Frequently Asked Questions

Our global fee is a sliding scale of $4500 - $7000. Families are able to choose the amount on the scale that works for them. We ask for a retainer at registration, and the remaining amount is due by 36 weeks gestation.

Our practice uses a variety of tools to ensure that finances are not a barrier to families who want our care, including extended payment plans, discounted rates, birth funding, and we are working towards being able to bill medicaid for care.

If you would like to work with us but cannot afford the midwifery fee, please reach out. We will work with you to ensure that you are able to access our care.

In Minnesota, all home birth providers are considered out of network with all major insurance companies (no matter what the insurance company says!) This means that our services are not covered at a locked-in rate, or may not be covered at all.

Because of this, clients pay the midwifery fee out of pocket, and then may choose to work with our biller to seek reimbursement. Our biller will submit one claim after completion of your care for a set rate, or bill throughout your care for a slightly higher rate.

We are able to accept payments from most HSA/FSA plans and ministry health plans, and we are able to accommodate providing documentation and billing documents for such plans.

Our practice is currently working towards getting credentialed with medicaid, and accepts clients with medicaid coverage. Clients on medicaid are billed independently for items not covered under medicaid, but the total cost is far below our sliding fee scale. We will discuss these items with you during your consult and make a plan based on your individual situation.

The fee for midwifery care covers:

• Direct access to the midwives for any questions, concerns, or needs between visits

• All of your prenatal care

• Lab draws

• Referrals to community resources

• Labor and birth attendance

• Water birth tub

• Immediate postpartum and newborn care

• All newborn procedures

• Herbal sitz bath, padsicles and peri bottle tea

• The midwives performing the newborn metabolic screen, hearing screen, and CCHD screens

• Six weeks of postpartum care including five total visits and any additional needs in between

• Six weeks of newborn care

• Ongoing lactation support

• Filing of the birth certificate and social security number

The following costs may be out-of-pocket depending on your insurance:

• Routine labs and ultrasound billed directly to your insurance company. Most of the time, these services are covered by insurance.

• Birth kit - if you are planning to birth at home, you will need to order a birth kit by 36 weeks gestation. Your birth kit contains all of the personal supplies you’ll need for your birth, like chux pads and your birth tub liner. We will provide a supply list with a link to purchase the full kit ($80-$100)

• rhoGAM - if you need rhoGAM during your pregnancy or postpartum, this is charged out of pocket. The cost for rhoGAM is typically $130-$150.

Most of our clients choose home birth because they want their labor to be as uninterrupted as possible, and because they want the opportunity to birth intuitively. Being at home in your own space benefits the body’s ability to do so in an enormous way! We approach care during pregnancy and birth as a normal, physiological event - not as an emergency or pathology. This approach resonates with many people, and they want to birth where they feel most comfortable with providers that support physiological birth all the time.

Other common reasons we hear: to avoid interventions, to have freedom of movement, to be able to eat/drink during labor, water birth, to feel free to birth how they choose, because they feel safest at home, and because they are pregnant, not sick!

Midwives carry medications and equipment, and are trained to handle many common complications that may occur during labor and birth, including hemorrhage, resuscitation, shoulder dystocia, and more. Most of the time, we are able to handle these complications without needing to transfer to the hospital. Additionally, our midwives are able to administer IV fluids, antibiotic prophylaxis for Group B Strep, and suture if there is a tear that needs to be repaired.

Certified Professional Midwives are trained exclusively in out-of-hospital birth, and we are specially trained to recognize impending complications so that we can intervene and transfer to the hospital before a serious complication occurs. More than 90% of transfers are non-emergent transfers. In a non-emergent transfer, the family has time to weigh their options, make a choice to transfer care, and drives to the hospital of their choosing.

Rarely, a complication occurs that is a true emergency or that requires immediate stabilizing medical intervention. In this situation, we initiate an emergent transfer of care. In these situations, we call 911 and the midwife accompanies the birthing person in the ambulance to provide stabilizing care while en route to the hospital.

