Frequently Asked Questions

If you’re looking for more information on home birth, midwifery care, pregnancy or postpartum support please click through the links. Still have questions? Get in touch. I’d love to meet you.

  • Midwives are skilled birth attendants, and primary pregnancy and birth providers, specializing in healthy pregnancy, birth, postpartum, well-woman and early newborn care.

    There are various types of midwives, trained in various ways, with various titles. Additionally, each state has its own laws outlining education, training, & legality. TM, Lay, TBA, LM, DEM, CPM, CNM, & CM are all acronyms that mean midwife! A midwife's experience & scope and style of practice may differ depending upon all of these factors.

    In the state of Minnesota, there are Certified Professional Midwives (CPMs), Traditional Midwives or Traditional Birth Attendants (TM or TBA), Independent or Community Midwives, and Certified Nurse-Midwives (CNMs). Most (but not all) CNM's are hospital-based care providers and CNM's are the only midwives allowed to practice directly in the hospital system, sometimes in conjunction with or under supervision of an Obstetrician, although the laws allow for independent practice. A few CNM's practice in birth centers or home birth practices.

    The majority of home birth midwives are CPM's, a national certification, specializing in out-of-hospital birth, certified via the North American Registry of Midwives (NARM). Some CPM's choose to be licensed, others do not, while a number of other midwives choose the less-regulated path, training and practicing as TMs, TBAs or other designations.

    Minnesota is a licensure-optional state, meaning it is legal for all types of midwives to practice, regardless of certification or licensure status. Each of these types of midwives and midwifery designations have their positives and negatives (most midwives have specific reasons for choosing their particular path) and each serve families seeking midwifery care in their own unique ways.

    The very best way to find out which midwife is best for you and your family is to talk to the midwives in your community. Ask us what you want and need to know! As confusing as some of this is, Minnesota law clearly supports the autonomy of birthing families and Minnesota families seeking midwifery care have a lot of wonderful options to choose from.

    If you have more questions or are curious about my practice feel free to check out my Birth Philosophy page or contact me.

  • While naysayers and study cherry pickers abound (typically with their own agenda drums to beat), to date, there are multiple studies that indicate the safety of planned home birth for low-risk mothers, particularly with a trained midwife. There is also data indicating that some women with even moderate risk can safely birth at home.

    Worldwide, there is a growing push towards developing and educating more midwives. And midwives are known to have a positive impact on both maternal and neonatal mortality and morbidity rates. We know that birth practices that support and encourage physiological birth (meaning those that support normal body processes in pregnancy, labor, birth and breastfeeding) are the key to safety and wellness for healthy birthing families, regardless of place of birth.

    We also know that home birth, and the midwifery model of care, by its very nature, offers families a greater likelihood of experiencing these protective practices. Risk assessment is an important part of home birth preparation for both the birthing family and the midwife. It is necessarily both broad and individualistic, and includes a view of statistics, personal health and birth history, personal accountability & informed choice, as well as perception of safety, excellence in midwifery education and training, and preferably, community support for families choosing midwifery care, as well as support for those same families and midwives in accessing referral services and respectful transfer of care when desired or medically necessary.

    While it is clear that some risks are absolute, it is also true that safety does not always mean the same thing to every family and that often safety, risk, and benefit are presented in narrow confines that do not take in to account all the various dimensions, or stake-holders, in decisions made and care offered during pregnancy, birth, and the postpartum.

  • Yes. No. Maybe? There are a variety of variables involved in this decision. There is a LOT to think about and the reality is that not every family is going to want to birth at home, or feel or be safe, doing so.

    As a midwife I don’t spend time convincing people to plan a homebirth. Instead, I enter into conversation with potential clients to learn about their desires, potential challenges or health issues, and to honestly answer questions and concerns. I can point you towards resources for educating yourself and explain how I handle normal healthy birth, as well as situations that depart from normal, including rare emergencies and the tools I carry to assist with those. I can also share my practice guidelines and other documents that guide my practice.

    The best birth scenarios are those in which the birthing person feels safe, supported, & respected, trusting in their body and the process of birth, and flexible and responsive to their unique birth, as it unfolds, leaning on inner strength, as well as their care provider, family or other support people for knowledgeable reassurance, and to help stay grounded if labor becomes intense or plays out in unexpected ways.

