Las Vegas Homebirth Midwife

Yes! I have the ability to come up with a flexible payment plan if need be, or the standard one is $1000 at your first prenatal visit, and $300 at each prenatal appointment. I take all forms of payment. 

Midwives are health care professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which results in confident, supported labor and birth. While there are different types of midwives practicing in various settings, all midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns. Many midwives also provide preconception care and routine well-body reproductive care throughout the life cycle.

The Midwifery Model of Care is a fundamentally different approach to pregnancy and childbirth than contemporary obstetrics. Our model of care includes:

• Monitoring the physical, psychological and social well-being of the birthing parent throughout the childbearing cycle
• Providing the birth parent and family with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
• Minimizing technological interventions and
• Identifying and referring individuals who require obstetrical attention.

The latest research on planned home birth, released in 2014 by the Midwives Alliance of North America (MANA), found that among 17,000 families:

• Better outcomes for babies: 97% of babies were carried to full-term, and weighed an average of eight pounds at birth. Only 1% of babies were transferred to the hospital after birth, most for non-urgent conditions.
• Low rates of intervention: Only 4.5% of the 17,000 study participants required oxytocin augmentation and/or epidural analgesia. This is much lower than average for the United States, where 26% have oxytocin augmentation and 67% have epidurals.
• Low rates of cesarean birth: The 2014 MANA study also found that of the 17,000 planned home births, only 5.7% ended up birthing their babies via cesarean. This is compared to the national average of approximately 31% for full-term pregnancies.
• High VBAC success rate: For low-risk individuals, the chance of having a vaginal birth after cesarean ranges from 68-87% when birthing outside the hospital.

Questions of safety and risk are deeply personal and something that all birthing people should examine- regardless of birth location. Birth inherently comes with risk. There is risk to birthing at home just as there is a risk to birthing at a hospital. The question becomes which set of risks feel safest to you.

Here are some studies and other material to explore:

-Film:  Why Not Home

– Article : Why Choose Homebirth

– Study by The Lancet

–MANA study

– Study on Perinatal mortality and morbidity

– Outcomes of planned home births with midwives versus physicians

– Outcomes of home births with CPMs in North America

• Individualized care: All decisions about your care are made together with you. We will have thorough conversation about your needs, preferences, and values, your individual health, and the evidence regarding the options available to you. We respect you as the expert of your own body and your baby's primary care provider.
• Continuity of care: Your midwife will follow you throughout the course of your prenatal, birth, and postpartum care. At every point in your parenting journey, you will see the familiar, comfortable, friendly face of your very own midwife.
• Evidence-based care: We stay current on the research around pregnancy, birth, postpartum, and breastfeeding so that we can provide up-to-date information to assist you in your decision-making.
• Your own environment: For many families, the comfort and security of your own home cannot be matched. You choose who attends your birth and who cares for you. You choose what to eat and drink. Walk, dance or sleep uninterrupted - it's your birth!
• Incredible postpartum care: From the first minutes of your baby's life to your six week postpartum checkup, The Joyful Birth midwifery provides attentive, personal support and education necessary for your baby's growth, help your family bond with your newborn, develop long-lasting breastfeeding relationships, and heal your body in the postpartum.

During your labor your midwife Ali will join you along with an assistant. A student midwife may be present during your care and birth. We value and respect your desire to know who will be at your birth and strive to make sure you have a chance to meet your entire birth team before labor time.

Yes! Waterbirth is a lovely option for those who desire it.  Many families choose to have birth tubs for comfort in labor, regardless of whether the family plans to have the baby in or out of the water.  A birth tub is included in your midwifery care. 

Most likely. Trying for a home VBAC has a high success rate - up to 87% - but there are some additional risk during labor, and some people are better candidates for home VBAC than others. 

Cesarean birth or other uterine surgeries leave a scar on the uterus, leaving some of the tissue weaker and slightly more prone to separating during labor. This is known as uterine rupture. The risk of uterine rupture is 0.2% if you have had one prior c-section, wait at least one year for your uterus to heal before becoming pregnant, have a low transverse incision, and your reason for the c-section does not necessitate another - like breech or failed labor induction. Additional c-sections, infections during healing, smoking, and possible anatomical reasons for c-section (ex: contracted pelvis) can increase your risk of uterine rupture.

We can discuss your prior birth experience and desire for VBAC during a free consultation. 

Some (not all) of the equipment we bring includes:

• Monitoring equipment for you and your baby, including a doppler, blood pressure cuff and stethoscope, thermometer, and infant stethoscope.
• Supplies for the newborn exam and any newborn procedures that you choose, including a scale, measuring tape, erythromycin ointment, and vitamin K.
• Antihemorrhagic herbs to stop excessive postpartum bleeding.
• Resuscitation equipment for baby and birth parent: a bag and mask resuscitator.
• Suturing equipment to do repairs if any tearing occurred, and lidocaine to numb for suturing.

