Home Birth in Nc
Supporting a homebirth client as she approaches the threshold!
Photo credit Hanna Hill Birth Photography
Are you curious about home birth? Wondering if home birth is right for you? Wondering where to begin the process of exploring your options in our state? Lets take a closer look!
There has been this misconception circulating for years, that it is illegal to have a home birth in NC. That is simply not true. Home birth is possible in our state! NC currently only licenses Certified Nurse Midwives(CNMs) to practice homebirth legally. What this means is that the state denies the licensure of Certified Professional Midwives(CPMs), which is a branch of midwifery that is trained and qualified to specialize in out of hospital birth. Even though CPM is a nationally recognized credential, our state refuses licesure to highly qualified CPMs.
It is the legal right of every birthing family to choose where and with whom they give birth and there are in fact many midwives who choose to support these birthing families and their right to their choice of care.
A Homebirth client enjoying a moment of laughter between waves!
Photo credit Raleigh Birth Photography
Starting the process
We are inundated by so much information about birth these days. It can be daunting to begin the process of learning about providers and what choices are available to you! I suggest exploring your options for a homebirth before you even become pregnant. Start educating yourself and exploring who might be the best provider to meet your unique needs. Although we do have options for out of hospital care, many of the homebirth CNMs in our area book up quickly, so consider reaching out to speak with midwives before your pregnancy to develop a relationship and get a sense of who you might like to work with.
I also suggest joining “Homebirth Community of NC” FB group. This is a group I founded in 2016 to assist birthing families in connecting with providers and building support and information concerning homebirth within our state. We do have a robust and growing homebirth community!
Reach out to local doulas who support homebirth clients and find out if there are any meetups in your area to connect with homebirthers. (Stay tuned…I’ll be starting one soon!) Other families who have had homebirths are a wealth of information and can offer insight into what to expect from a homebirth experience.
Gabe assists a homebirth client while Laura Gray, CNM checks vitals on baby
Photo Credit Raleigh Birth Photography
Interviewing Midwives
You will want to consider carefully who you would like to attend your birth. An experienced midwife will have a birth assistant that attends births with them, who you can meet ahead of time. You should also consider hiring a doula who is experienced and comfortable in a homebirth setting! Thinking about capturing the homebirth with pictures? You might want to add a birth photographer to the team. But let’s not get ahead of ourselves!
What do you even ask when you interview a homebirth midwife? Well, here is a list to get you started.
What type of midwife are you? Specific credentials/certifications/licenses?
What are your educational degrees/training /experience level/background? How long have you been a midwife? How many births have you attended?
How many births have you attended & in what settings? Regardless of how many years you've been a midwife, how many births have you attended in the capacity of primary homebirth midwife?
Who is your Midwife partner for births and what are their specific qualifications? Do you also bring assistants or students as a part of the birthing team?
Are referrals (with contact information) available from previous clients that have been cared for during pregnancy, birth and postpartum?
How many births do you plan to attend each month?
What equipment/medications do you bring to births? Medications, IV, oxygen,etc? Do you carry herbs & homeopathy to births?
What are your suturing skills?
How do you arrange for/offer screening tests, ultrasounds, labs if desired/become necessary? Do you have a preferred provider for parallel care?
What are your skills/training/expertise with preventing, assessing, diagnosing, managing concerns/complications for mother and baby? What emergency skills do you routinely drill with your birth assistants, and how frequently? Are you & all members of your team current on neonatal rescusitation training?
What specific high risk conditions would risk out of your care at home? How do you assess whether it is safe for me to have a homebirth?
What medical conditions for mother/baby are unsafe risks to be labored/delivered at home?
How do you manage emergencies for mother and baby? Ex. PPH, Neonatal resuscitation, Shoulder dystocia, FHR concerns etc etc
What are the transfer of care plans during pregnancy, labor/delivery, postpartum and newborn period?
Under what circumstances would you advise a hospital transfer?
Which medical conditions do you consult/collaborate with and/or refer to supervising physicians for continuum of safe care?
Which hospital would I be transferred to? Reasons for those decisions?
Would you accompany me to the hospital for continuity of care and transparent transfer of my medical information?
What are the financial arrangements for home birth, including transfer to hospital for delivery or postpartum if necessary?
Do you keep records of your practice statistics and outcomes and will you share them with me?
Do you have experience working with clients like me?
How do you prefer to communicate with your clients?
What is the backup plan if I go into labor and you are unavailable?
What do you offer for prenatal care and postpartum care?
If you are a "hands-off" midwife, how are you assessing for things that can't be perceived by watching me, for example - fetal distress or pre-eclampsia?
If you prefer not to "labor-sit" a primip, when and how will you provide assessment of our wellbeing?
Do you support my choice to have a doula present? Can you recommend a doula in the community that has homebirth experience?
Check out some of the wonderful midwives listed below. This list is CNMs practicing in Central NC, so if you need more information for providers in our state, be sure to reach out!
Formed + Foreknown Midwifery Services
Gabe Lazarus is the owner of Sacredsong Birth & Wellness,
Holistic Birth & Postpartum Doula,
Educator, Homebirther &
Founder of The Home Birth Community of NC
Learn more about Preparing for your Homebirth or contact me to learn about working together!