I think of midwifery as a seed full of potential - a seed that will grow into a lush, blossoming tree with green branches and plenty of ripe fruit for nurturing women, babies, and families.

- Marina Alzugaray
I'm here to help!

I have compiled the most Frequently Asked Questions to provide answers for soon-to-be mothers. If you have any additional questions, please don’t hesitate to reach out by email at mary@rvahomebirth.com or phone at 804-382-8222.

I encourage you and your partner to meet with me to discuss any concerns you may be having about making the decision to have your baby at home. I only work with normal healthy low risk mothers having normal pregnancies and anticipating a normal low risk birth.  I offer free consultations if you live within a 60 mile radius of Richmond. You can also find me on Facebook at Richmond Virginia Home Birth. Please call me at 804-382-8222 to talk more and set up a consultation appointment.

My fees are based on a sliding scale which is determined by your total family income. You will find my rates very affordable.  Please call me to find out what this would be for you. I can work with you on the amount and when your payments are made. At this point in time, I do not accept Medicaid and I only accept limited insurance plans. Most insurance plans do not cover the total cost of out of hospital births unless you have few other options in your area. You can contact your insurance company to talk about this and see what you would need to do to have them cover a home birth. I would require the whole fee for your home birth up front as a deposit by your 36th week of pregnancy and your insurance company can reimburse you for the services afterwards, if they make an exception for you. Many women find insurance does not cover very much of the costs of prenatal visits, home birth, and postpartum follow up visits as they also take out for deductibles and copays that are your responsibility. I also work with MedLoanFinace.com to help you get a small loan to cover your midwifery care. You will work out with them the loan arrangements but you must submit the application when we are together so that I can give you a quote for this. Many times the service fee is small if you agree to pay off the balance within 3 years. Ask me for a brochure when you set up your consultation visit. I occasionally put out coupons for a certain percentage off of your fee and I always give you a nice discount for paying in full when you decide to hire me! As always, repeat clients also get a good discount.

This is up to you. However, seeing that I would be your care provider, as soon as you know you are pregnant is optimal. It is important to have early prenatal care to minimize you and your baby’s chances of morbidity and mortality. It will also optimize your chance of having a healthy baby. If you wait until your last trimester, I don’t give you a discount because you have (hopefully) obtained prenatal care elsewhere. I don’t usually take on clients past 35 weeks because I provide a lot of education about home birth throughout your pregnancy and I need to have a good understanding of your specific needs/desires when giving birth.

Yes. At this point, I do not have an office and ONLY go to clients homes for prenatals, the birth, and postpartum visits. I do not charge any extra for this unless you are more than 60 miles from my home then there is a .57/mile additional charge. I will travel within a 60 mile radius from where I live in Midlothian (zip code 23113). Partners, children, and family members are always welcome at your prenatal appointments.

CPMs do not have hospital privileges as we are trained exclusively in out of hospital births. We do not go to nursing school or attend hospital births as part of our training. Many CPMs have been birth doulas and have attended hospital births as a doula before becoming a home birth midwife. VA laws do not require CPMs to have a back up physician either. However, I have worked with many of the doctors in the area as a doula and will be able to refer you for additional care or testing as needed. In addition, CPMs do not carry malpractice insurance or liability insurance.

If your care must be transferred to an OB or you are transferred to the hospital for safety reasons, you are still responsible for the amount incurred for your home birth prenatal visits and labor. Most of the time, if you are transferred for life threatening reasons during the birth, myself or my assistant will remain with you until the baby is born to help ensure continuity of care and to advocate on your behalf. Due to the COVID pandemic, I nor my assistant will be allowed to stay with you if you transport to the hospital for the birth. I work with a consulting CNM (certified nurse midwife) who can prescribe medications for you during your pregnancy and postpartum period.

Midwives are trained in helping women have gentle birth experiences and I will use that training to help you avoid tearing. However, sometimes women who have had an episiotomy with a previous birth may tear more easily in the same place. I will use natural remedies to numb your bottom and then suture your bottom if necessary.

Yes! I am a VBAC mom myself and was a long time leader of the areas VBAC support group. I have helped women have primary VBAC at home (HBAC) as well as VBAC after more than one c-section. You will need to get a copy of your operative report for your cesarean for me to review with you. We will need to discuss the reasons for your cesarean and your health history. 

I am a solo midwife and I do not overbook clients. I also will not induce my clients with any of the remedies available to home birth midwives so that you have your baby on my schedule. I will not send one of my assistants to your birth in my place. Unless you have a very fast birth, I will be there. Even if your birth is very fast, I will be on the way and will get there before the baby is an hour old.  I will be the one who will attend your birth and all prenatal and postpartum visits. You are not required to see an OB while in my care although I do reserve the right to request that you see another provider if I feel you are exhibiting some complications in your pregnancy or if you have another health issue that may put you at an increased risk for home birth if not managed carefully.

I limit my practice to 4 clients a month. I try not to take clients who are due in the same time frame. However, birth can be unpredictable and I will make every effort to let you know if other clients are due around the same time. I feel it is important to be there with you when you are in labor when you feel the need for me to be there. And I do not want to have you laboring alone for very long. Most of the time, I will arrive at least a few hours before your baby. I am on call for you from 37 weeks until your baby is born. 

Surprisingly, there is rarely a big mess during and after a home birth. I have attended births where there was less than half a kitchen trash bag of used supplies and only a full load of laundry that needed to be done. Most of the time, my assistant and I will help keep the place tidy as we work and start the laundry before leaving. We will also take down and clean the birth tub, if you decide to use this. Most of the time, we leave your place with few signs that a home birth has just occurred there. You can keep your placenta or I can encapsulate it for you for an additional fee.

I believe that birth is a normal, natural, physiological event that every woman is designed and equipped to do from the time they are a female inside of their own mother’s body. Birth is innate and inborn. It is also a rite of passage into womanhood. Our current culture has taught us that we should fear birth and the sensations it brings. I will work with you to learn to trust your body and to step out of the way mentally so that your body can do the work it knows how to do. I act as your guide during this process. I cannot do it for you. CPMs cannot carry or administer medications in VA, including for pain. I do encourage all first time mothers to attend child birth education classes especially for home birth and I recommend hypnobirthing classes for everyone. We will address any fears and concerns you have about birth in your prenatal visits and during your labor as they come up. Home birth midwives work with normal healthy mothers who are having normal healthy births. Most of the time, the woman who is choosing a home birth willingly acknowledges that she is solely responsible for her own health and that of her unborn baby. I firmly believe that all healthy low risk women should have the choice as to where and when they have their babies.

At each prenatal visit, I will take your vital signs, palpate your belly, and listen to the baby’s heart rate. I can also offer the glucose tolerance test and the group B strep test later on in pregnancy, after offering you informed consent. CPMs are noted for always offering their clients informed consent/informed choice and you will always have the option to accept or decline any testing or procedure unless it is an emergency situation and you or your baby’s life are in danger. Many women having a home birth do not choose to get any testing done once informed about the risks and benefits. For additional testing such as ultrasounds, AFP, or amniocentisis, you will be referred out to another facility for this and the results will be sent to me to go over with you. Your insurance will usually cover these tests if you decide to get them. I can usually accompany you to these appointments if you desire. If you have already decided to switch from a doctor or hospital midwife to me for a home birth, I ask that you get your medical records before our first meeting. I can do the metabolic screening test for an additional fee.

Yes! They are an ideal way to help a woman cope with the sensations of labor and to avoid tearing during the birth! My tub is available for rent for my clients or you may choose to purchase your own.

Have a gentle, loving, birth experience!

Learn more about the benefits of home birth with RVA Home Birth!