Do we take insurance? You bet!

Oh, the world of insurance and insurance billing!  It can be overwhelming to be pregnant but then also trying to figure out how much your birth will cost your family can be downright exhausting!

We are here to help you wade through this whole process- from finding out you are pregnant, to getting scheduled for your first prenatal appointment to figuring out how much your insurance will pay!

At Portland Natural Birth, we happily bill your insurance for you for your midwifery care and homebirth.  Mirra worked at a birth center for many years where she learned all the ins and outs of insurance billing.  It was enlightening;) She’s not afraid to get her hands dirty calling up the insurance companies if needed.  We are out-of-network with all insurance companies.

So what does that mean?  Most insurance plans have two pathways- in network and out of network.  In network providers are contracted with your insurance plan and you are given a list of who these providers are.  Often, in network benefits have low deductibles and low member co-insurance.  Out of network providers are not contracted with insurance plans and thus, out of network benefits often bring higher deductibles and less coverage.  Sometimes, these deductibles are shared, which is beneficial for you.

Although we are out of network and you may have a higher deductible, our lower-than-the hospital costs usually make a big difference.

Our fees are all inclusive, called a Global Maternity fee– it’s prenatal, birth, and postpartum care all rolled into one fee.  We collect your co-insurance during your pregnancy and then after your birth we bill your insurance company this global maternity fee.

There aren’t any extra fees for us to bill your insurance company, so if you do have private insurance, out of network benefits, and homebirth coverage come schedule an interview so we can chat about what a homebirth with Portland Natural Birth could look like!

Birthing Choices in Portland

Portland is great, for a number of reasons, right?  It is a great place to bike, be close to nature, shop at farmer’s markets, go paddling, take the bus, run into your friends at the grocery store, AND give birth!  We have a lot of different options in the Portland area, which means all families get to chose what works best for them.

Portland is home to numerous hospitals, a couple free standing birth centers, and many midwives.  So, what is the difference between all these options and what does each options look like for your birth?

Hospital

Well, the first option is the standard one that most Americans still go to for giving birth, and the majority of Portlanders do too- the hospital.  We have some great hospitals and each one has its own flair.  You could go down the standard American route and see an OB doctor for all your prenatal appointments.  This is a good option for someone who has some high risk factors, like diabetes needing insulin treatment, among other risk factors.  Often the doctor works in a group practice and takes turns being on-call fonewborn in hospital r deliveries.  Some doctors have multiple hospitals they deliver at while other doctors only work at specific hospitals.  Make sure to get to know the doctors in your group practice as well as taking a tour at the hospital that they deliver at.

Another option in the hospital is to work with Certified Nurse-Midwives (CNMs).   Like an OB practice, CNMs work in a group and you get to see different CNMs in that practice during your pregnancy.  Whoever is on-call during your delivery is the one you’ll get!  CNMs practicing in the hospital setting work under different protocols than homebirth midwives, as they are under the direct supervision of the hospital OBs and their protocols.  Hospital based CNMs are perfect for low risk clients who are most comfortable delivering in a hospital but want a natural birth and/or trying for a lower intervention birth.  The Portland hospitals currently that have CNMs on staff are Providence Portland, OHSU and Legacy Emanuel.  Some of the hospitals allow for laboring in the birthing tubs with the midwives and provide telemetry units that allow movement while still being monitored.  Providence Portland also has a doula program that works with the families that are under the CNM care.

Birth Center

For families that are unsure where they want to give birth, but leaning towards out of hospital, a free standing birth center could be an option.  In Portland there are now 4 birth centers that are not in the hospitals and are staffed by a combination of midwives.   Most of the birth centers are staffed by midwives on rotation, like the hospital CNMs, so you don’t have continuity of care (like with home birth midwives), but many practice differently than the stricter protocols from the hospital.  There are CPMs/LDMs, CNMS, and ND midwives at the area birth centers.  The birth centers are made to resemble more of a home like setting than a sterile hospital environment.  All of them have birthing tubs that you can labor in and at least two of the centers you can stay and birth in them.  This middle ground is great for families that want a natural birth (no epidurals here!) but aren’t ready to commit to a home birth.

Homebirth

And then there are homebirths!  We, of course, love homebirths but completely acknowledge that it’s not the place for all families.  And that is OK!  It’s important to give birth where you are comfortable and where is the safest for your pregnancy, birth, baby, and set of risks.  Homebirths are not for women who are high risk.  But, if a woman is low risk and wanting a natural birth with her loved ones, pets, candles, pillows,  and kids around her then this is her best option!  A home birth is nice because you don’t have to leave your house in labor or get in the car with a tiny, new human being.  You have all your own things and can eat out of your own refrigerator (yes, we want you to eat in labor!).  There aren’t strangers coming into your room while you are in labor.  It also provides the best option for homebirth baby continuity of care and individualized care with midwives.  We bring all the emergency equipment to homebirths along with a whole bag of other supplies.  You also have the option to have an inflatable birthing tub which some women use just for laboring in and others give birth in it.  You have more options in your movement and birthing positions if you are at home.  We also come back to you three times in the first week postpartum, another great reason for a homebirth!  There are a lot of homebirth midwives in Portland so go ahead and interview a couple to find the right fit for you and your family if this is the option that best suits you.

