childbirth preparation class to prepare for homebirth?

I do not require it but I encourage my families to take childbirth preparation classes especially if this is their first child.  It is great information and sometimes a nice refresher.  It is also encouraging to connect with other families in the community.

9.     Do I need to hire a doula for labor support or do you provide that also?

I highly encourage the use of a doula during labor.  I can provide a doula, however it is not included in my midwifery fee and a doula fee would apply.

10.  I am an abuse survivor and this may affect my experience. Do you have training in counseling or other trauma-healing work?

I am not a psychiatrist nor psychologist, but I have received a formal education and have clinical experience in counseling and support for women who are victims of sexual, physical, or emotional violence and trauma.  I offer and specialize in birth restoration and healing. 

11.  How many home birth clients do you typically have in a month and what is your plan if you have two clients laboring/giving birth at the same time?

I prefer to take on two clients per month but no more than three.  There are local midwives that are able and willing to attend a mother in labor if I am already at another labor.

12.  Can I go past 42 weeks and still have a homebirth?

The option to go past 42 weeks is discussed along with testing that is offered to reassure the baby's well-being.  As long as testing comes back positively and the pregnancy has been healthy without complication, going past 42 weeks can be an option.


Intrapartum Care:

1.     At what point in my labor will you come to my home to assist with labor/birth?

I come when you are ready and this timing is different for everyone.  A common question I ask is "Do you feel the need to have your midwife?"  If the answer is yes, I am coming.  During prenatal visits we do discuss optimal timing in contractions, but everyone's labor is so different and my arrival time is different with everyone.  Your midwife is there when you deicide you need her, this may be early labor or this may be active labor.

2.     What is your role during a birth?

Your midwife will help support you in giving birth in the way that you would like to give birth.  Your midwife will monitor your health and the well-being of your baby.  Your midwife will help you to progress in your labor through position changes, movement and rotation of the baby, hydration, nutrition, physical and emotional support.  Your midwife will support the natural progression of labor and encourage you to trust the process.  Your midwife is present to guard the health of mom and baby medically. Though your midwife may provide some physical support and pain management techniques, her primary role is the medical health of mother and baby. If you feel you will need more support, a doula is a great option that should be explored.

3.     What equipment and supplies do you bring to a birth?

I carry the majority of the items you would find in a hospital.  I would be more than happy to share my birth equipment with you at any time.  I carry birth supplies such as cord clamp, amnihook, sterile gloves, instruments to detach the cord, catheter, chucks pads, gauze, tape, suture material.  I also carry emergency equipment such as IV equipment, Delee, surgical instruments, Ambu for mother and baby, I carry oxygen per FL state law, however new guidelines state oxygen should no longer be used for neonatal resuscitation and can cause harm.

4.     How long do you stay after the birth? Do you help clean up?

I stay at least two hours postpartum and upwards of six hours.  My lovely assistance will help to straighten up your home.  Family members will also be a part of your team to help finish other tasks such as: laundry, take out trash, dishes, etc.  All equipment related to water birth will be removed by family or your other support persons.  We leave your home as if you would never know a baby was born at home.

5.     Are you able to suture the perineum if necessary?

Yes.  I am able to repair a first and second-degree laceration.  Lacerations that involve the rectum require the extensive knowledge of an OB/GYN and would require transport to the hospital.  

6.     What is your standard for cord clamping and cutting?

It is your option, you are the boss.  In standard practice I do not usually use a cord clamp on the cord until after the placenta has detached, delivered, and has stopped pulsing.  In rare lifesaving instances, the cord may be clamped and cut just before baby is born.  In the event that cord banking is being used, the process is different and requires the cord to be cut shortly after birth.

7.     How many assistants do you typically bring to a home birth?

I will generally bring only one assistant, at times possibly two if I have someone training.  No more than two assistants will attend your birth.


Basic Postpartum Care:

1.     Do you provide postpartum visits in the days after the home birth?

Once your baby is born, you will see your midwife 24-48 hours after the birth.  Postpartum appointments after the 24-48 hour appointment are unlimited.  You may see your midwife as often as you feel you need to up to 6 weeks postpartum.  You can schedule a postpartum at any point past 6 weeks postpartum until your child's first birthday at a reduced fee and your midwife is always able to schedule a phone appointment at no charge.

