Home Birth & Midwifery Care
Home Birth & Midwifery Care
We provide full spectrum, culturally centered Midwifery Care, from the moment you are pregnant, through your journey of pregnancy, labor and birth and beyond. With Raíces Midwifery and Community Care, the heart of the matter is focused on building a trusting and honest relationship with one another. We offer hour long prenatal appointments with the hopes of nourishing such a relationship.
In these appointments we will discuss your well-being, monitor you and baby’s health, provide options for screening and testing, and spend time getting to know you and your family. Our comprehensive prenatal care is compassionate, affirming and trauma informed, complete with lab work, screening and testing options, continuous labor support in your home beginning in active labor, skilled and family centered delivery of your baby and your placenta, monitoring in the immediate postpartum period after birth, and postpartum home and office visits until 6-8 weeks postpartum. By the time you have your baby, my hope is that we have nourished a strong, trusting relationship so that we may know how to best support you in your birth and transition into parenthood.
“During my prenatal care, Meshell was so empathetic and endlessly kind. When it came time to give birth, she was attentive and respectful. She was a source of serenity for me during labor and birth. I will be grateful for her for the rest of my life. I would recommend her to anyone who wants to have a positive experience during pregnancy, labor and birth.”
Sarah Hannam
Prenatal Care
begins at the start of your pregnancy, or whenever you choose to come into care with us. We offer comprehensive prenatal care including all screening and testing options that are available during pregnancy: prenatal labs, genetic screening, STI testing, gestational diabetes screening, Group B Strep testing, referrals for Ultrasounds, etc. Most labs can be done in the office or at your home.
During your visits we will palpate your belly to assess baby’s position, measure your uterus, take vitals, listen to baby’s heart rate and do additional assessments if needed. These appointments also include education and counseling, shared decision making, and consultations with other medical providers as needed. We provide evidence based information on all screening and testing options available to you so that you may make the best choice for you and your baby, and will make sure that all of your questions are addressed. Prenatal care appointments are available to you no matter where you choose to birth!
We are committed to embodied consent, meaning that we will pay attention to your bodies’ physical cues and responses as well as to your verbal consent, to be sure that you are comfortable during your visits, exams, etc. We know that you are the expert in your body, family and needs and are honored to be engaged with you in the shared decision making process regarding your health and wellbeing.
Prenatal Visits
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Initial free consultation in person or by phone to see if we are a good fit, and to answer any questions you may have
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1.5 hour initial prenatal visit, to get a full understanding of your medical history, discuss your pregnancy thus far, do initial lab work, pregnancy assessments and listen to fetal heart tones.
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1 hour long routine prenatal visits
Every 4 weeks until 28 weeks gestation
Every other week from 28-36 weeks gestation
A home visit at 36 weeks gestation (preferable involves anyone else that is planning to be at your birth)
Weekly visits from 36 weeks until birth
Additional appointments as needed
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Ongoing email communication to address non-urgent issues and concerns that arise. For non-emergent matters we respond within 48 hours
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On-call 24/7 phone availability for emergent/urgent support throughout pregnancy.
Labor and Birth
We are on call for your labor and birth beginning at 37 weeks gestation through the birth of your baby. Meshell Orozco will attend your birth as the Licensed Midwife and Partera, and will be accompanied by another Licensed Midwife or a certified Birth Assistant that is trained in emergency birth skills. Meshell will be in contact with you throughout early labor, offering support and guidance and will arrive at your home when you are in active labor.
During labor we will monitor your vital signs, intermittently monitor baby’s heart rate, track your labor progress and coping to assess you and baby’s overall well-being. We encourage freedom of movement and frequent position changes to facilitate progress. We may offer support measures, herbs to facilitate labor and will provide emotional support throughout your labor.
We highly recommend a doula for support during labor. Doula support in labor has been shown to dramatically reduce the rate of a potential transfer of care for first time birthers!
We prioritize monitoring the health, safety and wellbeing of you and your baby, but we also strive to hold you in a space that is affirming, and empowering. Physiological birth unfolds best when the birthing person feels cared for, safe, and is able to tap into the trust and wisdom of their own body and its ability to birth their baby. We encourage an oxytocin-rich environment (lights dim, minimal chatter, loving and intimate environment for you and your support team, minimal intervention, etc) during labor and birth to encourage the best outcomes for you and your family.
