Home Birth Services

Prenatal Care, Birth, and Postpartum Services $6100.00

Journey Midwifery is here to bring compassionate individualized midwifery care to you. Our goal is to equip you with knowledge so that you can confidently take charge of your journey; and to support you in your decisions. You will always be heard, and never coerced in your decisions.

Prenatal Care
Prenatal care is a time to get to know one another. At our initial visit, we will do a thorough history to determine your risk factors, make a plan for your care, and discuss how best to meet your needs. At your prenatal appointments we will listen to baby's heartbeat, take your vital signs, draw labs if needed, provide nutritional and other education, talk about your birth desires, and have ample time to answer any questions you may have. Our goal is to educate and empower you while having a healthy pregnancy and birth experience.

Prenatal care is provided at our office.

Labor and Birth
Midwife Holly currently provides home birth and water birth services in San Antonio & the surrounding areas. When you are in labor you will move about freely in the comfort of your own home, inviting whomever you want into your sacred birth space. When you are in active labor and ready for your birth team to arrive, we will arrive and monitor you and baby while you continue to labor and move about freely. During pushing and birth, your midwife (or a loved one with the midwife's guidance) will catch your baby and place baby immediately in your arms for uninterrupted skin to skin contact.

Postpartum & Newborn Care
Immediately after birth, your birth team is present for 2-3 hours after birth. During this time we are assessing both you and your baby's vital signs with minimal disturbance, with baby in your arms. We will assist you to breastfeed, make sure your bleeding and vital signs are normal, make sure you eat, check for any vaginal tearing, and do your baby's first newborn exam. The newborn exam is done right next to mom at the bedside, and family is welcome to help participate! During this time we are also cleaning your birth space and washing any laundry we may have used. After all this, your birth team tucks you into bed and your midwife returns 24-48 hours after birth for a home postpartum visit. I also see you at 2 weeks and 6 weeks after birth in office.

Your midwife will file your newborn’s birth certificate and you can obtain a copy from the Texas Bureau of Vital Records in person, online, or by mail. We offer all of the state mandated and normal newborn services, such as newborn screening, and CCHD (Critical Congenital Heart Disease) screening at your follow up visit. Your newborn will be referred for a hearing screen. Postpartum is the “4th trimester” and it is a time of growing and learning for you and your newly expanded family. We are here to support you and connect you with the resources you need to successfully navigate this time.

Our prenatal and birth service package includes:

· Regular prenatal visits that last approximately 45 minutes

· We are on-call for your labor and birth from 38-42 weeks

· Available by phone 24/7 for urgent concerns

· Available during office hours (M-F 9-5) for non urgent concerns

· Regular postpartum visits for follow up after the birth at 24-48 hours, 2 weeks and 6 weeks

· Newborn CCHD (Critical Congenital Heart Screen) & Newborn Screen

· Any incidentals that are needed during birth (medications, IV, suture material)

The following items are not included in our fees, as they vary, due to individual needs and preferences:

· The cost of any labs and ultrasounds (if you have insurance, it should cover a portion of these), or other health care provider appts (if necessary)

· The cost of RhoGam if needed (Rh Negative blood types)

· The cost of newborn hearing screening

· The cost of a childbirth class-if applicable

· Birth kit and various other supplies for the birth (such as birth tub liner. Birth kit and tub liner approx $100-125)

Frequently Asked Questions

Please reach us at info@JourneyMidwiferySA.com if you cannot find an answer to your question.

Is homebirth safe?

Yes! Homebirth is safe for healthy low risk women without certain pre-existing conditions. Most women-including women over 35 and those with one previous cesarean birth- are considered low risk for home birth.

Women seeking homebirth are intuitively choosing to take control of their pregnancy and birth experience; and are committing to a lifestyle of healthy nutrition and positive physical activity to stay low risk.

What does the midwife bring to the birth?

The midwife brings an assistant to the birth. Supplies brought to the birth are emergency medications such as Pitocin and cytotec (for post-partum bleeding), handheld Doppler to monitor baby, sterile instruments for cutting the cord, Vitamin K and eye ointment for the infant, suction device to remove mucus from the infant’s nose or mouth, oxygen tank, IV supplies, and adult and infant resuscitation equipment.

What about the....... mess?

We do a pretty good job of keeping mess to a minimum. At your home visit we go over ways to prepare your house for labor. When the birth is over, we put away the birth supplies, start the wash from the laundry we used during the birth, take out any trash that accumulated during the birth and postpartum period. The house typically does not look like there has just been a birth there when the birth team leaves your house!

What interventions can a midwife do at a homebirth?

Midwives do have a host of other clinical skills that they can use; this depends on their scope of practice, training and licensure but can include:

Monitor baby's heart rate intermittently with a handheld doppler.
Monitor labor progress, vital signs, maternal well being
Provide physical and emotional support during labor
Recognize complications and transfer to a hospital before (most of the time complications are recognized and transfer happens before there is an emergency).
Can suture tears
Can administer emergency medications and oxygen
Start IV's & administer fluids
Perform resuscitation (adult and neonatal)

Who can attend the prenatal appointments and the birth?

Spouses, children, family, friends, and doulas are always welcome to attend your prenatal visits and your homebirth.

When do I have my first prenatal, and how often do you see me?

The first prenatal appointment is typically between 10-12 weeks of pregnancy, but you are welcome to come in earlier if you'd like, or if you are having complications/discomforts.

After the first prenatal visit we typically see you:

Every 4-5 weeks until 28 weeks
Every 2-4 weeks until 36 weeks
Week 38, then weekly appointments until birth.

Isn't it expensive? Do you take insurance?

The cost of care with Journey Midwifery is $6100.00. Your fee will be divided into equal monthly payments to be paid in full by 36 weeks of pregnancy.

While this fee may seem expensive, homebirth is significantly less than hospital based care (between OB fees and hospital fees). Many people will pay this fee as they're out of pocket cost after insurance when having a hospital based birth. We also offer super personalized care based on the individual client's needs and desires.

At this time, we are not in network with any insurance companies. We do not bill insurance, which means clients with Journey Midwifery pay their bill as self pay clients. Upon request, clients will be given a superbI’ll which they can submit to their insurance for possible reimbursement.

What about hospital transfers?

There may be times that a client transfers to the hospital in labor or during the postpartum period. Your midwife is always aware of the closest birthing hospital to your house.

The main reason clients typically transfer to a hospital in labor is exhaustion/and or pain relief measures. If a client transports to the hospital for a non emergent reason, a client can choose to transport to the hospital of their choice. Your midwife would help you decide which hospital is a good fit for you.

If there is an emergent need to transport to a hospital where EMS is activated, the paramedics transport a client to the nearest hospital with birthing services due to a time sensitive nature.

In either situation, your midwife would call and give report to the OBGYN hospitalist, faxes your records to the hospital, and accompany you to the hospital for the birthing process.

How do I get my baby's birth certificate?

After the baby is born, I file the birth certificate with the state of Texas. Once I submit the birth certificate information; it kicks off your baby's social security number. Within weeks, your baby's SS card will be mailed to your house. Between 3-4 weeks after your baby's birth you can get a copy of the birth certificate two ways: Visiting your local birth registrar in person OR ordering one online from the Texas Bureau of Vital Statistics