We have gathered some of our most commonly asked questions and not only answered them, but also provided you links so you can research your own answers. If you have additional questions, email or call us for a free one-on-one interview where we can answer your questions in person.
What is a Midwife?
The word midwife means, “with woman”. To simplify a very broad subject, Midwives are primary health care professionals who are able to support women through out the Pregancy, Labor, Childbirth and the Post Partum period, as well as provide pregnant or non-pregnant women Well Woman care. In California we have two different types of licensed midwives who are able to support women for ‘out-of-hospital’ births, (which includes home births, water births and birth center births) Certified Nurse Midwives (CNM) and California Licensed Midwives (LM).
Certified Nurse Midwives (CNM) are advanced practice registered nurses who have additional specialized education and training in hospital Midwifery and are licensed by the Nursing Board. Once licensed, CNMs can support women at home, birth centers or the hospital with the supervision of a doctor. Most CNMs are trained in hospitals and rarely have home birth midwifery experience. But, we are lucky because our CNM's have been homebirth trained! Los Angeles has some great CNMs working in various settings. There are group midwifery practices at UCLA, California Hospital and USC County Hospital. We are honored to have the only midwife in town who has an individual practice and can support you not only at our birthing center or your home but also at one of our local hospitals. Send us a message to set up an interview with Naomi today.
California Licensed Midwives (LM) are also Certified Professional Midwives (CPM), because you can not become a LM in California unless you are also a CPM. LMs are licensed by the California Medical Board (yes that is the same medical board as your OB/GYN) and have learned a specific skill set through extensive hands-on training in low-risk pregnancy and childbirth in an out of a hospital setting. This hands-on experience combined with studies from a MEAC Accredited School allows LMs to safely monitor and support laboring women and emerging babies at home, in a birth center and even in water. LMs are experts at differentiating between "low risk" and "high risk" situations and have a deep understanding of how the birthing environment can influence the birth outcome for both safety and efficiency. Because they do not need to have a supervising OB (which means they work autonomously) they are able to offer you collaborative care with any doctor they (or you) choose and have no challenges when transporting to any local hospital.
What is the difference between a doula and a midwife?
A Doula is the emotional support and physical comfort for the mom and family. A doula is not licensed by the medical board or the nursing board, so she can not perform medical tasks. A Midwife is in charge of the physical safety and well being of both the mom and baby through Pre-natals, Labor, Birth and Post Partum periods. The midwives at GraceFull all have Medical Board Licenses (the same as an OB) and are experts at low risk childbirth.
Our midwives have also worked as doulas and/or monatrices as part of their learning experience, so they are well versed in trouble shooting anatomy challenges that may be caused by fetal malposition and will try many different techniques, including the use of the Reboza. We also respect the emotional challenges that becoming a new mother can create and want to create a trusting environment where you can express yourself, be seen and heard during labor to support a Grace-Filled birth.
As much as we know about positions to get you into to help baby come out, and how to use a reboza to turn a baby... and as much as we love to put a cool cloth on you and tell you what a great job you are doing...we can't do that for a long labor AND be well rested for when baby comes out.
Our first priority is the safety and well being of you and baby. Because we do not know if your birth will be long or short, your midwife and her team will take turns listening to baby and resting to make sure that they are alert for any emergency situations when your baby is being born and the immediate post partum period.
If you feel you are wanting one on one care, with someone to rub your back, getting you cool cloths, making you food and being with you from the first contraction, then, getting a doula might be a really good idea. Also, we don't want to be your 'everything' - we want to help you create a community of support around you, and hiring a doula can be another layer of that team. We love working with doulas, and they love working with us!! Los Angeles has a great doula community in the form of DASC and Carriage House Birth has doulas in every price range that we have personally approved as supportive, loving and kind doulas who will enhance your birthing experience.
Here is a simple chart we created to explain all of our services and costs with and without insurance. Some other things to remember are that no matter which plan you choose we can always bill your insurance for all of your labs and OB/Perinatology visits. If your insurance insists on having a CNM for billing purposes, yes we have one.
Fees(Out of Pocket Costs)
If you are choosing to birth with our CNM at the hospital, please call for pricing. (Please call the hospital directly to find out the hospital facility costs.)
BIRTHING CENTER BIRTH
Blue Shield PPO*/HMO
Cost varies based on your deductible and coinsurance. Please contact our biller for a personalized estimate.
Please see below and discuss with our biller.
Classic Care ONLY
Cost varies based on your deductible and coinsurance. Please contact our biller for a personalized estimate.
Please see below and discuss with our biller.