“Our birth journey took us far into what we could have never foreseen. Meshell stood with us, solid, clear, caring and fierce, as we navigated some very challenging realities within the process. I would recommend her as Midwife in a heartbeat”
Rashida Williams
Postpartum Care
Immediate Postpartum Care
After the birth of your baby, we encourage immediate and uninterrupted skin to skin contact between you and your baby as well as delayed cord clamping (generally until the birth of the placenta or longer if desired). The birth team will stay for 3-4 hours (sometimes longer) to ensure that both you and your baby are stable and well. During this time we will perform a complete newborn exam and monitor vitals, and assess you and baby’s general wellbeing. Before we leave, we will have a thorough discussion about how your family and support team can best care for you and baby in the coming days. We leave you with a printed version of these postpartum instructions so that you can be aware of the common concerns in the immediate postpartum period and know when to call your midwife for support.
If anything should arise during your labor or birth that is cause for concern, or requires more specialized care than we can provide, we will consult or transfer care to the nearest or preferred hospital; the safety of you and your baby is our top priority. If a transfer occurs in labor, your primary midwife will accompany you to the hospital (as Covid-19 protocols allow) and continue to support you through your birth.
Please see the section on Home Birth FAQ’s regarding the safety of home birth, our emergency skills and capacities, and information about emergent and non-emergent transfers to the hospital during labor or in the immediate postpartum period.
Postpartum care is dear to our hearts, we cherish and value quality postpartum care as one of the tenets of receiving care with us. As your Midwife/Partera, I am dedicated to providing family and culturally centered postpartum care, while tending to your unique needs and desires in the postpartum period.
Postpartum Visits Services
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Monitor the overall health of you and your baby
Offer support and education with lactation/infant feeding, breast/chest feeding, including troubleshooting issues, monitoring frequency and feeding patterns, monitoring baby’s output and referring to lactations consultants as needed
Offer the Congenital Heart Defect screening, A Hearing Screening, and the Newborn Metabolic Screening if desired
Monitor vital signs and overall physical and emotional well-being for both you and baby
Support you in your journey and transition into parenthood
Provide opportunities to process and debrief your birth experience, as well as give your midwives feedback and evaluation of care
Answer any questions you might have about caring for you and your baby
If you end up transferring to a hospital for your care during labor and/or birth, we will continue postpartum care once you and your baby are discharged
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We continue to be available by phone throughout your postpartum to answer questions and address any concerns you may have regarding you or your baby.
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Home visits
Between 24-36h postpartum, day 3-4, and day 7
Office visits
2 weeks, 6 weeks and additional visits as needed
Payment and Fees
Our total fee for prenatal care, labor and birth, and postpartum care is $6,500.
We use a self-placed sliding scale model to ensure access to midwifery care. If you find that these fees are a barrier to receiving midwifery care, we would love to discuss an alternative payment plan to meet your family’s needs!
This fee includes the non-refundable $600 deposit, as well as the $375 birth assistant fee.
This fee does not cover lab fees (which are billed to your insurance and typically covered), or hospital related fees if an emergent or non-emergent transfer of care occurs. Again, these are usually covered by insurance.
If you desire midwifery care, but plan on birthing elsewhwhere, prenatal and postpartum appointments are available a la carte, please inquire!
Thanks to Worts and Cunning Apothecary for the Green Bottle Sliding Scale Model
Equity Fund
Those with access to financial resources are encouraged to contribute to our equity fund and pay an additional percentage of the full fee to support accessible midwifery care for all people. In solidarity, I will contribute 5% of any fee that is paid in full to the Equity fund.
Private Insurance
For those with private insurance, we will provide you with a superbill that you can submit for reimbursement. On average, clients with private insurance are reimbursed 45-65% of the total fee by their insurance providers. You also have the option of working with Alternative Medical Billing to prepare a claim to your insurance for reimbursement. We are out-of-network providers with private insurance companies.
Medicaid
Home birth is poorly covered by insurance. This reflects the values of our larger health care system. Due to low reimbursement rates, we are currently not contracted with Medicaid. Our hope is that the reimbursement rates for Licensed Midwives will increase in the next year or so, and that we can then accept Medicaid as a payment option. For now we have developed a model using the self placed Green Bottle Sliding Scale and the Equity Fund to make our care accessible.