    Pregnancy, Birth and Postpartum are deeply personal experiences and regardless of where you choose to birth or with whom, it is worth it to spend time and energy figuring out what matters most to you.

    If you’d like to meet with me to discuss please get in touch!

  • So many people are worried about the mess factor, but the answer is, not really. While various body fluids are a part of the birth process, usually people are surprised by how little "mess" there is (we midwives are really good at containment!) In any event, while you are busy greeting and getting to know your beautiful new baby, your midwife and her assistants clean up any mess that happens and leave your house looking just as it did before your birth.

  • Water is a wonderful tool for labor and birth and most people benefit from its use. Deep water immersion increases relaxation and comfort and allows the birthing person easier pelvic mobility, as well as the benefit of warmth on gently stretching tissues. Most of my clients plan on using the tub during labor and many of them go on to birth in it, as well. Waterbirth is one of the many topics & choices covered in our prenatal appointments. You can find more information here.

  • Most of the time, these concerns are rooted in love and mixed up in safety fears and a misunderstanding of what home birth and midwifery care has to offer. Clear communication and empathy go a long way in these situations, understanding that each of us brings our own stories to the table that inform our feelings about and experiences with birth. Our family and friends are no different! Sometimes this communication means staying clear in your intentions while keeping communication open, while other times, you might choose to discuss your plans only with people you know will be supportive, or with no one outside your home at all. Partners or spouses need to know that their beloved and their baby will be cared for safely and gently and it is difficult, if not impossible, to plan a homebirth without their support. Indeed, to choose homebirth is to take on a much larger responsibility.

    In my practice, the birthing person and any partner or spouse (unless they will not be present at the birth) must be supportive of the homebirth plan. However, one of the beauties of Midwifery care is the development of the midwife-client-family relationship. There is time to talk; time to question and discuss all of the myriad details, and to develop trust and confidence. In this way, we all come together, and it is often the most reticent partner or spouse who becomes the most ardent supporter of midwives and homebirth!

    It is also very beneficial to have anyone else you plan to have at your birth, available to attend an appointment or the home visit around 36 weeks. Ultimately, the birthing person must decide both where they will birth and with whom.

  • The majority of prenatal appointments occur at our office, located in the Nurture Collective, in Duluth, MN:

    203 North 8th Ave East, Duluth MN 55805

    We visit your home at least once during pregnancy, typically between 35-37 weeks gestation. Additional home visits or a prenatal care hybrid combining in-person office and virtual visits may be available but are at the midwife’s discretion.

    All postpartum and well-newborn visits in the first month after birth take place in your home, with a return to the office for an (optional) 4-week visit and our final 6-week completion of care visit.

  • Prenatal care appointments include thorough discussions about what to expect in various scenarios, including normal processes, as well as less-common complications or emergencies. If there is any indication that the laboring person or their baby is not tolerating labor normally or if there are complications that are not easily managed in a home setting before, during or after birth, or if a laboring mother changes her mind about staying at home for birth, we simply transfer to a local hospital and transfer primary care to a hospital-based birth care provider. We will accompany you and continue to provide labor support throughout. Most commonly, we continue on with midwifery postpartum and well newborn care, upon discharge.

  • First Memory Midwifery primarily serves families within a 60-mile radius of Duluth, MN. A travel fee or mileage charge applies for client’s living further than 45 minutes from the midwife’s home. We do occasionally travel further afield, depending upon the practice’s birth schedule, so please inquire about our availability. In some cases, clients who live in locations remote from labor and delivery emergency services or further from our usual service area are asked to consider securing a birthing space closer to Duluth.

    Our practice typically serves families in Minnesota, in and around Duluth, Cloquet, Saginaw, Moose Lake, Virginia, and along the North Shore, in Two Harbors, and Silver Bay, MN. We also travel to Superior, WI and surrounding WI communities.

  • The comprehensive prompt-pay package fee is $5500.00. Payment is expected, in full, by 36 weeks of pregnancy, prior to the midwife going on-call, and includes most aspects of care for you and your baby. A non-refundable retainer of $700.00 is due at the start of care, upon signing the financial agreement, with remaining payments made based upon an individualized plan discussed at that time. First Memory Midwifery accepts cash, checks, HSA/HRA cards or checks, and credit cards.