*Blue Shield Home Births do NOT include insurance billing services, but a superbill can be provided.
Medi-Cal, Tri-Care, or Kaiser
We are unable to accept these insurances for your midwifery service fees or facility fees. You will be considered a cash pay client and must pay in full by 36th week of pregnancy. You may use your insurance for all labs and ultrasounds.
Blue Shield Explained
You do not need to pay a facility fee for the center as we are in-network. Midwifery service fees must be paid in full by 36th week of pregnancy, and Blue Shield will send reimbursement checks to you directly once billing is complete. The reason for this cash flow is because we have had too many families in the past deposit the insurance checks instead of forwarding the checks to GraceFull. Yes, we are an “In-Network” provider for our facility and have “In-Network Exceptions” for midwifery services. Blue Shield will not let any midwifery practice go In-Network with midwifery service fees. If you have an issue with this, please call Blue Shield and ask them to start sending the Midwifery Service Fees to the midwives (that will help out all of the midwives in town!)
Blue Shield PPO
Midwifery service fees must be paid in full by 36th week of pregnancy. Blue Shield home births do not include insurance billing services, but a superbill can be provided. You may use your insurance for all labs and ultrasounds. Make sure you have a LOW deductible in order to have most of your costs covered. (Facility Fee is in-network and paid by Blue Shield directly to us and you don't need to pay it.)
Blue Shield HMO
Midwifery service fees must be paid in full by 36th week of pregnancy. Blue Shield will NOT cover this cost unless you get a referral/authorization from your Primary Care Physician/OBGYN. This can take time and persistence, but it can be done! (Facility Fee is in-network and paid by Blue Shield directly to us and you don't need to pay it.)
Cost varies based on your deductible and coinsurance, but in general, they are very supportive of birthing center births and have paid us in full. Sometimes your insurance will pay for a birth center birth but not a home birth. And yes, we do have a CNM on staff if your insurance insists. Our biller will give you an estimate. You pay the estimate by your 36th week of pregnancy, and GraceFull will bill the difference. Make sure you have a LOW deductible in order to have most of your costs covered.
You will need to work with our biller and help with the negotiations on your end to get it covered. This can take time and persistence, but it can be done!
Health Share Plans
Please understand your group’s regulations, but in general, they are very supportive of out-of-hospital births and have paid us in full. Health Share plans can be used in addition to insurance plans. Clients have recommended Liberty, Unity, Solidarity, and Altura. You can ONLY get these plans BEFORE you get pregnant. Make sure you have a LOW deductible in order to have most of your costs covered.
Birth Center Facility Fees
The facility fee includes birth supplies, birthing room and birthing tubs. If you are considering Community Care, it can be more cost effective to birth at our center than it does to birth in your home as you will not have to rent a tub or get a birthing kit. Many insurances will pay for an Accredited Birthing Center but not a homebirth. Please contact our biller to find out if your insurance benefits.
Hospital Birth with Our CNM
If you are choosing to birth with our CNM at the hospital, please call for pricing. (Please call the hospital directly to find out the hospital facility costs.)
Yes we do! Not only do we have a Client Concierge who will hold your hand regarding fees, but we also have an in-house insurance biller so you do not need to deal with a third party biller. We are an In-Network provider for Blue Shield as a facility and will help you get an In-Network exception for the midwifery fee. (see our midwifery fees explained for more details on Blue Shield).
We can help you get an in-network exception for most HMOs and most privately funded PPOs (like Aetna, Health Net, Cigna and United Health Care). And don't forget a HealthShare account like Liberty, Unity, Solidarity and Altura tend to pay for both home and birthing center births (and remember you MUST get a HealthShare before you are pregnant and make sure you understand your deductible).
If your insurance insists on having a CNM, yes we do have one!
If you choose to use your insurance you will pay us your deductibles, co-insurances, and copays prior to your birth and then we will collect the rest from your insurance, which should significantly reduce your upfront costs. That’s our way of helping you with your expanding family. (see our FAQ above called "Can You Explain Your Costs" for a detailed chart)
Any time you want. We get a lot of calls from families who are disappointed with their care provider and are in dates for giving birth. We want you to know you always have a choices. As long as you are low risk, have been receiving appropriate medical, and have all of your labs, you can switch into our care at any time. Send us an email and schedule an appointment so that you can feel good about your choice no matter where you choose to give birth.
That's a hard question to answer because we have so much respect for our colleagues.
