How do you have a home birth? A Doula’s Guide to Home Birth in Georgia
Updated: Apr 22, 2021
By Hannah Murfet
Hannah Murfet is a certified Doula and Licensed Clinical Social Worker. Hannah has worked with pregnant and parenting women in different capacities over the last 6 years. Today, she co-owns The Supported Mama, with her sister-in-law, Ashley Demmitt. Based in Peachtree City, The Supported Mama offers birth doula, postpartum doula, and perinatal mental health services to the South Atlanta area. If you have any questions at all about your home birth experience or planning, you can reach Hannah at TSMtherapy@gmail.com.
More and more Georgians are considering home birth these days – maybe it’s the coronavirus or maybe people have just realized that such an important event doesn’t always have to be experienced under fluorescent lights, in a hospital gown or induced on someone else’s schedule. Regardless of the reason, it’s been so exciting for Ashley and myself to see the attention that home birth has received this past year! With so many “newbies” considering home birth, I get a lot of questions from people who want to start with the basics. So I’ve put this guide together.
Note: Home birth is a legitimate and safe option for low-risk pregnancies. While it may not be for everyone, it could be a good fit for you! The question of whether or not a home birth is right for you is a whole different topic that could fill a book on its own. So I’ll be covering that in a separate blog post. If you’re looking for my list of FAQs, check that out here.
Introducing your Home Birth Team:
Midwife: A professionally trained individual who provides prenatal care and oversees the delivery of your Bub. Midwives earn their certification through various forms of training, including schooling and apprenticeships. Training has an emphasis on the traditional model of care.
Doula: A trained individual who provides support to expecting parents through pregnancy and birth. Doulas are primarily known for tending to the laboring mama and all others in the room- to assist in comfort management and emotional support throughout the labor process. Doulas begin their relationship with the expecting family during pregnancy, helping the family prepare for their baby both physically and emotionally.
Obstetrician (OB): a doctor/surgeon who specializes in pregnancy, childbirth, and a woman's reproductive system. Training has an emphasis on the medical model of care and delivers babies almost exclusively in a hospital setting.
Family/Friends: Provide emotional support and intimate connection during the birth.
How do I find a midwife for my home birth?
The first step in your home birth journey should be finding a midwife. Home birth
midwives practice independently, or as part of a collective. They will provide your
prenatal care, attend your birth, and provide postpartum care. Labs, bloodwork and
ultrasounds will be additional costs (see below). Some of these things can be performed by the midwife, while others -- like the ultrasounds -- will be outsourced. Most insurance companies do not cover home birth services. Your "outsourced" services could be covered, depending on if your provider is in network, etc. Some insurance companies may reimburse you for the cost of midwifery services if you submit a super bill after delivery, but in Georgia, I wouldn't get my hopes up. Here is a blog about how to pursue reimbursement, if you are interested.
A midwife’s approach is holistic and natural-minded. Most of the midwives I’ve encountered believe birth should be left undisturbed unless necessary. With that being said, midwives are trained to administer IVs, manage bleeding, respond to emergencies, and perform newborn assessments. If you developed a serious condition during pregnancy or labor, your midwife will be equipped to determine if you can proceed with home birth or if you should transfer to hospital-based care.
When choosing any provider, it is important to ask questions during your consultation to make sure that your preferences and priorities align with each other. Just like OB practices have their own “personalities,” each midwife has their own style and approach to care. Their training and experience will certainly contribute to their style. Midwives can train to become a certified “baby catcher” in 1 of 2 ways:
Certified Nurse Midwife (CNM): These are advanced nurse practitioners with additional training in midwifery. Because CNMs are licensed healthcare professionals, they can practice in traditional OB offices or in the home setting.
Certified Professional Midwife (CPM): These are midwives who have completed a nationally accredited midwifery program, which may include classroom hours and/or multiple years as an apprentice. The CPM certification is widely recognized in the United States; unfortunately, Georgia is one of fifteen states that does not formally recognize CPMs as approved perinatal providers. CPMs cannot become licensed in Georgia to provide midwifery care and, therefore, practice outside of a governing body -- in our state.
Generally speaking, Georgia has a conservative approach to birth. The State’s laws and social pressures value the medical model as opposed to seeing birth as a natural physiological process. As a result, it’s hard to find a traditional OB practice that openly supports home birth or who has a formal partnership as a “back-up” for the home birth midwife (in case of risking out or transfer). So, home birth midwives practice independently from OB practices. If having a back-up OB is important to you, you can pursue concurrent care (aka “shadow care”) with the midwife and the OB practice of your choice (this will significantly increase your cost). Unfortunately, the two providers will not collaborate and the OB will likely not support the home birth plan. There is 1 known exception to this – Ob2Me is a new concierge obstetric practice located in Marietta that openly supports home birth and provides prenatal care with the understanding that you will deliver at home with a midwife. In the event of transfer, Ob2Me can take over care at the hospital. If you do not have a concurrent provider, you go to the hospital if needed and be treated by the OB on call (this is what I did for a concern that needed to get checked out -- it was less scary than it sounds). There is always an OB on call at the hospital and they are equipped to treat your concern or receive you in labor – just be sure you go to a hospital that is in network with your insurance!