While every birth is a little different (depending on if you, your partner, your child, or your midwife catches your baby), at a typical birth we will wait for you to take your baby and bring them onto your stomach or chest, and we will keep a close eye on your bleeding and your baby's adjustment to life outside the womb. After the placenta is born and the baby's cord is done pulsing, we ask you if you are ready to cut the cord and who is going to be the one to do it, and we help clamp and cut the cord. Then we give you some space for family time, staying close by with an ear out for your needs and checking on you periodically. Whenever your baby is interested in nursing, we offer help with positioning and latch if you would like it. After a thorough newborn exam when your family is feeling comfortable and ready for a nap and we’re satisfied that you and baby are healthy and stable, we leave. Then one of your midwives will return in about 24-36 hours for your first postpartum visit.

We aim to leave the house as clean as it was when we arrived! During your pregnancy I will give you a link to a website where you will order a "birth kit" which includes all the disposable supplies for your birth. Many of these supplies are meant to keep your house clean during the birth. While you have family bonding time with your new baby, we quietly tidy up.

We provide lab services: blood draws, urine tests, pap screening and infection swabs during regular appointments or in between if any concerns arise. We also provide referrals to medical imaging professionals in order to obtain ultrasounds as needed or desired. We are able to refer you to other professionals for additional testing if it becomes necessary. There are no tests available in obstetric care that we cannot provide you or help you access.

No, your midwife is your primary care during pregnancy, birth, and the postpartum. You would be referred to a hospital-based provider in the event your pregnancy or birth becomes higher risk than what is within the midwife’s scope of practice.

The option of going to the hospital at any point in your labor is always available. Having said this, it is very uncommon in a labor that is progressing normally that women opt to go to the hospital. Having the ability to eat, drink, move, and having the constant support of loves ones makes an incredible difference in one’s ability to cope with the hard work of labor.

Your midwife will file your birth certificate.  One of the questions on the form is for assigning a social security number at birth. We can check ”yes” or “no.” If you choose “no,” you must then register the child for a social security number by the age of sixteen. Approximately 3 weeks after the registration of the live birth you can visit SNHD and order the official, state-documented birth certificate.

Midwives are trained to handle a wide spectrum of labor and births. However, if something falls outside of our scope, looks as if it is trending that direction, or if we are in need of an intervention that is not available in the home setting, we will transfer to the hospital. Most of our transfers are non-urgent and we often go by personal car. If an ambulance is needed, we call to initiate their services. We accompany you to the hospital, relinquish clinical care, but stay present with you as your advocate.

Birth doesn’t need a lot of space. If you consider the size of a hospital room, most homes are of adequate size. Laboring people often gravitate towards small spaces, like bathrooms or a cozy corner of the bedroom. We are used to working in small spaces. And contrary to what Hollywood would like us to believe, birth is a relatively quiet event. 

Absolutely!  Children of all ages do very well in the birth environment.  I find children take their emotional cues from the adults in the room.  When a child sees their parent in discomfort, they will look towards the adults in the room for assurance.  When the child sees us quietly smiling and telling their birthing parent that they are SO STRONG (with a smile on our faces), they can confidently believe in the process.  I do encourage you to use your best judgement in regards to children being in attendance.  You know your child best - if you feel you won’t be able to relax with your toddler in the room, please feel free to not have them present for the birth.  I do recommend that any child under 10 have an adult support person (grandmother, aunt, family friend, etc) also present.  This person can provide care such as food and bathroom assistance, and reassure the child.  They can also take the child out of the birth space or home if the birth is particularly long, or the child decides s/he does not want to be present any longer.  If you do not have a support person in your circle who can provide care for your child, we can help you find a sibling doula.  I also recommend a sibling prep class for childbirth, and watching birth videos with your children so they know what to expect.

A midwife is not a doula.  A doula is a trained labor support person who provides emotional and physical support to those who are giving birth and their families.  Doulas are not medical professionals, but are valuable to the birth experience and we recommend everyone hire a doula!

You do not need a doula if you hire a midwife, but you may still want one! The role of the doula is different from that of the midwife. A doula is an emotional, physical, and informational support person. Doulas act as labor “coaches”, guiding you through the stages of labor using labor positions, comfort measure tools, affirming language, and other tools. A doula will often arrive at your home before the midwife does. A midwife’s role is clinical and she is responsible for the health of you and your baby. Midwives often arrive after the doula and stay longer into the postpartum. The differing roles of the doula and the midwife make them a comprehensive care team! We recommend doula support to all our clients, especially first-time birthers.