IT's LIKELY THAT The answers to most common questions are here, but if not, CALL US!

Scheduling Appointments
Q: How can I schedule an appointment for a consultation/tour?
A: You can call our office at (786) 953-6534 and we will be happy to schedule your appointment over the phone.

Insurance Coverage
Q: Are you in-network providers?
A: No. Locally all licensed midwives working independent of birthing centers are out-of-network providers. The reason for this is that insurance companies don't pay providers their actual fee for service. They pay what they consider to be "fair and customary". For a business like a hospital, or even a busy obstetrician office the volume is so high that having their rate undercut is negligible or there are enough clients so that what the lose is made up for in quantity. But for a midwife who is doing 3-6 births per month, being paid $2500 for example (the amount the insurance company thinks is 'fair") versus their actual rate ($4800-6000 in our area) is a substantial deficit. This loss of income does not make for a sustainable business and would not allow us to keep our doors open so we can continue to serve families. It also compromises our ability to provide the quality of care typical of the midwifery model: personalized visits, longer appointments, minimal waits. 

In addition, if we become an "in-network" provider, because Magnolia is connected to our home birth practice, Blue Mountain Midwives, we would create a restriction for all the other home birth practices in our area, because they will no longer be able to easily secure "in-network exceptions" - limiting you as a client to where you can choose to give birth and use your insurance benefits. This is unfair to local midwives, but also to clients who should be free to make their choices based on the care provider who is the best fit for them and the birth experience they want, not the provider who is most inexpensive.

If you would like to get an estimate of your costs before you meet with us or schedule a tour please contact Larsen Billing Service,  and use our PIN 12092.  For a fee of $20 they will complete a verification of benefits, so that we can provide you with detailed information about what portion of the facility fee (if any) will be covered.

Safety
Q: Is giving birth at a birth center safe?
A: There have been several major studies of birth center births in the last thirty-five years. The most recent national study of birthing centers found that out of the women who planned to give birth at the birth center when their labor began, most (84%) ended up giving birth at the birth center. Of those transported, most were done for non-emergency reasons like prolonged labor. Less than 1% (n=140) of the study sample (15,574) transferred to the hospital due to an emergency in labor or postpartum. Additionally, one of the most important findings of the study was that 9 out of 10 women (94%) who entered labor planning to deliver at the birthing center, were successful at having a vaginal birth. This means that the C-Section rate for low-risk women who choose to give birth at a birth center was 6% - a staggering difference when compared to the national C-Section rate of 32.3% and the local C-Section rate of 49.1%
 

Doulas
Q: If I'm hiring a midwife, do I need a doula?
A: Absolutely. A doula is highly recommended, no matter where or with whom you are giving birth. The skills sets a doula and a midwife offer are vastly different, albeit complementary. Your doula's role is to provide emotional support and physical comfort measures, while your midwife will provide clinical care. In the event of a transfer to the hospital, your midwife will facilitate your transfer but will not stay for the duration of your birth. Your doula will provide continuity of care until a couple of hours after your baby is born. We highly recommend BOTH doula AND midwifery care. One can not replace the other.


Prenatal Testing
Q: Am I required to do prenatal testing?
A: In many ways informed consent is the corner stone of midwifery care and an important part of what separates the services midwives provide from those of other maternity care providers. By legal and ethical obligation we must give our clients complete information about the boundaries, limitations and benefits of the services we provide. A client cannot truly make a decision about her care if she does not fully know her range of options and the consequences of each choice. Informed consent as it applies to medical care refers to the full disclosure of information to a client to facilitate knowledgeable decision-making. Essential to the concept of informed consent is that we outline the nature of the procedure, list reasonable alternatives, relevant risks, benefits and uncertainties associated with both the alternatives and the primary option, assess your understanding and ultimately accept the decision you make. there are a variety of blood tests and screenings that are commonly performed during pregnancy. Compliance with 100% of them is not required for us to provide you with safe, high quality care. each test/screening will be discussed with you in detail and you will have the opportunity to make informed decisions about what is best for your and your family.
 
Transferring Care
Q: I've been seeing another provider for my care, but now feel that i want an out of hospital birth. Can i transfer to your practice?
A: We are always willing to consider clients who want to transfer care. Transfers after 28 weeks are possible and are evaluated on a case by case basis. We require that you bring a complete copy of your prenatal record at your initial consultation so that we may review your prenatal history.
 
Risk Factors
Q: Do you accept clients with risk factors?
A:  Midwives specialize in caring for normal low-risk women meaning we are trained to work with women whose pregnancy and births exhibit few or no risk factors. By definition low-risk excludes categories of women who have conditions that predispose them to medical management during pregnancy and birth for their own safety and that their baby. We perform a thorough history and physical and maintain an ongoing risk assessment during prenatal care. This allows us to establish a baseline that we can reference later in your pregnancy and enables us to determine any health areas that might be of concern as your pregnancy progresses. It will also allow us the opportunity to implement preventative measures with a potential concern before an actual problem arises. Hand in hand with the history and physical the initial risk screening during the first prenatal visits is an essential component of providing quality care. Risk screening allows us to provide guidance in anticipation of future problems & concerns.  
 
As a result of the many physical changes that occur in a woman’s body during pregnancy, conditions which were “borderline” prior to pregnancy can quickly escalate during pregnancy when unaddressed. Additionally many things that are found to be normal during a pre-pregnancy physical can become abnormal after pregnancy has begun.  In select moderate-risk cases, a collaborative  care management plan can be created. Signed by the patient, midwife and physician, the plan will identify specific guidelines for management strategies and treatment, as well as criteria for discontinuing the collaborative management agreement. This arrangement is especially useful for normally healthy mothers and their babies who are experiencing temporary moderate-risk problems that resolve during the course of the pregnancy. 
 
Low Risk
Q: How does the midwife know when things are no longer "normal" or low risk?
A: Midwives are acutely sensitive to any variations of normal or any signs and symptoms of complications that may manifest during labor. Knowledge of the physical and emotional histories of the women in our care and attention to detail during prenatal appointments also prepares us with knowledge needed to recognize what is abnormal for an individual client. A mixture of lawful practice and intuition in combination with the kind of knowledge that can only be gained through experience, we are able to offer our clients care that is sensitive to even small changes and variations that can occur during labor and delivery.
 
Emergency Transport
Q: What if there's an emergency or complication while I'm in labor or after the birth?
A: Licensed midwives are educated in emergency care procedures, to administer prescriptive drugs and to provide collaborative care under physician supervision for at-risk patients in any birth setting. Despite popular beliefs to the contrary, true obstetric emergencies are extremely rare. However, when they occur, we do everything possible to protect you and your baby’s safety. Under some circumstances, hospital transfer is a necessary component of maintaining a healthy birth outcome. In the case of an emergency transfer, we utilize the services of the nearest hospital, during which your care would be supervised by the covering obstetrician. In a non-emergency situation you have the option of traveling to hospitals in South Florida where physicians we collaborate with have admitting privileges: Jackson North Medical Center, North Shore Medical Center or Jackson Memorial Hospital. In both cases the midwife will accompany you the the hospital and someone from your birth team, most likely your doula will remain by your side until your new baby arrives. 
 
Family Involvement
Q: Can my family be with me when I give birth?
A: We view families (in whatever way you define family) as integral to the birth process. We welcome all families: married, partnered, single, gay, straight, traditional and everything in between. During birthing we find that clients feel safe and comforted by having their loved-ones around them in labor and babies deserve to be born into a community of people who love and support them. Your family (including other children) and friends are always welcome at your prenatal visits and at your birth. A supported and welcomed family means a supported client.