It is important to know there are multiple birthing options and find the best match for you.  Just because your best friend had a homebirth doesn’t mean that’s right for you if you are worried to be out of the hospital.  Or just because your mother in law thinks all babies are born in the hospital doesn’t mean you shouldn’t look into a birth center or homebirth like you’ve been wanting to.  Go ahead, do some research, visit a couple places and talk to a couple providers and the right choice will present itself.

Happy birthing!

 

So, What’s it like to be an on-call midwife anyways?!

Have you wondered what it’s really like to be a homebirth midwife?  Every birth is so different but here’s a snippet of what an average night being call to a birth is like for your dear, midwife 🙂

9:45 pm  Make myself go to sleep early because I know a client has been having irregular mild contractions through the day.  She reported bloody show around dinnertime and we had a chat about what to do and what to look for.  So I make a pile of my birth clothes and grab her chart to lay on top of my prenatal bag and then crawl into bed.

12:05 am Reach over my sleeping husband to look at a new text on my phone and respond that they are doing great but that its still early and to try and rest as much as possible until they can’t!  I emphasize that although labor is exciting, it could still be many hours before active labor begins and its important to rest to conserve their energy.

I then roll back and try to fall back asleep as quickly as possible because even though I just told them to rest I know I’ll be awoken in the next two or three hours 😉

3:20 am Reach across in bed to read my new text and quietly get out of bed.  I call the laboring family so I can really hear what is going on.  Its so different reading a text that says a mom is contracting every 4 minutes.  Sometimes that means she’s in hard active labor and other times it might still mean early labor.  How do I know the difference?  I hear the difference in the mom’s tone of voice, her level of consciousness and I read between the lines.  I usually only need to hear her through half a contraction to know exactly what part of labor she’s in.   Except if she did hypnobirthing…. then that’s a different story!

I close the door to my bathroom, and talking softly I chat for less than a minute with the partner and then ask to speak to the mama.  Sorry partners- you are super important but I always ask to talk to the laboring person before I come over there! The mama is doing great and yes, she’s progressed to a nice active labor pattern. I ask questions to make sure baby is moving, that her bag of water hasn’t ruptured, that she rested a little, and that she’s eating and drinking well.  Mamas need energy to give birth so its vital to mom and baby to continue eating and drinking through labor.  I listen to how well she’s breathing through the contraction and find out what she’s doing during them. I make a plan to come over in an hour.

3:45 am I gather my clothes from my bedroom and go back into the bathroom. At first, I don’t want to turn on the light because then I can pretend I’m still sleeping but then my brain kicks in and I realize, yes in fact I need to fully wake up so I turn on the light, brush my teeth and get dressed.  I check my phone for the time and start collecting the meds from my fridge.  Its funny having a mom as a midwife for my kids.  They know there’s a container on the fridge door that stays there and they don’t touch it.  They also know sometimes they may open the fridge and find a bagged placenta waiting to be picked up by Kelley for encapsulation.  They also know that sometimes they wake up and only their papa is in bed and they may not see their mama for the day.   But they also get excited knowing a new baby is being welcomed into the world❤️

3:55 am I carry my homebirth bag, prenatal/postpartum bag, and the oxygen tank to my car.  Then lug the birth tub and bag (if they don’t already have it) outside as well.  And run back inside to grab my personal bag (I always bring an extra change of clothes because birth is messy!) and the client’s chart.

The client’s address is already preprogrammed and good-ol’ google maps gets me to where I need to go. I text the rest of the birth team to let them know I’ll update once I get to client’s house.Portland Home Birth

4:20 am I arrive to the homebirth to smiling faces, relieved to see me, knowing this is finally it!  As I comfort the family and take in the scene before me I start setting up all our equipment/supplies.  From here, birth happens!  Mama progresses and we lay witness to the raw, beautiful, intense energy of birth.  We clean up and tuck the sweet, happy, tired family in bed, promising to return the next day.

Being a homebirth midwife is a pretty crazy profession.  It is not for the faint of heart nor for those needing routine and order!  I have to be completely flexible yet 100% dependable.  My family knows I may not be with them for a holiday or I might miss that family hike we planned Saturday morning.  My friends know I may cancel plans 30 minutes before I’m supposed to be at their house- or they at my house!  My east coast family knows not to text/call me before 7 am PST because I sleep with my phone and will wake up to their texts.  I know I always need gas in my car, or at least know where the 24/7 gas stations are and that my phone always needs to be charged!  I always have to keep a log of all the medications I have to make sure they aren’t expired and that I have enough newborn screen kits for all my clients that want them.  I always make sure I have at least one clean outfit for a birth.  And yeah, I can’t go more than an hour from my house if I’m on-call.  And on-call is for all my clients that are between 36 and 43 weeks.  Crazy, huh?  It sounds crazy sometimes.  But… I wouldn’t trade it for the world!  I was called to midwifery at a younger age and knew that was what I was supposed to do.  I can’t imagine sitting behind a desk or computer all day.

