Yes. FL law mandates that birth with a midwife in the location of the mother’s choice be covered by insurance companies. (See Florida Statute Number 627.6574) Whether or not the insurance company will pay for services at in-network or out of network rates is strictly up to each individual company and your policy. We are in network with all Blue Cross Blue Shield/Florida Blue plans. While we are not in-network with other insurance companies, our billing coordinator can file claims on your behalf to your insurance company for reimbursement. Reimbursement amounts are determined by your policy’s allowable rates and amount, if any, is not guaranteed. We will work to obtain a gap exception, which allows your claim to be processed at the in-network level. If a gap exception is denied, your claim will be processed as out of network. Some items are not covered by insurance and are the responsibility of the client. Lab fees and fees for services with other healthcare providers, and in the event it becomes necessary, fees associated with emergency hospital transfer are billed separately to your insurance by the individual provider.
Due to overhead costs and low payment rates, we are unable to accept Medicaid. While we do not accept Medicaid, we do offer a sliding scale for those who currently have Medicaid based on annual household income.
Most visits are 45 minutes to an hour. We take time to get to know you and your desires for your birth and will discuss any physical issues you may be having. We also will discuss topics relating to pregnancy and birth to prepare you for your birth. We encourage you to bring your spouse or significant other, children, and any other family members you wish to include in your birth to your appointments. At each visit we will check your blood pressure and other vitals signs, obtain your weight, check your urine for protein, glucose, and any signs of infection, listen to your baby’s heartbeat, and monitor your baby’s growth and position.
We perform standard labs throughout pregnancy to ensure you remain low risk, and will order extra labs if necessary. We will order ultrasounds for early date confirmation, a fetal anatomical survey at 20-22 weeks gestation, and other diagnostic ultrasounds as needed. Genetic testing and carrier screening is also offered.
Pursuant to FL Law, we are required to assess all clients’ risk status according to a specific scale. Depending on any risk factors you may have, you may need to have a consult with an obstetrician to determine if you are expected to have a normal pregnancy, labor, and birth. We also may collaborate with Maternal Fetal Medicine specialists to help you stay in our care for your intended out of hospital birth. Should you develop a condition that risks you out of our care, you will be transferred to an obstetrician of your choice.
No. You will not need to see a physician during your pregnancy if you are low risk and do not have any complications.
Yes. Pursuant to FL Law, we are required to carry malpractice insurance.
All clients are strongly encouraged to take our childbirth education series. We offer classes for Early Pregnancy, Childbirth Education, Breastfeeding, Newborn Care, and Postpartum Self Care. We also offer a private Sibling Prep Class upon request to help prepare siblings who are planning on attending the birth. For more information about our classes, please contact our office.
We do require a doula for our first time moms and VBAC’s. Doulas provide continuous physical and emotional support throughout your labor and birth, while your midwife and the birth assistant work to ensure the health and safety of both mom and baby. We do not require you use a certain doula, and while we have doulas on staff, we are happy to work with other doulas in the area.
You will need to gather some common household supplies, such as towels, a flashlight, paper towels, etc., as well as purchase supplies for your birth. We will provide a list of items for you to gather and have prepared by your 36 week home visit at which time a birth assistant will come to your home to ensure all supplies are ready and your home is in order.
If you go beyond 40 weeks, it’s no big deal. Many women deliver after their due date. On average, first time moms will deliver 7-10 days after their due date. As you approach your 41 week mark we will schedule you for a test called a Fetal Non-Stress test and a specialized ultrasound called a Biophysical Profile to ensure the health of your baby and the condition of the placenta. We will discuss natural measures to try and encourage labor to start. These measures may include using a breast pump, walking, herbs, acupuncture, etc. We will not, under any circumstances, induce labor using pharmaceuticals such as Pitocin, cytotec, or other drugs used in the hospital setting to induce labor. These methods of induction require significant monitoring and are not safe for out of hospital use. If by 42 weeks we are unable to get labor started, you will be referred for induction.
We do limit the number of clients we take on in any given month to avoid conflicts as best as possible. It is feasible, however for women who have due dates even one month apart to give birth on the same day. A benefit to being a client at Beautiful Beginnings is that we are a mult-midwife team, ensuring you will always have someone you know at your birth. Having more than one birth suite at the birth center also means we can accommodate more than one family at a time in the event there is more than one woman in labor.
We will always have a birth assistant with us at the birth to assist the midwife and have a second pair of hands in the event of an emergency. All of our birth assistants have gone through extensive training and are certified in both CPR and NRP. Beautiful Beginnings is proud to be one of two testing sites in Florida, for the American Association of Birth Centers (AABC) birth assistant certification program. We are also a clinical site teaching facility with midwifery schools and nursing programs, and have nursing students and student midwives who may be involved in your care. You have the right as a patient to decline student participation in your care.
Once we have spoken over the phone and determined you are in fact in active labor, we will make a plan to meet at the birth center or our arrival at your home. It is often not the best thing for us to come right away if you are in very early labor. This can make many mothers uncomfortable as we sit around waiting for something to happen. We will direct you as to when to check back in with us if you are not in active labor and keep in close contact with you.
It’s your birth. You may have as many or as few people as you like at your birth. Children are more than welcome to be in attendance; however we ask that you plan to have someone other than your partner available to care for them throughout your labor. We also know that sometimes when there are a lot of people present it can hinder the labor process and prevent you from getting into your labor zone. We advise that you plan carefully and take into consideration that birth is not a spectator sport and any friends or family that you have at your birth should have a defined role and be an active participant in supporting you through your birth. If a situation arises that we feel it would be in your best interest to have less people in attendance, we may ask people to leave temporarily.
Yes. We will discuss this during your prenatal care. Your partner will need to be present for at least a few appointments in if they wish to catch the baby so we may discuss the plan.
During labor we assess the baby’s heart rate using a Doppler using intermittent fetal monitoring. Research shows that intermittent fetal monitoring is equally as reliable as continuous fetal monitoring. Depending on how far you are in your labor progress will determine how often we check. The closer you get to delivery, the more frequently we will monitor baby’s heart rate and pattern.
Midwives are trained to handle many different labor complications and we carry the same medications and equipment found in the hospital for vaginal deliveries. In the event of an emergency that we cannot resolve, we are equipped to handle an emergency until transport to the hospital is complete.
During pregnancy we will educate you on perineal massage techniques for you to perform yourself prior to labor. It has been shown that perineal massage prior to labor reduces the incidence or degree of tears. During your delivery, we will support the perineum as best we can, however tears still happen sometimes. We will assess any tears after delivery and repair them if necessary by suturing. In the rare case that a tear is beyond our capabilities to repair, we would transfer to the hospital for the repair to be done.
Sometimes babies need a little help getting started. We are equipped to handle resuscitation and both our midwives and our birth assistants are certified in CPR as well as NRP and we are equipped to handle complete newborn resuscitation should the need arise.
Yes. We will perform a complete newborn exam after birth. The newborn metabolic screening and cardiac screening will be performed at your 48 hour postpartum appointment. The newborn hearing screen can be done in our office any time during the first month. You will be encouraged to make an appointment for your baby to see Caleb Quick, APRN, FNP with the Family Health side of our practice, or the pediatrician of your choice.
Depending on the time you give birth, at approximately 48 hours, or day two, we will see you for your first postpartum visit. We will see you again at approximately three weeks and six weeks postpartum. We are always available for problem visits, or by phone if you need assistance between visits.