To summarize, home birth midwives are qualified professionals who truly believe in the work they are doing -- providing a physically and emotionally safe space for you to welcome your baby into the world.
You can find a midwife by simply doing a Google search, asking a doula (I would love to share my recommendations if you’re in the South Atlanta area!), or joining a Facebook group. Some of my favorite Facebook groups: Midwife Assisted Home Birth in Georgia, Georgia Moms for Better Birth, South Metro Atlanta Home Birth Support.
What is a Doula and how do I find one?
A doula is an important part of the birth team but is NOT a midwife. And before you ask: Yes, you do need both. While a midwife is assessing your progress and listening to fetal heart tones, your doula is applying counter pressure, helping you into a comfortable position, and making sure you and your partner stay hydrated and nourished. Why do I need a doula, won’t my midwife look after me? Well, yes, of course she will. But she needs to be available to see the bigger picture. If she is rubbing your feet and “in the weeds” with you emotionally, she will not have the objectivity she needs to observe and assess how your labor is going. You’re going to want and need close attention, but one person cannot do it all. That’s where I come in :) There’s a lot that needs to be done to make sure everyone is well cared for!
A doula’s support begins during your pregnancy – we help you prepare for what’s ahead and share (evidence-based) information to make sure you’re confident and prepared for the big day! During labor, the doula is responsible for supporting you (and your birth partner) by providing emotional support, guiding you on positioning and movement, assisting with comfort measures, keeping the environment comfortable, and creating space for your partner to support you. Please note: Doulas do not attend births without midwives. We do not do medical or clinical procedures (like checking dilation, etc.). We do not deliver the baby.
What to Expect.
Many people think that if you choose a home birth, you are not getting quality prenatal care. But from my personal experience -- it’s quite the opposite! I had exceptional care – my midwife paid attention to everything. After all, she didn’t want any surprises at the birth either! She got to know me, asked me questions, invited my husband and daughter to participate in our appointments, and left no stone unturned (pictured: my husband listening to our baby's heartbeat at our prenatal appointment!). Prenatal care will happen on a similar schedule as it would at a traditional OB’s office. You will likely be asked to receive at least one ultrasound to ensure the pregnancy is low-risk. You will also have the opportunity to complete blood work, the glucose test, and Group B strep test. As the big day approaches, you will have discussions with your midwife and doula about preparing for your home birth. As a doula, I believe practicing before the big day is super important. We will go through what to expect, laboring positions, comfort management techniques, and make sure all of your questions are answered so you feel 100% ready for birth day!
Birth doesn’t (usually) happen quickly, and that waiting time is much better spent at home rather than in a maternity wing of a hospital. When I was in early labor, I walked the trails behind my house with my partner and midwife. My mom dropped by with some homemade soup and, when labor was more intense, I relaxed in my tub with music and my favorite candle. My birth team was standing by, ready to assist as needed, but also gave me and my partner the privacy to experience this special day together. Those moments were so special and are some of my favorite memories today!
Midwife: $3,500-$6,000 (this covers all prenatal care, birth and some supplies).
Doula: $700-$1200. (this includes prenatal visits, birth support and a postpartum visit. You can see what’s included in my typical doula package here.).
Labs/Ultrasounds- Estimate $300 - $2,000 (varies depending on your preferences, need, and insurance coverage).
Additional supplies: Estimate $150-$300 (this includes things like a tub, essential oils, towels, and a hose- ask your midwife what is included in her package)
Total Estimated Cost: $4,650 - $9,500
Return on Investment.
Home birth allows you to be an active participant in your birth – from planning to
delivery. It is more than just an “experience” – it is a deliberate choice to challenge the norm. To step away from the over medicalized approach and get back to the basics. Once you experience this kind of care, this kind of birth, you won’t go back.
Hannah Murfet is a birth doula with The Supported Mama, located in Peachtree City, Georgia. Hannah serves the south Metro Atlanta area and attends births in home, birth center, and hospital settings. She recently welcomed her son in the comfort of her own home, which further fueled her advocacy and appreciation for home birth. Hannah is passionate about removing the stigma of home birth by sharing information about how it works, the quality of care involved and the safety of this option.