GraceFull midwives see you as an individual, not a statistic. We acknowledge the mother child relationship both inside the womb and out in the world. Our critical thinking skills allow us to view you and your baby as whole people with not just physical needs, but mental, emotional and spiritual needs as well. We are curious, about who you are, what events in your past might influence you birthing journey and want to know what healthy support looks like for you. Before we were midwives we were doulas, so we understand your emotional needs during labor. We spend time with our clients for the sake of time spent, because we believe that when you feel comfortable with your care providers, it helps birth to be less painful and more efficient.
GraceFull midwives value our own physical and emotional health: Just like a healthy mom is better able to parent her child, a healthy midwife is better able to support you. We try to be good examples for our clients to model empowerment in choice. We are proud of our relationships with mainstream medical care providers, alternative healthcare providers and the vast and varied spiritual and religious groups in our community. We continue to learn not only medical skills, but also deepen our bandwidth for holding space through self reflection and personal healing.
We provide you continuity of care. We do not leave you in the middle of your birth for a shift change, but rather stay with you from the moment you arrive at the birthing center until your baby is in your arms.
Most of all, we enjoy our clients, respect each other and love our work.
We want you to not only birth your baby safely and gently into your arms, but also learn how to connect to your child on the inside as you learn how to be the parent you wish to be. We want you to be seen and heard and co-create a trusting relationship between you and our midwives. We work hard at being available for adult communications and embrace opportunities for growth, learning and healing.
Because supporting women is not just a job for us, but a passion, a calling. Because we practice what we preach by living our professional and personal lives in alignment to natural choices that support our earth to be here tomorrow for the children being born today - with chemical free drinking water, environmentally friendly office space and hospital grade non-toxic green cleaners. Because all of our staff work on themselves with reflective listening and accountability so we can be open-hearted, judgment-free and kind to each other and our families.
Not only are we an accredited birthing center with all the medical gear that you need to stay safe, but our midwives are also trained in the non-invasive traditional Mexican technique of the Reboza. We are constantly evaluating the physical relationship of the baby's head to your pelvis, your contraction pattern and where you might be feeling pain. This wisdom is not used in hospitals nor taught to doctor or nurses. This technique can safely realign your baby and be the difference between an efficient vaginal birth and a cesarean birth
That being said, we have it all going on within the space too! We have home-like rooms that feel like a well designed boutique hotel, with organic spa amenities, large birthing tubs that come with colored lights, aromatherapy, organic mattresses and sheets on our queen sized beds and intentionalized equipment to help you labor and birth (Birth Balls, Birth Chairs and Birthing Swings). When you go into labor we have underground parking, a mini kitchen downstairs, a full kitchen upstairs, private bathrooms with private showers and have a private waiting room if you should choose to invite family to the birth.
We take your safety seriously which is why we assess risk at every prenatal, are constantly learning new skills, keeping up to date on evidence based care as it arises and make sure we drill emergency situations regularly so it becomes a "muscle memory".
We also pride ourselves in the healthy relationship we have with our transport of care doctors. These relationships help you stay safe because we know we can call them any time to review a case, ask a question and consult to make sure you are still considered low risk.
With GraceFull you get to choose where you want to birth with a midwife: Home, Hospital or our Birthing Center.
At GraceFull we want to help you not only birth your baby but feel prepared as parents, which is what our free classes and groups help you with.
As an accredited birthing center we assess risk at each prenatal visit, during the labor and the post partum period.
You will NOT be able to birth with us with the following situations as per California State Law: No breeches, twins, babies born before 37 weeks and babies born after 42 weeks.
Other than that, we have pages and pages of risk assessment that let us know if we need to offer up simple nutrition and exercise suggestions, consult with a license higher than ours (for instance, if you have a heart issue we want to consult with a cardiologist to make sure you can birth safely with us) or risk you out of our care and into hospital care. Risk assessment is done with the intent of making sure that you and your baby stay safe.
Here are some of the common questions asked about risk so you can feel confident coming to see us for an interview:
Yes, you are low risk if you are over the age of 35. (Please look at the dates of the age-related studies and you will see how old they are and also notice that no one was supporting people over the age of 35 with nutrition and exercise to keep them healthy and low risk).
If you can control your gestational diabetes with diet and exercise and our perinatologist (who wants you to birth safely outside of the hospital) is overseeing your co-care, you can birth with us.
If you have fibroids it depends on where they are and how small/large they are to determine if you can birth outside of the hospital with us. (If not, our CNM Naomi is a great choice for a hospital birth).
Yes, you can birth with us at home, a hospital or our birthing center if you are wanting a VBAC.
The issue with this questions is that it assumes that “non-home births” are the safety standard, and the truth is that there are actually no studies that say a "low risk" in hospital birth is more safe than "low risk" out of hospital births. There are however two interesting studies on the subject.