2.     Do you do placenta encapsulation? Is there an extra charge?

Yes, I do offer placenta encapsulation, placental tincture, placental prints, and placental creams.  I can also create a smoothie.    All placental products are delivered by your follow up postpartum visit and are stored in glass along with dosage instructions.  The charge for placental products is $350.

3.     Do you have experience breastfeeding? Will you be able to help me with any breastfeeding problems?

Yes, I have over 5 years of experience as a Certified Lactation Counselor.  I am able to identify breastfeeding complications, provide counseling, support, and will continue to be available for service until your child is finished with breastfeeding.


Transfer of Care and Complications:

1.     What are some reasons for transfer?

There are many reasons for transfer throughout pregnancy, labor, delivery, and postpartum.  Anything that would cause the need for a higher level of care would be a reason for transfer.  Here are some examples, they are not limited to this list, but may include: abnormal progression of labor, abnormal fetal heart rate, hemorrhage, unresponsive infant, third or fourth degree laceration, etc.

2.     How would we transfer if it was needed?

There are two types of transfer, non-emergent and emergent.  For non-emergent transfers, the transfer may be made by car to the hospital of your choice within proper distance.  For emergent transfers, transfer will be made by ambulance to the nearest hospital with a labor and delivery unit.  

3.     What care would you provide to me if a transfer were necessary?

Your midwife will accompany you to the hospital and would be in the role of a doula.  Your midwife will stay with you at the hospital until the birth of your child or unless you desire to release your midwife.  Exceptions to this would be if another client were to call in labor, to which your midwife will follow up with you as soon as she can.

4.     Have you ever handled a postpartum hemorrhage? What protocol do you use to stop excessive bleeding after delivery?

Yes, I have handled several postpartum hemorrhages.  I use a cocktail of herbs at delivery to help prevent the chance of postpartum bleeding.  If a hemorrhage occurs, I will use medicinal products to help control bleeding and fundal massage.  In the event that bleeding becomes emergent, we will transfer to the hospital by ambulance for further care.

5.     Have you had any bad outcomes with a mother/baby? Please explain them.

I have not had a mother nor a baby die.  I have dealt with unforeseen complications that include: shoulder dystocia, unresponsive infant, placenta accreta, hemorrhage, abnormal fetal heart rate, etc. All care in emergent conditions have resolved in care at a hospital.  I would prefer to prevent a complication rather than cause one, my management approach is centered around this philosophy.

I would love to meet with you and your family to further explore your options

Words of Kindess

Karson will be four in July and he's still nursing. We wouldn't have made it without you! Thank you for your part in the most empowering, beautiful experience of my life!”

K. May

“I am so grateful that we had Deborah as our midwife. She's worked with me from the beginning of my pregnancy and provided so much information on natural birth. She's continued to be available even now at 9weeks postpartum by helping me figure out a few breastfeeding issues.

This was my third child but my first home birth and I loved everything about it.
We had our daughter at home in the water and Deborah was amazing! I couldn't have asked for a better experience!”

J. Dooley-Jernigan

Deb is amazing! After a very difficult last few weeks of pregnancy, we welcomed our little Jude at home. This was our third and the best experience we have ever had. Deb was so wonderful throughout my pregnancy and a calming force during my birth. Thank you from all of us for making this birth a healing experience.

K. Walden

Deborah became part of my family late in my pregnancy (over 32 weeks) from that moment she checked in often - even through snowstorms, attended my sons birth & continued to check on me & baby. She was extremely thorough & explained everything to us that was going on. She really gave us both sides of things when having to make a decision such as declining certain testing. During my labor she was an amazing supporter & encourager. She showed my hubby, myself & my 5 year old daughter so much love (including having her cut the cord & help weigh the baby) Even during a couple of "complications" she remained calm & just worked her magic. We feel that we can reach out to her about anything & she has so much knowledge! I am so grateful to have found her. Thank you & we will forever cherish your kindness, wisdom & friendship!!

C. Chiarappa