Over the years I’ve found families have many similar questions. Below is a list of many of those.
Midwifery and Homebirth
Why choose to birth at home?
Many homebirth families choose home because they are low risk and feel safe in their own envirionment. The comfort of knowing their birth team, choosing their own supplies, feeling involved in the decisions regarding their care, and avoiding intervention are all factors that play in. Another very common reason is the option to labor and give birth in the water when it is safe. In the end, the choice is extremely individual and should be based on what is safest and appropriate for you and your family.
Do you serve my area?
Our practice routinely serves families from all surrounding areas. Factors that play into the decision about the safety of your midwives travel time include what hospitals are close to you, your alternative plan if you labor too quickly for our team to make it, and your birth history. With the right situation we will travel long distances to accommodate your desire to have us as your midwife team. We see mothers at 3 locations. You will need to come to one of these locations for all but one of your prenatal and agree to attend your appointments on a regular basis. We charge a small additional travel fee for each trip to homes that are greater than 50 miles from the greater Kansas City area. You may also need to provide a place to rest and food for your midwives.
My partner is hesitant about birthing at home.
Many partners are hesitant about the idea of giving birth outside the hospital. The great news is, in general, we agree with your partner on most points. Our number on goal is for you and you baby to be safe and health above and beyond anything else. The easiest way for both of you to find a middle ground is to bring them in for an interview and give them the safe space to ask every question and express every concern. In the end, the best birth happens when both parents are on the same page.
When did you begin practicing?
Cheryl began practicing as a Traditional Midwife in 2006 and as a CPM in 2007.
How many births have you attended?
Cheryl Gates, CPM has attended over 900 births as of 2020. What is your transfer rate?
Our highest transfer rate has historically been first time mothers and VBACs. Most years our first time mothers and VBACs will have an intrapartum rate of around 12%, while multiparaous mothers will transfer around 5-6% of the time.
What is your cesarean section rate?
Most years our practice will have a cscetion rate of 1-2%.
What is your religion or faith?
Our practice is as diverse as our clients. All of our providers and students are open hearted and happy to serve families wherever they are in their life journey. We do not require our clients share our belief system on life choices, religion, or politics and ask that we be treated with the same respect for autonomy. While we will sometimes share many of these, it should not be the basis of your choice for our practice.
Do I need to see a hospital based provider also?
There may be times when a midwife needs to consult a hospital based provider in order to give you the best care. Midwives can provide all the care needed for a normal low risk mother and baby from conception until 6 weeks postpartum or 6 weeks of age. If we encounter a risk factor that needs another opinion we will reach out to a local OB or Perinatologist.
Do you have a physician over seeing your care?
We do not have a physician over seeing any part of your maternity services. We do not have a backup physician but does strive to maintain positive relationships with local hospitals and pregnancy providers. This is a benefit to our entire practice.
Am I able to have an ultrasound if use your practice?
We are not trained as a sonographer/ultrasound technicians. We refer clients for ultrasound to several different locations in the KC metro area. Some locations take insurance and one does not but is extremely affordable.
What are prenatal visits like?
Prenatal visits with our team begin with a conversation about how your life is going in general: work, family, stresses, nutrition, hydration. We move on to education items that pertain to your current trimester of pregnancy. We might perform any testing you have decided on for your care. Then we listen to your babies heartbeat, measure your fundus, take your blood pressure and palpate your babies position. We answer any questions you may have brought to your prenatal visit. Our visits leave time for the kind of care that few women ever experience!
Are there tests or interventions you recommend routinely?.
We recommend certain tests in order to give you better care. We recommend an OB panel, a mid pregnancy diagnostic ultrasound, some form of glucose testing and GBS screening. These tests help us, and if needed hospital based providers, what we need to give you the best care.
Are there reasons you would risk me out of your care?
Yes. If a client is not honest, we cannot give you good care.You must maintain timely and appropriate communication with us or we can not give you good care. We assess your health and the health of your baby at each prenatal visit and after each communication with you. If at any time our assessment is that you or your baby would be safer with a higher medical provider, we will discuss this with you and explain why we feel this way and tell you of options for your care. We would typically help set up a consultation with a higher level medical provider at that time in order to assess whether home birth is still an option.Examples of health issues that might risk you out of our midwifery care are preeclampsia, maternal health issues that are not within the scope of a home birth midwife, premature rupture of membranes (rupture before 37 weeks), fetal health issues shown on ultrasound, certain clotting discorders, VBAC, twins, breech at onset of labor, and insulin dependent diabetes.