The evidence shows that outcomes are just as good if not better for midwife-attended community births. Additionally, it shows a reduction in mortality and morbidity for Black and Indigenous people, significantly lower c-section rates, lower intervention rates across the board, higher breast/chestfeeding rates,significantly higher rates of client satisfaction with their birthing experience, and lower rates of birth trauma.

Additionally, new studies show that midwife-attended home births are as safe and have comparable outcomes to birth center births.

While the birth is often viewed as the “main event,” the care you receive before birth has a huge impact on your birth and your experience entering into parenthood:

A more personalized approach
Midwifery care offers a slower, more personalized approach to pregnancy care. You see one of your two midwives at every visit, giving you the opportunity to build relationship and trust throughout your care. We truly get to know you and how you need to be supported, and that personal relationship makes a huge difference both in pregnancy outcomes and your personal wellbeing during and after having your baby.

Whole-being wellness
Midwifery care focuses on your wellness and health as a whole being - not just the health of your pregnancy. We get to know how you’re feeling physically, mentally, and emotionally - how well you’re being suported, what stressors are currently impacting your life, what values add to your views and practices around your health, how your lived experience shapes your pregnancy and your care. This approach has been shown time and time again to improve pregnancy and birth outcomes as well as greatly improves family’s experiences and satisfaction with their care and pregnancy journeys.

A holistic approach
Pregnant people are not sick! Midwifery care works from the foundation that pregnancy is a normal life event, not a pathology. We focus on holistic approaches to wellness and complication prevention, such as reducing stress, increasing support, education on keeping pregnancy normal, herbs, nutrition, and wellness care. When people have the right information, are well supported, and are empowered to be active in their healthcare, outcomes are better and most pregnancies progress normally. We believe every single pregnant person should have a right to this information, and believe taking care of families planning a hospital birth is a pivotal step we can take to making that happen.

Informed consent and collaboration

Midwifery care removes the power imbalances of the “doctor knows best” approach to healthcare. No one is more qualified to make decisions about your body, your baby, and your health than you are!

We focus on informed consent, collaboration, and parent-led decision making. This means that we see our role as blending evidence and ancient midwifery wisdom to give you the information you need to make decisions about your health. There are so many decisions to make during pregnancy, from which labs and testing you want to how and where you want to birth your baby. These should be your decisions, and you should always retain full autonomy over your own body.

We believe that everyone should be empowered to make their own decisions about their healthcare and that when you are - it positively impacts your confidence and wellbeing as you enter parenthood.

Birth preparedness
We want every one of our clients to walk into their birthing journey feeling prepared, confident, and ready. As midwives, we believe that the spiritual and emotional parts of labor and birth are just as important and being physically healthy and well. We work with you throughout your entire pregnancy to help you prepare mentally and emotionally for birth - from teaching you about your birth choices to discussing your fears, anxieties, and concerns about birth. We want you to enter your birthing time feeling at peace and trusting your body and your baby because we know birth works better when those things happen. Helping you get there is a huge part of what we do and what your care centers.

Pospartum
Today, much of the policy work happening around maternal outcomes in the United States focuses on postpartum because it’s where people slip through the cracks. In the modern healthcare system, people see their care team once - six weeks after they are discharged from the hospital - with no follow-up in between. If there is a concern or complication, they are sent to the emergency department.

We see our families 3-4 times in the postpartum to ensure they have adequate care and follow-up, and that they are healing normally. We communicate frequently in between visits, and remain on-call for you through the entirety of your postpartum care course. Our approach is one of the areas where we see the most drastic improvement in outcomes for families.

In addition to focusing on medically caring for you and baby, we focus on your healing, your transition to parenthood, ensuring you’re well supported, lactation, mental and emotional wellness, and your bonding with your baby. We can’t tell you how many times we hear how impactful the postpartum care was for the families we work with - and we agree wholeheartedly. Having solid care and support in the postpartum can drastically improve how you’re feeling as you enter parenthood whether it’s for the first time or for the fifth.

