Hospital or Home?

Choose the Path that is Best for You

Birth at Home

If you choose to birth at home, I will provide your labor and birth care in addition to prenatal and postpartum care. To have an extra pair of caring hands, a second midwife, birth assistant or a midwife apprentice will assist us during your homebirth. During labor we will encourage you to walk around your home and change positions. This increases your comfort and advances your labor. Your comfort will not prevent us from closely monitoring vital signs to ensure that you and your baby are progressing safely through labor.

We will stay with you in active labor, offering encouragement, massage and guidance. We encourage you to eat snacks throughout labor and hydrate with water, juice and electrolytes. Many women find that a shower or warm bath are the most comfortable places to labor. I provide you with a labor pool if you want one. We have helped women give birth standing, squatting, reclining, seated on a birthing stool, supported on their hands and knees and submerged in water. You will find whatever position works best for you.  

When your baby is born, we will place him or her on your chest for you to cuddle and nurse. We do newborn examinations beside you in bed. Afterwards, we will clean up, assist with nursing and ensure that you and baby are stable and adjusting well. This is usually completed within 2-3 hours of the birth.

Because we serve only healthy, birth-educated women, we encounter few complications. Nonetheless, we are fully trained to evaluate labor and birth and to carry out emergency medical procedures as needed. I never delay necessary medical care. The vast majority of our hospital transfers are not urgent, but are due to drawn out labors in which we decide together that it's time to try some of what the hospital has to offer. When a woman transfers to the hospital in labor, one of us accompanies her to brief the doctors and nurses and to serve as her doula throughout labor and birth.  

Birth at the Hospital

I provide complete, personalized prenatal and postpartum care for people who desire a midwife-assisted birth at the hospital, but I do not attend the birth.  St. David’s Medical Centers in Central and North Austin now have excellent groups of Certified Nurse Midwives (CNMs) that work with a team of dedicated obstetricians.  These midwives support natural childbirth, but do not provide prenatal or postpartum care.  So, to support families who are most comfortable with a hospital birth, I provide individualized prenatal and postpartum care. The cost for this service is $3500 and is paid in monthly installments with final payment due a month before your due date. We will submit a claim to your insurance after your baby is born to try to get some reimbursement, if you desire.

My prenatal visits last 1 hour, giving you lots of time to ask questions.  At least one prenatal visit occurs in your home.  You can tour the Labor and Delivery unit at St. David’s Main and North Austin Medical Center before the birth. NAMC is supposed to open an in hospital birthing center in Fall of 2023 that could be an option, as well. I will help match you with a compatible doula to support your labor.  Together, we will help you know when it is time to go to the hospital in active labor. The CNMs will attend you at the hospital, with support of their obstetrical colleagues, as needed. Your doula will provide extra labor support. The CNMs, nurses and lactation consultants at the hospital will provide postpartum and newborn care for the first day or two after delivery. I will resume your care once you and your baby leave the hospital. I am on call day and night to answer questions and provide support, when you need it.  The day after you go home, I will visit you and your baby. I’ll do a second home visit between 1-2 weeks.  More visits are scheduled as needed, typically for breastfeeding support.  Our final visit will be in my office when your baby is 6-8 weeks old.