Where do you see families?
We see families at one of the three locations: North Kansas City, South KC (Olathe), Central KC (between downtown and the Plaza), and St Joseph, MO.
Do you do home visits?
We will come to your home for a prenatal visit sometime around the 37th week of your pregnancy and then again shortly after your birth.
What is expected of me during our care?
We will expect honesty.We will expect you to attend your scheduled appointments for maternity care.We will expect you to request any previous records that can help us give you good care.We will expect you to call to cancel an appointment rather than just not showing up.We will expect you to come with any questions to your prenatal appointment.We will expect you to maintain timely and appropriate communicationWe will expect you to take active responsibility for the choices you are making. While we can make recommendations based on the standard of care homebirth requires more focused decision making.
What do I need to buy for my birth?
The charting software will send a list of needed items for your homebirth during your 28th week of pregnancy. Most of these items will most likely already be in your home. If you are wanting a water birth, there are a few extra items to purchase (i.e. pool liner). We require our birth kit as well and will walk you through ordering it online.
Do you take VBACs?
We only take a few selectively chosen VBAC mothers and requires they meet our requirements for consideration.
Do you delivery twins at home?
We choose not to attend a twin birth in the home setting at this time.
What if my baby is breech prior to or during labor?
We choose not to attend a known breech birth in the home setting at this time. We begin encouraging the baby to be head down early and reach out for help to try to ensure cephalic presentation before the onset of labor.
What do you believe creates the ideal birth environment?
The ideal birth environment is different for each person. We hope to help in guiding you to find your ideal birth environment and work to create that for your birth.
Who can I have at my birth?
You may invited anyone you want to your home birth as long as they are welcome to you and non disruptive. We talk about appropriate birth partners during your care to help you choose the people who will serve your needs the best.
What about the mess?
We will clean before we head out. Typically, there is no mess by the time we leave your home. Birth is usually not messy at all. Because we know what to expect we have a system that is used to protect your home. There may be laundry to start or trash to take out and we find fathers are more than eager to help complete any needed tasks while you rest.
Do you attend water births?
Yes.We also rent pools to our clients.
Do I have to buy a pool?
You may, if you choose or you may rent one from us. We rent our Birth Pool in a Box Mini pools for $75. You will be responsible for purchasing a liner for the pool. This liner is a one time use and we will typically throw it away when cleaning up after the birth.
Have you dealt with the common complications?
Yes. If you have specific questions, please feel free to bring them to either the interview or your prenatal visits so we can revisit this.
What are the most common reasons to transfer to the hospital during birth?
First time parents transfer most often for pain relief and/or epidural to sleep.Multiparaous mothers most often transfer for unreassuring fetal heart tones, Meconium upon rupture of membranes, in addition to other factors. A few mothers will request to transfer to the hospital for birth without medical necessity.
What do we do if we need higher level care?
We have a good working relationship with several area OBs as well as perinatologists. If you need a higher level of care, we will help you find it as best we can. While we have hospitals we prefer, depending on the urgency , we can transfer to the nearest hospital that offers the care we need.
What if you are at another birth when I need you?
I will either send a member of our team to check your progress and/or stay to monitor your labor. The great thing about a team who works together is we have many similar and familiar hands.
Who will you bring to my birth?
Our goal is to provide exemplary care. Often we will have two midwives, a senior student, and a junior student. Our families know our team and can help us cater their care to their own needs.
Do you offer breastfeeding support?
Yes.We can also refer you to a KC metro IBCLC.
What if my baby needs more care?
If you need a higher level of care prenatally, we will do our best help you find it.If your baby needs higher care at birth, it is our practice to transfer the baby to Children’s Mercy-Hospital Hill if it is safe to get the baby there. They give great care to babies.
What should I expect in my postpartum period?