Safe space
We are extensively trained in providing trauma-informed care for BIPOC, QTPOC, all different family structures, disabled people, neurodiverse people, all body sizes, survivors or sexual and/or domestic abuse, and culturally-affirming care for families from all different backgrounds. Not only do we hold many of these identities ourselves, but our work is and will always be committed to creating safe spaces for marginalized communities. Having access to a safe spaces and trauma-informed providers - especially in the context of reproductive care - makes a huge difference for families as they bring their babies into the world.

Better outcomes for Black and Brown parents and babies
As many people know, outcomes for BIPOC people - especially Black and Indigenous people - are drastically worse for people receiving care in the hospital setting. Having access to a BIPOC midwife in the community setting has continuously been shown to improve outcomes for BIPOC families in virtually every metric - from maternal mortality to greatly reducing medical trauma. Because the care you receive in your pregnancy and postpartum have a significant impact on your birth outcome, receiving care with a Black midwife is deeply beneficial even if you aren’t birthing at home.

If you are planning to birth at the hospital, we will complete all of your routine prenatal care. Most families see their hospital team 1-2 times total throughout their pregnancy in order to establish care, receive logistical information and prepare for labor.

We work closely with your hospital team to complete records transfers, to discuss anything that your team should know regarding your care, and to ensure you have everything you need for your birthing day. Your will be able to pre-register at your hospital and tour the labor and delivery unit before your birthing day.

When you go to the hospital in labor, your team will already have all of the information they need to care for you and your baby. The midwives will remain on-call for you if you have any questions, concerns, or needs during your birthing time.

Once your baby is born, you will be discharged from the hospital and will transfer back into our care for postpartum and newborn care. We will see you 3-4 times in the postpartum period, and provide comprehensive care to both you and your baby for six weeks after your baby is born.

Always! You are not locked in to your choice of birth setting. It is totally okay to begin planning a hospital birth and then choose to switch gears, and vice versa. We want you to birth wherever you feel safest and most supported, and will support whichever decision is best for you.

We offer home births to families with low-risk pregnancies, and offer routine prenatal care for families with high-risk pregnancies who are planning hospital births.

There are complications that can occur before or during pregnancy or labor that can make out-of-hospital birth no longer a safe option. Depending on what the complication is, we may need to plan a hospital birth in these circumstances.

Additionally, we sometimes need to use a co-care model. This means that we provide your routine prenatal care, and we also work with a physician or certified nurse midwife to support you in caring for the complication.

Many factors that are considered high-risk in the hospital system are not considered high-risk in the out-of-hospital setting, such as being postdates, having anemia, diet-managed gestational diabetes, high BMI or being over the age of 35. In these situations, you would still be able to plan a home birth as long as your pregnancy remains normal and uncomplicated.

When someone planning a home birth develops a complication that contraindicates home birth - or makes it unsafe to birth at home - we complete a transfer of care to a hospital based provider. This can look differently depending on when the complication develops.

When a complication develops during pregnancy, this would mean transitioning to planning a hospital birth. You would remain in care with us for your routine prenatal care, and we would work with an in-hospital provider to care for the complication and to care for you during your birth.

If a complication develops during labor or in the immediate postpartum, we would transfer to the hospital for continued care.

We provide comprehensive midwifery care through pregnancy, birth, and postpartum! This means we provide all of your care throughout your entire childbearing journey.

In the absence of a complication that contraindicates out of hospital birth, you do not need to sde a hospital provider if you are planning to birth your baby at home.

Birth can be a bit messy, but luckily, you will not need to worry about cleaning up after your home birth. You will be well-prepared with floor and furniture protecting items received in your birth kit, and the midwives will clean up your birthing space before we leave your birth. We will clean and sterilize any blood or body fluids, drain the tub, and wash any linens that get used over the course of the labor and birth. By the time we leave, you won’t even be able to tell that the birth happened!

We do offer water birth, and many of our clients choose to labor and/or birth in the water! We will provide a spacious birth tub towards the end of your pregnancy so that you will have tub access when you need it during your labor. You are welcome to use the tub as you see fit during labor and birth. We use a water-proof handheld doppler to monitor baby during labor so that you can remain in the tub in whatever position you’d like while we check on your baby. Once baby is born, you’re welcome to continue relaxing in the tub. We routinely perform monitoring after the birth while you remain in the water. You can even stay in the tub to birth your placenta!

