Home Birth
Availability 2025
February- 1
March- none
April- none
May -2 spots
What is home birth like?
Home birth is personal, private, and spiritual in nature. You as the individual decide who will attend your birth. Individuals that choose to have a home birth accept that pain is a part of the process of natural birth but that it depends how one perceives and copes with the pain. The process involves going through physical, mental, emotional, and spiritual challenges. Many feel empowered after meeting this challenge and feel accomplished because of their own decision making in the birth experience. Home birth also involves low interventions which allows each person to birth how God intended while reducing interference in the process that can hamper labor progress.
As a nurse-midwife my job is to support you throughout your labor and continually assess your labor pattern and progress. Your own body and intuition will guide you and I support you in this natural process. I help you make decisions based upon evidenced based practice and make suggestions to help you progress in labor. I do not perform interventions without your permission unless it is deemed a medical emergency.
What is included in home birth services? What does it cost?
We charge a flat rate per home birth. Our home birth package includes prenatal care, 24 hour call throughout pregnancy, attendance of birth by me and an assistant, postpartum care and newborn visit. At first initial prenatal visit a down payment will be collected for care which in non-refundable and then a payment plan set up to be paid in full by 34 weeks. Lab work, ultrasounds, and primary care visits are not included in fee and would be billed separately. Please contact us to learn more about our fees.
Financial Assistance
It is important to us that women have access to midwifery care, so if there are financial hardships we will do everything in my power to make prices reasonable for your family. Please let us know at our initial consultation visit and we will discuss.
Location
To provide the best care possible, we currently only take on home births located in the following areas: Casper, Mills, Evansville, Bar Nunn, Alcova, Glenrock. A travel fee is incurred for births located more than 15 minutes away from our office in Casper. A one-time fee will be incurred, payable by 34 weeks. This fee is one-time mileage from my office to your house, multiplied by $5. Insurance does not pay for this fee.
How does insurance work with home birth?
If you have insurance, home birth may or may not be a specific policy in your insurance plan. Every insurance provider and plan is different; however, these are some things to know:
The midwife’s credentials may determine your insurance coverage. Certified Nurse Midwives (like us) should be covered by insurance as we are licensed nationally.
Some policies will exclude any payment for the birth portion of home birth.
Some policies do not allow out-of-network reimbursement.
Divine Women’s Care is out-of-network. Approximately 25% of clients obtain in-network Gap exceptions because there is no in-network home birth provider. When they submit (after birth) the amount is honored toward their in-network deductible.
Home birth will be considered an out-of-network expense. To be reimbursed, you will pay in full for your services. A superbill can be issued after the birth, and you will submit this to insurance to be reimbursed. You can do this yourself; however, it might be better to have a professional biller handle this process for you so that you can rest and enjoy postpartum life. We recommend Napier Midwifery Billing. She can help you to apply for in-network exemptions if possible through your insurance.
Home birth will be considered an out-of-network expense. To be reimbursed, you will pay in full for your services, and then submit your bills to insurance to receive reimbursement after services are completed.
Depending on your deductible, it may not even be worth filing a claim. If you have a high deductible, you may even want to consider lower-cost ultrasounds with cash-pay options.
If you do submit your claim to insurance, you cannot anticipate what amount insurance will assign to your claim. They may consider a prenatal and birth claim to be worth $2,000 - $4,000. Insurance will apply the amount to your deductible and send you a check for the amount over the deductible.
Your labs, ultrasounds, perinatal consultations and co-care with any OB practice will usually go toward your deductible since you often use in-network insurance for those.
Is home birth safe?
Short answer is yes for those that qualify as low-risk. A risk assessment is performed every trimester to continue to determine safety of home birth. Conditions that are not appropriate for home birth entail Diabetes Mellitus, Epilepsy, Confirmed HIV, Insulin Dependent gestational diabetes, uncontrolled pregnancy induced hypertension, oligohydramnios, thromboembolic disease, Rh sensitization, Multiple pregnancy, premature labor before 36 weeks gestation, presentations not compatible with vaginal delivery. At this time, I am taking VBAC clients. Please refer to my resource page on links to safety of midwifery and home birth. It is a personal decision in which all risks and benefits will be discussed for each unique individual. I do consult with other nurse practitioners and doctors in town when needed. I also can collaborate with your primary doctor when needed. If I assess a pregnancy to be out of the scope of a home birth I refer and follow-up to make sure appropriate care is received.
Who is eligible for home birth? How are complications managed?
At the initial consultation visit the midwife will gather a brief health history of prior births, health, and discuss personal health needs and desires. Divine Women’s Care practices according to national and state guidelines to meet certain criteria for homebirth in order to keep mothers and babies safe. Therefore we do not accept all clients but have a selection process.
Factors assessed prior, during, and just before birth: Health condition, mindset, location of home. Growth assessment, labs, and vitals during prenatal care. Ultrasound- fluid, placental location, blood flow and heart rate when term.
Factors that deem someone ineligible for home birth:
Chronic prior or current health conditions:
Cardiac: May need cardiology clearance
Thyroid: Must be well controlled. Most cases of hypothyroidism can be controlled during pregnancy with medication and will not affect development.
Uterine: prior uterine or abdominal surgery. Will need records. Afer review of records may consider on case by case basis.
Severe Anemia: Unable to be managed by IV or oral therapy.
RH Isoimmunization or other blood disorder
Obesity: BMI >30 (case by case basis)
Seizures
Pregnancy History
Abnormal fetal growth pattern
Abnormal amniotic fluid volume
Abnormal ultrasound or genetic screening
Hypertension/ pre-eclampsia
Intrahepatic cholestasis of pregnancy (ICP)
Platelet problems
Anemia non responsive to treatment
Gestational diabetes with abnormal growth pattern or uncontrolled with diet
Non-vertex (head down) baby
Labor
fetal heart rate irregularities
Thick meconium stained amniotic fluid
APGAR below 5
Gestation prior to 37 weeks or after 42 weeks
Hypertension
Delayed progression in labor or inability to cope with labor any longer
What supplies do you bring to the birth?
I carry many medical supplies into the home setting in case of emergency interventions. There are two major concerns for birth bleeding of mother and the newborn having troubles breathing. I carry an oxygen tank and resuscitation equipment, antihemorrhagic medications, supplies for monitoring blood pressure, fetal heartbeat, and oxygen saturation. I also carry antibiotics for group B strep management in labor. If a laceration occurs I have equipment for suturing for 1st and 2nd degree tears. I refer out for 3rd and 4th. I basically have all the equipment a birth center would have and take it to your home. If you have any other questions about supplies just ask.