Check in call around 24 hours, Home visit usually within the first 72 hours, In office postpartum visit in the first week, In office postpartum visit in the second week, In office postpartum visit at six weeks, Additional postpartum visits, as needed to support the postpartum experience
Do your mothers have support if they struggle with postpartum depression and/or anxiety?
Yes.
Will I be able to get a birth certificate or social security card if I have my baby at home?
Yes.We will fill out a birth certificate and send it off to the state that you live in. Both Missouri and Kansas will file the social security card for your baby if the certificate is filed in a timely manner.
What about newborn screening?
KC Homebirth is able perform the metabolic newborn screening.
What about CCHD (critical congenital heart disease ) screening?
We perform the CCHD screening.
What about a hearing screen?
We perform the hearing screening.
Do you take insurance?
We will collect fees for midwifery services prior to your birth. We have a billing service that will send a global bill for midwifery services after your birth has occurred for a fee. It is possible, but not guaranteed, that you may get some amount of reimbursement after your birth.
Do you take Medicaid?
Not at this time. We do however try to help families from all walk of life have the birth they desire.
What do you charge?
KC Homebirth does not post pricing online. We can discuss this at your interview.
Another midwife charges less/more.
Midwives do not typically price match. Our midwifery services pricing is due to a variety of factors which include experience, training, etc. Our practice offers great care and we do our best to help every family find options to afford the birth they want. Choosing a midwife based solely on pricing may not match you with the best midwife for your care. We can discuss more during an interview, if needed.
How do I know if you are the right midwife for me?
You know you have met the right midwife for you when you go home feeling relieved. It is good to interview several midwives and get a feel for training, education, personality, and how the midwife may practice. Kansas city has many wonderful midwives. You can find more midwives at www.kansascitymidwives.com
How will I get ahold of you?
When you hire us, you will be given a contact information form to sign. We have fax, phone, email, and charting software messenger for communication pathways.
MONITRICE AND SPECIAL CIRCUMSTANCES DOULA CARE
What is monitrice care?
As a monitrice for the birth, we act as sort of hybrid between doula and midwife. We are able to provide some monitoring of your labor (monitoring vitals and fetal heart tone, vaginal exams, etc) during labor at home, while providing the labor support and comfort suggestions of a doula. When you are ready to transition to the birth center or hospital, we will stay with you as your doula. A monitrice is not your medical provider and does not provide medical prenatal care or attend your home birth.
How is that different than doula level care?
A doula provides emotional and physical support during pregnancy, labor, birth, and the postpartum period. A doula is a good source of information and can help you find resources you may need or be interested in. A doula has not been trained in nor provides any medical services (monitoring vitals, fetal heart tone checks, vaginal exams, etc).
If we hire you for this service will we still need a midwife or OB/GYN?
Yes. A monitrice is not your medical care provider for maternity care.
What is included in this package?
A monitrice will act as your doula to give educational, emotional, and physical support during pregnancy, labor, and birth. During your labor, your monitrice can also help monitor by listening to baby and providing vaginal exams in order to help you gauge when you would like to go to the hospital, birth center, or call your homebirth midwife.
What if you are needed for a birth while I am in labor?
The midwives and student midwives of KChomebirth are all trained to attend you as a monitrice or doula. If one of us has been contracted as your doula or monitrice, any of the others can serve as a backup, as needed.Midwifery clients always come first in the schedule, but we will always strive to have a back up ready to come to you.
Do you have specific hospitals or providers you prefer to work with?
Yes. We can discuss this further during an interview.
What do you charge for this service?
KC Homebirth does not post pricing online
POSTPARTUM SUPPORT
Do you have postpartum doulas in your practice?
Yes. All of my students are postpartum doulas.
What kind of support can you offer?
Postpartum doulas ‘mother the mother’ . Things like :Help with breastfeeding,Light housekeeping (load a wash of clothes, load the dishwasher, do a quick sweep through the house, etc.),Throw together a casserole you have ingredients for ,Go grab you a coffee ,Go grocery shopping ,Take care of the baby while you eat, shower, and/or nap,Instruct on how to pump ,Feed you ,Make sure you have snacks/meals ,Make sure you have a drink/tea,Instruct on baby wearing and Instruct on parenting tips.