The first one is on birth center births that came out in Jan/Feb 2013 and states: "One of the most important findings of this study was that more than 9 out of 10 women (94%) who entered labor planning a birth center birth achieved a vaginal birth. In other words, the C-section rate for low-risk women who chose to give birth at a birth center was only 6%—compared to the U.S. C-section rate of 27% for low-risk women. This means that the C-section rate for women in birth centers is more than 4 times lower than what is seen among low-risk women in the U.S." - Journal of Midwifery & Women's Health, Outcome s of Care in Birth Centers: Demonstration of a Durable Model.
Another study that came out in August 2009 from Canada says, “Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.” - CMAJ August 2009.
One of the ways that GraceFull makes sure that mom and baby are safe throughout the entire pregnancy, labor and post partum time is by assessing risk at every visits, reviewing and updating our protocols during weekly midwife meetings, having good relationships with our transport of care doctors and hospitals, offer in house trainings and skill up dates for our employees, having up to date medical equipment and emergency medications available at every birth and making sure everyone at the birth is up to date with Neo Natal Resuscitation and CPR.
In the past year, out of all the clients who started labor in the care of a GraceFull Midwife, 13% needed a transport during labor (10% of them were non-emergent transports) and all were accompanied by their midwife. 5% needed a Cesarean birth, 3% needed the help of a vacuum extractor, and 7% chose an epidural.
Some of the physiological reasons why we would get in a car to go to the hospital for a non-emergent transport are high blood pressure, initial heart tones on the baby that don't sound reassuring, strong pushing that does not move the baby down and a post partum fever of unknown origin. In all of these cases we join you in mourning the loss of the out-of-hospital birth while at the same time sitting in appreciation of the hospital care that is available and being used appropriately and responsibly.
We are really proud of our transport rate and want to tell you a little something that we figured out. This year, all 13% of our families that needed to be transported did so for confirmed physiological and anatomical reasons. What this means is that we are rarely having transports because mom is feeling unsafe or mentally unprepared (which can be translated into feeling "scared" or "anxious"). In the cases where a mom feels that an epidural is needed to support her in having a vaginal birth she feels empowered in her choice. Why did we think this is happening? We feel it is the way we approach birth through our prenatal care, our knowledge of birth physiology, our skills at using a rebozo and our exclusive classes to help you not only birth a baby but birth yourselves as parents.
Who are the midwife and assistant who will come to my birth?
All GraceFull Midwives are either California Licensed Midwives or Certified Nurse Midwives who spend time making sure you are seen and heard. We have different personalities, but come together with the same essence in how we practice midwifery - from a love of the journey, excitement in seeing new souls being born, honed skills, learned wisdom - and we all enjoy going slow - especially after the baby is born!
We have a small home birth practice within or birthing center which means you will get to know the two midwives who share call and the third midwife who works as a backup. We want to make sure that you always have a happy and well rested midwife on your team, so we take turns being on and off call not only to support you, but in supporting each other to be 'midwives with lives'. It is important that we take care of our own needs and replenish our well so we can be fully present for you when it is your turn.
Our assistants are seasoned assistants who are enrolled in a midwifery school. They will join your midwife at your prenatal visit so you get to know them before you go into labor. All of our assistants are trained in CPR and Neonatal Resuscitation and are experienced at emergency skills such as IVs and injections.
As California Licensed Midwives we practice in alignment with our Medical Board License which offers a standard model of care that is evidence based. As community midwives we trust you as parents. We offer education and information around all test and then give you the choice as to what you would like to do by offering "informed choice".
Informed choice means that you are given information by the midwife of the risks and benefits of a test or drug and then you give us your parental approval to accept or decline a test or drug. Our information is based on three things: evidence based care, anecdotal information and our boundaries as licensed midwives. Our midwifery protocols are in alignment with our Medical Board License, which has us legally bound to offer standard of care that has at least 3 scientific studies to back up the information we give you. We as woman also recognize the wisdom of complimentary medicines and those who have gone before, so in addition to scientific data, we will also offer you anecdotal information. Our license also requires us to have a transport of care plan, and that doctor or hospital might have their own boundaries.
We will offer you all testing and drugs as required by state law, and if you choose to decline some part of standard care then you must take responsibility for this choice and sign an "Informed Choice Document that states that you are informed about the risks you are taking and are acknowledging full responsibility for your choice.
