General Services Offered

Homebirth, Naturally is a service composed of two Certified Professional Midwives with a client base in the Adair County Area, predominantly Kirksville, Missouri. They add to the market of resources available to expecting parents planning for a vaginal birth in the local area, providing “prenatal care on a regular obstetrical schedule” (Midwife Interview, 2018). This includes initial consultation meeting, general lab work throughout all three trimesters, the birthing process, and postpartum care. The initial consultation includes discussing care options and answering any questions the expecting parents may have. The general lab work they perform, according the the Homebirth, Naturally website, includes, “group B strep, glucose screening, hemoglobin, and for the baby, PKU and congestive heart test, along with several others” which are done without requiring the mother to leave the comfort of her own home (Homebirth, Naturally, 2018). For the birthing process, it usually occurs in the client’s home, where Homebirth, Naturally will provide everything necessary for the birthing process (birthing pool, medications if desired, other medical supplies needed for birth such as anti-hemorrhagic, stitching, a catheter, among others). The client will stay and give birth at home if it is low risk, but, if the birth ends up, “transporting to the hospital, [they] continue to stay with the mother and support them there” (Midwife Interview, 2018). As for postpartum care, the midwives will continue appointments up to 6 weeks after the birth for both the mother and baby.

Who The Serve

Homebirth, Naturally serves about 4 to 8 women a year from Adair county, varying year to year. According to the midwife interviewed, they, “only work with low-risk pregnancies and birth who are seeking a natural birth” but will stay with their client in the hospital if the situation becomes too dangerous to stay at home. The clients that chose to work with Homebirth, Naturally are often looking for attentive, personal care through their pregnancy as well as “rich and familiar relationship with each of [the midwives]” (Midwife Interview, 2018).  These pregnancies often require more planning than the usual pregnancy, as the correct provisions need to be made for the birth to go smoothly at home.

Impact on Kirksville

With the reversal of lower court ruling in 2008, Missouri once again allowed families to seek the care of professional midwives, “who hold a current ministerial or tocological certification by an organization accredited by the National Organization for Competency Assurance (NOCA)” (Walden, 2008). This has since popularized home birth in Missouri, including Kirksville, as it is mostly midwives  who perform this type of service. Nationally, Missouri does stand out in the Midwest for having a slightly higher than average proportion of home births, between 1% and 1.49% of births occurring at home (see Figure 3, Centers for Disease Control and Prevention, 2012). It should also be noted that the Centers for Disease Control and Prevention reports that home births are less likely to be preterm births, low birth rates, and multiple births  (see Figure 6, Centers for Disease Control and Prevention, 2012). This lower risk profile suggests that midwives are selecting clients that provide a low-risk profile, as they are not able to provide all of the same services that a high-risk pregnancy would require. Since there are less resources needed for a low-risk pregnancy, it is usually more cost effective. According to a US National Institutes of Health study, “the average uncomplicated vaginal birth costs 68% less in a home than in a hospital” (Anderson, 1999). Noting that the cost of midwifery care is significantly less than typical obstetrical care such as in hospital, most clients of Homebirth, Naturally pay out of pocket, as this service is not covered with all insurance plans. Because of these two facts, the midwives of Homebirth, Naturally “charge a sliding scale and encourage clients to choose the amount they will pay based on their income and financial situation” (Midwife Interview, 2018). Taking all of this information into account, the services of Homebirth, Naturally are ideal for low-risk pregnancies for expecting mothers looking for a cost effective and empowering vaginal birthing experience.

References

Midwife Interview, Homebirth, Naturally. (2018). Interview with Midwife of Homebirth, Naturally. Conducted via email.

Homebirth, Naturally. (2018). Organization’s Website. Retrieved from http://www.homebirthnaturally.com/

Centers for Disease Control and Prevention. (2012). Home Births in the United States, 1990–2009. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db84.htm

Anderson. (1999). The cost-effectiveness of home birth. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10063222

Walden, Rachel. (2008). Missouri Supreme Court Ruling Makes Midwifery Legal. Retrieved from https://www.ourbodiesourselves.org/2008/06/missouri-supreme-court-ruling-makes-midwifery/