Midwifery FAQ

Is midwifery legal in Alaska? 

Yes. Certified Direct-Entry Midwives (CDMs) are governed by a regulatory board which sets standards for education apprenticeship, examination and ongoing review

Must you have a back-up arrangement with a doctor? 

Midwives are not required to have formal back-up arrangements. We are independent practitioners. Midwives do all your prenatal care, delivery and postpartum care including lab work. However, we do have access to doctors and can refer you if concerns arise. 

 

Will my insurance cover out-of-hospital delivery? Does Medicaid/Denali Kid Care reimburse midwifery care?

Insurance companies cover CDMs. We also receive Denali Kid Care reimbursement. Speak to our in-house billing team for specifics. 

 

What if I need a cesarean section or have to go to the hospital? 

The genuine need for a cesarean section is lower, statistically, than you may realize, especially in the population of low risk mothers who qualify for out-of-hospital delivery. However, if you fail to progress in labor, develop complications, or if your baby shows signs of fetal distress, you may need hospital assistance, intervention or surgical birth, not available in a birth center or home setting. In this case, your midwife would accompany you to the hospital. Please bear in mind that midwives transport less than 12% of their clients and have a very low c-section rate. 

 

Is water birth safe? 

Many studies have shown that water birth is a safe option for low risk, healthy pregnancies. The warm water can significantly help decrease the intensity of labor. Babies have a dive reflex that keeps them from breathing until brought into air after being born.

 

What do midwives carry for emergencies? 

Midwives carry an array of emergency equipment and supplies. For every birth, whether at home or a birth center, we will have on hand: medical oxygen, infant and adult resuscitation equipment, IV equipment, anti-hemorrhagic medication (in case of postpartum hemorrhage), Delee mucus traps or res-q-vac for suctioning the newborn, suturing equipment, and antibiotics. 

 

What if I have twins? 

If your midwife discovers twins, you will be referred to a physician for a hospital delivery, as twins are considered higher risk. Twins are usually diagnosed early in pregnancy which helps facilitate an appropriate transfer of care.

 

What if my baby is breech? 

It is quite common for babies to be breech during pregnancy. They usually settle into a head down position by 32-36 weeks. If your baby is breech, your midwife will recommend several exercise techniques to facilitate the baby into a head down position. Persistent breech presentation are referred to an obstetrician who can usually turn the baby by performing a “version” under ultrasound. If version attempts fail, a hospital birth is indicated. 

 

How can you tell if the baby is in the correct position? 

Midwives have been trained to use their hands in order to feel for the baby’s position. This is an acquired art that has been all but lost to modern technology. If there is any question to the position of the baby late in pregnancy, an ultrasound can be ordered with the mother’s consent. 

 

What if I have too much blood loss after the birth? 

Midwives carry antihemorrhagic medications and medical oxygen and are trained to handle emergencies. Prevention and vigilance are the midwives approach. Herbs and homeopathy are also on hand to help if appropriate. 

 

Will I have access to labs and ultrasounds in my pregnancy? 

Midwives adhere to the same standard of care that any medical provider does for pregnancy and childbirth. You will be offered the same labs and ultrasounds and see your midwife on the same schedule as you would with an OB/GYN or CNM. The significant difference is a strong emphasis on informed consent and time to discuss options. 

 

How do I access my records? 

Our records are HIPAA compliant, electronic and always available to you online. It is your medical information after all. 

 

What is the call schedule and availability of my midwife? 

Most importantly, your midwife will be available to answer your call 24 hours per day. You always have access to a midwife to help with concerns or questions. Heirloom’s midwife enjoys having a personal relationship with each client and our clients appreciate knowing exactly who will be attending their birth. An important part of the midwifery experience is meeting apprentice or student midwives who are on the path towards being licensed midwives. 

 

Can I have a home birth or a birth center? 

That is completely your choice. We offer birth center births at both our Anchorage and Palmer locations and do home births as well, serving families from Willow to Girdwood. The most important thing is that you are birthing in the space you feel most comfortable and able to relax. All the emergency supplies necessary for a safe and successful birth will be at the birth center or brought to your home for the birth.

If you don't see your question answered here, make sure to ask your midwife at your next visit.