Philosophically speaking, you are the parents of your child, and we as your midwives will not be raising your child, so we will not tell you what to do. We at GraceFull look at all choices as parenting decisions. We are passionate about helping you not just birth your baby, but parent your child. Being informed, finding clarity and then standing in your truth as to what is best for you and your family - whether it is scientific or anecdotal - is an important part of becoming a parent, and you will always have our full support no matter what your choices and/or beliefs are.
Do I have to have any ultrasounds and where do I get them?
Good news, we now have a portable ultrasound machine so we can do simple ultrasounds to check baby's position, heartbeat and fluid levels.
Scientific studies indicate that 2-3 ultrasounds are supportive of a safe pregnancy, but more than that do not make any difference in the outcome. We do not require you to have any ultrasounds unless there is something going on with your body or your baby that indicates a need for more information (e.g.: ruling our of twins, breech baby or a low lying placenta). There are some transport of care providers who will require ultrasounds with them in order to secure their services. If you do not want an ultrasound we can find you a transport of care option that will allow for that choice.
Your midwife will guide you through some of the reasons why you may choose one or more ultrasounds. If it is a simple ultrasound you can do it with us or your OB. For more extensive ultrasounds we have great relationships with local Perinatologists. We charge $75 cash for an ultrasound and are happy to charge your insurance.
How often do we meet for prenatals? What happens at a typical appointment?
Just like an OB, we will meet once a month until 28 weeks, when we will meet twice a month. At 36 weeks we will start our weekly visits. Unlike an OB, we will spend 30 - 90 minutes at each visit. It takes about 10 minutes to make sure that your pregnancy is still considered safe for a home birth or birthing center birth as we listen to baby, measure your belly, talk about nutrition, check your blood pressure and pulse.
With the rest of our time we support you as parents by discussing what the future tests are for so you can make an informed choice, discuss your fears and concerns about birthing so we can make appropriate supportive plans and generally get to know each other so that we can create a field of trust for you to gently birth your baby at your home or our center.
We offer three different kinds of care, depending on where and when you want your prenatal visits. Our Community Care meets on Wednesdays from 10:30-noon and allows you to create your community before you give birth. You will have 5-10 minutes of private time with the midwife and then the rest of the time is spent with educational topics in a supportive environment of like minded mothers. Our Classic Care allows you to schedule prenatal and post partum visits one-on-one with our midwives during office hours (which included evenings and weekends). Our Enhanced Care has all of your visits in your home and on yours schedule.
Outside of our prenatal times we are available by text, email, phone and skype. Skype is a great way to include partners who are out of the state (or even the country) in prenatal exams so that he (or she) can also listen to the baby and ask questions. Also, if you are planning to be away for an extended period of time, we can set up skype prenatal visits so you can experience continuity of care.
When do you you come to my house or I come to the birthing center during labor?
When we do our first visit during labor if we find out you are not in an active labor pattern we will make suggestions on positional changes, herbs for resting or ways to pick up your labor in support of having an efficient labor. We will leave your home (or send you home from the birthing center) as we know that the active labor pattern will be soon. Once you are in a full active labor pattern (somewhere around 6 cm in dilation) we will stay with you at your house or you will stay at the birthing center.
Yes we do! We believe that pregnancy and birth is a normal life event, but should that event go outside of normal, we really appreciate having our medical equipment at the birth so that the situation does not turn into an emergency.
Along with our herbs and homeopathy to support you at every stage of labor, we also have oxygen tanks (for mom and/or baby), a bag and mask (in case baby needs to be resuscitated), pharmaceuticals to stop a mom who is bleeding too much after giving birth, IV fluids (for dehydration and/or antibiotics), antibiotics (in case of prolonged rupture or a GBS + mom), as well as numbing medication and suture equipment (in case you tear). We have all of these medically approved items at our birthing center, and if you birth at home, we bring this equipment to your house.
Firstly, please know that not every mother experiences pain during labor. As much as we want you to have a pain-free birth it can be common to feel pressure, pain, intensity and/or burning.
Licensed Midwives are experts at physiological childbirth, which means we can support your pain with positional changes and optimize fetal positioning which may result in a more efficient birth.
To help you navigate your labor, we encourage you to receive massage from your partner, friend or a doula. Certain essential oils have been known to alleviate pain when applied directly to the skin or in one of our in-room diffusers. We have birth swings to help take the weight off your body, are trained in using sterile water injections to relieve back pain and can use the reboza to readjust the baby off of your back. We have a tens unit available to not only give you something to control but also relax your lower back muscles. Our spa like birthing tubs are know as the "aquadural" and you only need to ask a friend who has used it to know how well it works. We trust you and your body, but if you are completely caught off guard by the pain, are highly anxious, need to "control" something or are thinking of going to the hospital for an epidural, we have one more trick up our sleeve: Gas and Air (or Nitrious Oxide) as used all over England.