Its neat to be coming and going through the night… I sometimes feel like a little birth elf that comes in and slips away unnoticed to help new life into this world while all the neighbors continue sleeping! Its pretty amazing to witness sheer strength and determination from the families that I work with.  Its humbling to support such strong empowered women!

So to all the families that I have had the chance to work with- thank you for including me in your intense and magical journey to parenthood ❤️❤️❤️

 

 

What does prenatal care look like with PNB midwives?

When I meet clients for the first time during our consultation I tell them that yes, we follow the normal obstetric visit schedule but the similarities stop there. Portland Natural Birth dedicates a whole hour to every prenatal (and postpartum) appointment with all our clients. So, what exactly happens in the hour?

Well, first off, here’s a peek into our cozy office room in the sweet Awakening Wellness Center…  The love seat is perfect for our clients to come in, relax, have some tea or water, and start telling us about how their past month (or week) has been.

We talk about any new experiences in this pregnancy they’ve encountered since our last visit or any continual issues they are having.  We do a lot of listening and then, when they are ready we dive into some great remedies from herbal and homeopathic recommendations to body work to physical exercise, nutrition, or mental health stability, along with any western treatments that are needed.

We continue talking about what is normal during this part of their pregnancy and any expectations or fun new things that may pop up in the coming months.  We make recommendations on additional educational classes, depending on how far along they are.  And we discuss, at length about any upcoming medical decisions or tests they may have at their next appointment.

At Portland Natural Birth, anyone you feel comfortable with is invited to your appointments.  We love having partners at appointments and getting to know them and making sure they are comfortable with us and the current plan.  We also love having children present at appointments if that feels right to you.  Or sometimes parents are visiting and want to check out their child’s care provider or maybe they’ll be part of the birth so they can come to your appointment and discuss any questions or concerns they may have.  Your appointment is really all about YOU.  Its about making you feel comfortable.

We still do the normal vitals: blood pressure, pulse, urine analysis (good ol’ peeing in a cup), palpating and listening to the baby and measuring your fundal height (how big your uterus is growing to accommodate your baby).  We also draw all labs in our office.  This allows you to feel comfortable getting all these vitals taken care of but in the comfort of our office and by people you trust.

Lactation News!

Well friends, the time came to step up my game as a midwife!  I love attending births and providing care to all our sweet families in those precious days during the postpartum period. I already spent time with all families making sure they had a good latch, gave them pointers on different nursing positions and gave them a quick run down of how their milk was made and why their breasts seemed fuller at different parts of the day.  I’ve always loved helping with nursing.  Not only is breastmilk AMAZING but it provides such an untouchable bond when families have the right support.  postpartum breastfeeding baby

So, I decided to further my education and learn more about breastfeeding.  After many months studying and learning more than I thought possible, I sat and passed the IBLCE (the international exam for certified lactation consultants) in October 2016!  I am now an IBCLC which means I am certified as an international lactation consultant which is the highest certification for this specialty.

What does this mean for Portland Natural Birth now?  Well, its an additional service, as needed for clients that may not have birthed with us or used other services but need some lactation support.  But, honestly, more than an extra service, its more help I can give to my own midwifery clients.  I’m really excited about spending a little extra time on prenatal education during our visits.  I’m happy to provide additional information and problem solve during the prenatal period on any possible problems or issues we may face.  And I’m happy knowing that I can save my clients an extra trip to another care provider while we snuggle in at home during their normal postpartum visit and troubleshoot whats going on.  Another perk as an IBCLC is that I can make direct referrals if necessary (specifically for a frenotomy, or tongue tie revision).

So, sit back and relax Portland families:  your homebirth midwife is now your lactation consultant as well!

Why Choose Midwifery and a Home Birth?

Portland Midwife Jamie Burke homebirthMidwifery is near and dear to our hearts as we have studied countless hours to finish our training to become midwives, stayed up long nights with laboring mamas as midwives and collectively have had six home births with midwives.

Midwifery care far exceeds most families’ expectations.  We provide one-on-one care, dedicating an hour to every prenatal and postpartum visits.  We are available through email and phone to address any fears or concerns that arise outside of your appointments.  And we are knowledgable.  We know western obstetric treatments but we offer alternative treatments first.  Our goal is to always start with the least interventive treatment and work with you within what is comfortable and safe.

Midwifery care focuses on the individual.  Each mama is different.  Every labor progresses in its own time.  Every family brings a new story to us.  As midwives, we know what normal pregnancy, birth, and postpartum look like and we help you find your stride within it.

Every birth is different and that is why midwifery care is so important.