    A limited number of financial need discounts are available each year. Please contact the midwife for more information.

  • First Memory Midwifery is considered out-of-network with all insurance companies. However, we do contract with a biller specializing in out-of-hospital birth and private insurance reimbursement may be available, depending upon your insurance coverage (sometimes at in-network rates). It is important to understand that there is no guarantee of reimbursement and that amounts reimbursed are extremely variable, based on coverage, services rendered, your insurance plan “allowed amounts” for covered services, in combination with your deductible and any co-insurance they require you to pay. Claims cannot be submitted until after the birth of your baby. Clients wishing to utilize private insurance should start by reading the FAQ and completing the online Verification of Benefits form at Birth Professional Billing. Clients are responsible for fees associated with this service.

  • Unfortunately, I do not accept Minnesota’s Medical Assistance or MHCP/MN Care programs. While this may (& hopefully does!) change in the future, the program currently does not fully pay for homebirth care or pay homebirth midwives at sustainable reimbursement rates.

    We believe that midwifery care should be accessible, so clients who are enrolled in these programs, may be eligible for income-based fee reductions or more flexible payment options. Please contact us for more information.

    I am an enrolled provider with Wisconsin’s Medicaid program, ForwardHealth and am able to accept a limited number of clients enrolled in BadgerCare Plus, each year. Fees for non-covered services apply and there are a few steps that clients must take to be eligible for coverage. Please contact us for more information.

    Additionally, our practice is deeply aware that perinatal health care disparities fueled by systemic racism and other oppressions cause markedly increased rates of trauma, physical harm, and death to birthing people and their babies. We are actively committed to increasing equity in and access to midwifery care and provide discounted services for people in historically marginalized communities, who are under-resourced and would not otherwise be able to access home birth care. Please contact us for more information.

  • The short answer is, “Yes!” We have supported many births with children present and it is generally a very positive and joyful experience for everyone. It is best to have a backup plan for someone who can care for their needs, separate from the birthing person and their partner.

    The longer answer is that it can depend on the child/ren. You know your children best. Some kids become very overwhelmed by the sounds of birth, impatient with the time it takes or upset that a parent is unable to focus on them. Often, those factors can be mitigated by preparing them ahead of time and we take time to talk about this in our prenatal care visits.

  • Very often, yes. Late transfer decisions are made on a case-by-case basis and are dependent on our availability, the reasons for transfer, health conditions or risk factors you may have, and prenatal care received during the current pregnancy. Late-transfers must provide their previous pregnancy and birth records and current prenatal care records at or prior to their initial appointment.

    It is important to know that unless you have been working with another community homebirth midwife throughout your pregnancy, there are NO fee discounts. Late-entry into homebirth midwifery care entails a great deal of work in a shorter time period with less opportunity to build trust and relationship and for the midwife to provide continuity of care.

  • We bring our heart and hands and our belief in and respect for the sacredness and normalcy of birth.

    We also bring the equipment and supplies needed for clinical assessment and fetal heart rate monitoring, newborn and adult resuscitation, and management of complications and emergencies (including oxygen, IV supplies and fluids, herbs, and medications).

    A list of supplies to gather to prepare your home and birth space is provided during prenatal care, and includes home items such as towels, bedding, a clean bowl for the birth of your placenta, and nourishing snacks and drinks.

    Instructions for ordering your Birth Kit (a kit of disposable supplies) and waterbirth supplies are also provided during prenatal care.

  • Care with me is relaxed, relational, and educational. I value clarity and actively engage with helping you identify your most important goals, values, and resources in planning your birth and in supporting you to make choices that are right for you and your baby.

    Our work together is a collaboration, and an invitation to growth and self-understanding, and my framework is one that supports both the science and nature of birth and the long historical perspectives and practices of midwifery and natural health (some of which is not studied or studied well). Science and Evidence, Intuition, and Experience, Intellect and Spirit, the Body and the Mind, Culture, Family, and Ancestry are dynamic parts of a whole, and we will consider what each of these bring to the table, as we walk through your pregnancy, birth, and postpartum time, together.

    You can read more about me and my background and my birth philosophy.