Thanks for noticing! That was done on purpose. Did you know that we are mammals? And when having an unmedicated birth we birth just like other mammals? We need a dark, warm space where we are not being "watched".
Have you ever seen a bear give birth? It does not choose an open field on a sunny day. Rather it will go into a dark cave where there is one door in and one door out so it can see if anyone comes into her mama bear space. Birthing in a "cave" is what helps human mamas feel safe on a somatic (or feeling) level. It is the work of Michel Odent who has influenced us when we built your birthing rooms from the ground up to help the mother child relationship transition from inside the womb and out into the world. Michel helped popularize physiological childbirth, which has now expanded into bio-dynamic childbirth, which are the cornerstones of GraceFull's birthing philosophy.
So yes, there are no windows or views in our rooms, and that is on purpose, so you can feel safe birthing in your sacred "mama cave".
Because everything good in LA is in a strip mall! That's how we roll! LOL
In all seriousness, Elizabeth choose this Medical Building because of the close proximity to the Fire Station (8 blocks away), how quickly we can get to the number one hospital in Southern California for Newborns (Children's Hospital) and the close proximity to Kaiser and Hollywood Pres for labor emergencies (1.6 miles).
We are located on a block of destination restaurants and stores in Silverlake that we call: Urban Ojai. Our friends at Moon Juice are next door, one of the top 50 restaurants in the world is our neighbor and the tattoo shop in our building using vegan ink.
People are always surprised by the calm oasis we have created for our birthing center and the high loft-like ceilings in our wellness space. Our space is intentional and you will feel it when you walk through the doors.
We love our Silverlake/Echo Park Community and the families we serve. Feel free to book an appointment and see if our home is your home.
Our job as Licensed Midwives is to not only help you stay low risk, but to constantly evaluate you and baby for risk and use our skill of critical thinking to help you both stay safe and birth efficiently.
Our Facility was chosen because of how close we are to the local hospitals. Children's Hospital, the number one hospital in Southern California for Newborns, is 1.6 miles from our facility. Both Kaiser Sunset and Hollywood Pres are 1.6 miles away too. Our hospital of choices is Good Sam (2.6 miles away) where we have wonderful relationships with some great doctors who will empathize with you while offering excellent medical care. We are open to working with both California Hospital and USC who have midwives on staff. But please remember these are teaching hospitals and you are going to a hospital for medical care, not midwifery care, so we would rather have you in the hands of a skilled OB rather than a medical student or resident in the case that you need a surgical birth.
A transport does not typically mean an "emergency". Most of our transports are done via a car and are for physical reasons where the interventions and support of the hospital is warranted and welcomed. We spend a lot of time prenatally with our families so they feel supported, seen and heard. Plus our unique class created by GraceFull's Owner, Elizabeth Bachner, helps families understand what emotional, mental or family issues may come up and get in the way of an efficient birth. Because of all the preparation work we do with our families our transport rate is currently 11% and all are for physical reasons that warrant the need of a hospital environment. When people take our exclusive class: "History, Hats and Hormones" families feel prepared to not only go the distance physically, mentally & emotionally but understand how a transport works, why we would need to transport and how we continue our care in the case of a transport.
We are not attached to "where" your baby is born, which is why we offer midwifery care within a hospital setting. We understand how hard you have worked towards an out of hospital birth and want the choice to transition to the hospital to be an empowered one on the part of our families.
We have worked hard in creating clear lines of communication with our local fire station and to ensure safe transports by ambulance. In the case of a 911 transport our local fire station is 8 blocks away and can arrive within 2-5 minutes of an initial phone call.
If you should transport to the hospital, we do not abandon you. We provide continuity of care, so the midwife who starts your journey at the birthing center will accompany you to the hospital and switch into her new role as your Monatrice, so she can advocate for the appropriate tools that hospitals can offer.
We can transport into the care of group midwives at our local hospitals but prefer not to as we do not want you to have a resident in the case of needing a surgical birth. As we have a midwife who has hospital privileges you may choose to transport into her care. We have fostered excellent relationships with a few chosen transport of care doctors in the area.
Because of our great hospital relationships, we know that you will not be rushed into a cesarean birth and only have one if it is medically necessary with a trained surgeon. We are not afraid of going to the hospital as we know you will be well received physically and emotionally. Most of our families find the transports surprisingly pleasant and empowering. This is one of the ways we offer you a safe birth, because we are so well received by our local hospitals.