You can have anyone you want at your birth. We set no limitations on who or how many support people you have! We welcome your family’s participation in your birth including your children. You, your partner, or your support person is welcome to catch your baby. We welcome your doula as part of the birthing team and work collaboratively with your doula to support you in whatever way you need.

In most cases, your baby does not need to go to your pediatrician until after our six week visit - even if you gave birth in the hospital. We provide routine newborn care until six weeks of age. After that, we will discharge your baby to your chosen pediatrician and send records of all of your baby’s care.

Occasionally, a baby will have certain needs that are out of a midwife’s scope of practice. If that happens, we will collaborate with your baby’s pediatrician to provide co-care - we will continue to care for you and baby, and your pediatrician will support you by helping to care for baby’s complication.

Do you attend twin births?
We do not specialize in twin births at this time. If you are expecting twins, there are many amazing midwives in the twin cities that we are happy to refer to!

Do you attend breech births?
If your baby is breech at term, we will offer the following options:

• Suggestions and recommendations to encourage your baby to turn head-down

• Gentle ECV

• Planned hospital breech birth with experienced in-hospital breech provider (subject to availability and service area)

• Breech home birth

In order for us to continue plans for a home birth if your baby is breech, we have the following protocol in our practice:

• Pregnant with one baby

• You have given birth before

• You are not planning a VBAC

• We have discussed your options and you have given informed consent to move forward with a planned breech home birth

• Invitation of one additional midwife to join us for the birth

We offer planned home births if your baby is breech to clients already in our care. We do not take late transfers for breech home birth at this time.

Do you work with families planning an HBAC (home birth after cesarean)?
We are highly supportive of HBAC and are honored to support families planning an HBAC or HBA2C with a history of low transverse uterine incision. Additionally, we ask for a third trimester ultrasound to ensure normal placenta implantation, and that the placenta is not implanted over your uterine scar.

What happens if my pregnancy goes postdates?
We are happy to continue waiting for spontaneous labor if your pregnancy goes postdates - even if you are pregnant past 42 weeks gestation. Should this occur, we will have an informed consent conversation with you, and we will offer you options, such as expectant management (continuing to wait/doing nothing), or herbal stimulation of labor.

We will also offer additional monitoring of your baby to ensure your baby is doing well and that the placenta continues to function normally.

Community Birth Twin Cities midwives Bee and Sasha are both Certified Professional Midwives and Licensed Midwives.

In Minnesota, there are multiple different types of midwives that offer home birth:

Certified Professional Midwife (CPM)
A certified professional midwife is a midwife that was trained through traditional apprenticeship and midwifery education through apprenticeship or attendance at a midwifery school. CPMs participate in full-time clinical apprenticeship for 3-5 years, are required to attend a certain number of prenatal visits, births, and postpartum and newborn visits at three different compentency levels, demonstrate mastery in more than 750 midwifery-based skills, and pass a standardized board examination to receive their credential. CPMs are trained exclusively in community birth and do not work in hospitals.

Licensed Midwives (LM)
Licensed midwives are CPMs who have gone on to receive their traditional midwifery license through the Minnesota Board of Medical Practice. In Minnesota, CPMs can choose whether or not they’d like to get licensed.

Certified Nurse Midwife (CNM)
Certified nurse midwives are registered nurses who have gone on to complete a master’s degree in midwifery. CNMs receive their training primarily in hospital birth, and perform their clinical rotations in the hospital setting. Most work in the hospital setting, however CNMs can choose to work in the community or hospital setting. CNMs can also prescribe medications or work with families planning an in-hospital birth who want an epidural or need to be induced with pitocin.

Traditional Midwives
Traditional midwives are unlicensed midwives who have chosen not to pursue a credential or license to practice midwifery. In Minnesota, it is legal to practice midwifery without a license or credential. Most traditional midwives have the same extensive clinical training as certified, licensed midwives and are highly experienced.