Home Birth | Salmonberry Birth and Wellness

Why Choose Home Birth?

I worked as a midwife in various hospital systems for over ten years. I felt that my job as a hospital midwife was to protect physiologic birth as much as possible, and to intervene only when medically necessary. Until I experienced home birth, I thought that I did a pretty good job. What I did not understand is this: In the hospital setting, even unmedicated births are influenced by multiple interventions.

- IV insertion is an intervention.

- Continuous fetal monitoring is an intervention.

- Rules and devices that inhibit movement and physiologic positioning are interventions.

- The presence of medical equipment that flashes and beeps and alarms is an intervention.

- Observation by medical personnel who are there "just in case" (the respiratory therapist, pediatrician, anesthetist, etc..) is an intervention.

All of these interventions alter the body's perception of privacy and safety and inhibit the natural symphony of hormones that promote labor progress and your ability to cope with pain.

All of this is to say: interventions have side effects that lead to other interventions. This is why the C-section rate in American hospitals is over 30% while maternal and infant mortality rates remain some of the worst in the developed world... and why home birth is proven to be safer than hospital birth for low-risk women and babies.

Midwifery Care

Midwifery care prioritizes building relationships and providing personalized care that is respectful of the autonomy and values of the expecting family. Prenatal visits with home birth midwives are longer than appointments with doctors or even hospital-based midwives. This means there is more time to build trust with the person who will deliver your baby, to communicate your thoughts, ask questions, and exercise true informed consent.

Home Birth Midwives do not change shifts and do not delegate to a nursing staff. Your midwife will be with you throughout your active phase of labor and for several hours afterward. She will visit your home to check on you and your baby 1-2 days after your birth. And at any time if there is an urgent concern, you can contact your midwife directly without going through a phone tree or an answering service.

Home Birth Midwives are highly skilled in facilitating natural births and have extensive experience in supporting women through labor without interventions. They are also trained to recognize deviations from normal that might require transfer to a different level of care, and to effectively manage emergent situations should they occur. Healthy women cared for by midwives are less likely to miscarry, deliver preterm, be induced, need pain medication, have a C-section or episiotomy, and tend to be happier with their care overall. Newborn outcomes are similar to birth in the hospital, though rates of breastfeeding are higher with midwifery care.

Evidence on Midwives

There are numerous advantages to giving birth at home with a midwife you trust. Foremost among these is feeling safe and relaxed in a familiar setting. In nature, animals typically give birth in secluded, dark places, away from predators. If they sense danger, their labor may stop. Similarly, the intricate hormonal changes that orchestrate human labor, newborn bonding, and breastmilk production can be disrupted by stress. This is one reason hospital births often take longer and/or require narcotic pain medications and Pitocin.

Evidence for homebirth

Another important factor to consider is the microbiome. The term microbiome refers to the millions of bacteria that colonize our bodies, inside and out. Most of these bacteria are helpful, even essential to our physiologic processes and overall health. In fact, scientists refer to the gut and bacteria contained there as our "second brain." In a home birth, newborns are immediately exposed to their family's healthy microbiome as they are born in your sheets, dried with your towels and swaddled with your blankets. This exposure jumpstarts your baby's immune and digestive systems, and even plays a role in brain development. In a hospital setting, everything that touches the baby is sterilized with chemicals. On the one hand, this is a very good thing as it protects you and your baby from being infected with strange viruses and bacteria that are present in the hospital but not in your home. On the other hand, it decreases the beneficial effects of exposure to healthy bacteria.

Understanding the Costs of Birth

Hospital Birth

$20,000 – $30,000

Birth Centers

$10,000 - $20,000

Standard Home Birth

$5,000 - $9,000

Hospital-based practices operate on a tight schedule and follow one-size-fits-all protocols. Despite high costs, outcomes are not better for low-risk moms and babies.

While birth centers provide a cozy, home-inspired environment compared to hospitals, they do include facility fees that generally make them more expensive than choosing a home birth.

Most home birth midwives are not contracted or "in-network" with insurance plans and charge their full fee out-of-pocket.

Cheri Shields is the only local home birth midwife who is in-network with both public (Apple Health) and private insurance carriers. Because you can use your insurance benefits to help pay for your home birth with Salmonberry, the average cost paid out of pocket is significantly less than a hospital birth or even an home birth with out-of-network providers.

But remember, the value of home birth midwifery is in the personalization of care, the relationships that are built, and the emphasis on physiological support and wellness that results in fewer harmful interventions and healthier outcomes for mom and baby.

The Salmonberry Difference

Myths about Home Birth

Myth 01: Home Birth is expensive

Insurance often covers both hospital and home births, though there are likely some out-of-pocket costs and copays (You’d have to check with your provider for specifics in your case). However,
At-home births are frequently less expensive than mainstream hospital-based care.

Myth 02: home birth is dangerous

Certain health or personal conditions may make a hospital birth a safer option for some people. However, for most women and babies,home birth isn’t riskier and may actually be a better option. At Salmonberry, Cheri does an extensive screening to ensure you’re a good candidate for home birth.

For example, home birth may be suitable if you have PCOS, a thyroid disorder, are 35 or older, have had a Cesarean, or used IVF or other fertility treatments to become pregnant.

It’s also important to note that — for those for whom home delivery is deemed safe — emergencies are rare.

Myth 03: home birth means no medical oversight

Myth 04: Home birth is more painful

Midwives are not hands-off birth keepers; they provide quality, modern healthcare. Certified Nurse Midwives like Cheri are highly trained, licensed, and participate in rigorous continuing education programs and peer review. Moreover, they spend all day every day providing prenatal care and facilitating healthy deliveries.

Midwives also carry many of the same supplies as hospital nurses and doctors might use. For instance, Cheri's kit contains IV equipment, medications to stop bleeding, newborn resuscitation supplies, suturing instruments and lidocaine.

You aren’t going to get an epidural with a home birth, but midwives have plenty of other ways to help reduce pain. Water birth, for instance has been shown to significantly reduce the experience of pain during labor.

Additionally, if you need sutures, your midwife can administer lidocaine.

Many women are more comfortable and at ease during childbirth when they’re at home. Being in your own space, with people you care about, can be a truly special experience that you can’t have in a hospital setting. Plus, you have a lot more say in what happens

Myth 05: Only Flower Child Hipster Types Do Home Births

Myth 06: Home births Are Messy

Oh so wrong! All kinds of people opt for home births for all kinds of reasons.

Salmonberry provides a clear, step-by-step guide to help you prepare your home for birth. At your 36-week home visit, Cheri will walk through your plans with you. Home birth midwives are skilled at containing the natural messiness of birth, and your birth team will help tidy up while you relax and enjoy your Golden Hour.

Myth 08: It's Not Covered by Insurance

Myth 09: Babies born at home Face Higher Infection Risk

Salmonberry Birth and Wellness is unique in being in-network with many plans. For most families, homebirth is an affordable and sustainable financial choice.

Babies at home are exposed to their family's healthy bacteria, which primes their immune systems. Hospital-acquired infections are a far greater risk for newborns.