As we value continuity of care, you will return to our on-going postpartum and well-baby care after you are discharged from the hospital. You'll continue to be a part of our community, including being welcomed into 6 months of Mama Meet-Ups as well as GraceFull family events.
Please make sure to take GraceFull's owner, Elizabeth Bachner's, exclusive class: History, Hats and Hormones. Elizabeth will talk about transporting expectations and the many physiological, mental and emotional layers that need to be considered when birthing. The intention of this class is to help you have an efficient birth by minimizing the emotional/mental need for transporting while embracing the physical reasons for needing one.
How long can I stay at your center (or you stay with me at home) after I give birth? Who stays with me?
Childbirth is a huge event, and that take time to integrate. That is why we can not emphasis enough how important it is to "go slow" after you give birth. We know everyone wants to know the weight and length of your baby, but we would rather make bonding time a priority because we want to do what we can to make sure your child has the best start in life.
After you give birth we still have work to do. There is a full newborn exam to confirm your baby is healthy and we want to assess you immediately after birth to make sure you do not bleed too much, suture any tears, help you with breastfeeding and make sure you are able to urinated. We are just as passionate about the mother/child dyad after you give birth as we are with a safe pregnancy and labor. The post partum time can take anywhere from 2 to 6 hours and is done with the midwife the whole time.
When one births at the hospital you are considered "high risk" and need to spend 1-4 nights in a hospital where you can be monitored until you are considered "low risk" and can go home. When you birth at GraceFull you and baby are considered "low risk", which is why you can go home (or the midwife will leave your home) between 2-6 hours after you give birth with the security that you will have a home visit 24-48 hour later by a Licensed Midwife.
Many people want to invite their family to the birthing center to be there immediately after you give birth. While this is tradition for hospital births, and we do welcome your family, we want you to know that we view your birth as sacred and never want you to feel rushed. Since you will be going home between 2-6 hours after giving birth, another choice that might work for you is to have your family waiting at you at your house. They can be there praying, celebrating, supporting each other while they cleaning up, prepare meals and getting ready to welcome you home after you leave the cocoon of GraceFull's birthing suite.
If you choose to birth at home we encourage you to wait a bit before you invite your whole family over so that we can make sure you and baby are low risk, get you into the shower and clean up your room.
Please note, we always welcome siblings to be at the birth at home or our center. If you do not want the older children to be at the birth, may we suggest having someone come to bring them to the center so you can travel home as a family together.
We are able to draw blood (to provide routine blood work and the MT21 tests), provide vaginal/urinal cultures and pap smears in the comfort of GraceFull’s office. Ultra Sounds, Amnios and CVSs are done at a Doctor’s office (this is a good time to meet your back up physician).
We have quite a few choices in local doctors that trust how we work and are willing to back us up for transport of care situations. These doctors would like to visit with you at least once so that they can put a name to a face, and you can know who they are, should you need to transfer your care during labor. If you have a desire to have an ultra sound (and we do not require them) it is a great idea to do that when you meet the transfer of care doctor. Other than that, there is no need to see a doctor, unless we have some concerns during your pregnancy. If you are comfortable with transporting into a group practice, Good Samaritan Hospital (which is 2.6 miles from the birth center) will receive you with without having to meet them first.
Can you recommend an OB or CNM for a hospital birth ?
We are SO fortunate to live in Los Angeles where we have wonderful choices for Obstetrical Care. We have strong relationships with the following OBs and some will even agree to be transport of care if you need it. If you are wanting a hospital birth or are considered high risk, we know you will be in good hands with these doula friendly and highly skilled doctors. And don't forget, our CNM Naomi Drucker can be your primary care midwife while you are having a hospital birth.
What are some questions to ask a midwifery practice ?
Midwives differ in personality, training, protocols and practices. We want you to have the kind of midwife that will help you feel safe at your birth. Here is a list of questions that we feel are important to ask the midwives you are interviewing with for a home, birth center or hospital birth so you can make sure you choose the right care provider for your family.
Was your primary training done in a hospital or outside of a hospital setting?
Do you understand the physiology of the body? How do you support the body's hormones to create a safe and efficient unmedicated birth?
What are you thoughts about diet and exercise while pregnant?
Do you believe that my mental and emotional state effect my labor? If yes, what skills do you use to support me.
Do you consider yourself a "hands off" or a "hands on" practitioner?
In what situations would you manage a birth?
Do you like to work with doulas?
Do you practice Evidence Based Care?
Do you offer me Informed Choice around the tests and western medication offered to me and my baby?
Do you ever recommend herbs or homeopathy? If so, when?
Do you provide Continuity of Care, meaning is the midwife who starts the birth with me going to be the midwife who is there when my baby is born?
How many midwives are on call for your practice? And will I meet all those midwives before I give birth?
Do you come with me to the hospital in the case of a transport?
What is your relationship with my transport of care doctor?
Will I ever be in the care of a student or resident if I transport to a hospital? If yes, what year is the student or resident?
After I give birth, how long will the midwife stay with me before she leaves? How long before I have to leave the birthing center?
Who will come see me at home for a post partum visit? A midwife or an assistant?
Are you an Accredited Birthing Center? If yes, why? If no, why not.
What are you thoughts about the baby's position in relationship to my pelvis for an efficient birth?
Have you ever used a Reboza? If not, what do you do to help a malpositioned baby?
How much and what kind of support can I expect from you if my water breaks before labor begins?
How long can I go with my water broken before you will need me to be induced at the hospital?
Are any classes included in my fee?
Do you have any post partum groups included in my fee?
We are so glad that you asked! We have spent a lot of time creating this statement and are proud of what it stands for and how all our employees are supportive of our mission.
GraceFull Birthing is a Birthing Center whose purpose is to provide health care, perinatal instruction and other health-related education and services, including the training and education of health care workers to provide those services.
GraceFull Birthing Mission Statement:
The mission of the organization is to support families to birth at their home, our birthing center, or a hospital with presence, connection and choice so they may start the journey of parenting with an internal connection to their own clarity, power and trust.
We are dedicated to serving the public by providing education and services to meet the needs of care within the community. We are passionate about finding a way to bridge the economic discrepancies regarding who can afford an “out of hospital” birth. We refuse societal judgments in regards to tell where a woman needs to birth a baby when she is considered low risk. We support a woman’s right to choose where she births by creating a new way of working with mothers by emphasizing the common denominator through community prenatals: All mothers want what is best for their children no matter where they choose to birth and have an internal wisdom for parenting.
We believe our Mission Statement will lead to a new generation of woman who will know the power of their voice and trust in their ability to make decisions so they can move forward as parents without guilt or shame and move through the world as an embodiment of their truth.
What is your company's formal philosophy statement?
In the words of GraceFull's Owner, Elizabeth Bachner, "Birthing babies is what it is all about...and birthing babies is the TIP of the iceberg!"
GraceFull Birthing Philosophy Statement:
GraceFull Birthing is a “Wombcentric” business as it was built from the ground up to support the mother/child relationship transitioning from inside the womb to out and into the world.
Our employees work at modeling the dynamics of a healthy family relationship by knowing what support looks like for their unique self and then asking for and receiving healthy support both within and outside of our company so we may be present and clear when working with the families we serve.
At GraceFull Birthing, we believe that women have the right to seek care that is medically safe, and recognizes and respects their individual physical, social, spiritual, psychological, and economic needs. Women and their families have the right and responsibility to assume an active role in their own health care. Decisions will be made as a team with the midwives and the couple as equal decision making partners.
We believe that childbirth is a normal, healthy process. The role of the midwife is to support and promote this normal process, while recognizing and dealing with any deviations from normal. Throughout prenatal care, midwives encourage and empower women, helping them develop the confidence to give birth vaginally and state their choice with clarity and connection.
Education is an essential part of quality health care. With knowledge freely exchanged between staff and clients, women and their families are able to assume shared responsibility for and make informed choices about their health care.
Midwifery is both an art and a science. Every attempt will be made to practice “evidence-based” medical care while allowing families to learn about natural medicines, wholistic choices and anecdotal information.
Women and their families are provided support and resources during the childbearing years. There is emphasis on maternal-infant bonding and healthy attachments as this builds a healthy foundation for the mother/baby relationship and the family unit as a whole.
We believe in the power of birth as a form of healing. At GraceFull Birthing we are supporting women to not only birth babies, but also heal imprints from their own life or lineages so they may move forward feeling how loved and held they are in their original blueprint.
We have a saying in our field, "For every mother there is the right midwife". Our goal at GraceFull is to help you make your decisions with clarity. There is no "better" or "worse" within our field, there are only choices and finding the right fit for you. It is our job as women to lift each other up and support each other in our endeavors to create potent women led businesses! We want you to find the right space that helps you settle and feel seen so that you can have a calm, relaxed and enjoyable birth experience you desire. If you meet us and you are clear that we are not the right center for you - and another midwife or obstetrician offers the care that feels right for you - then we have done our job and done it well.