Part of my services as a midwife is filing for the birth certificate.  In accordance with state law, I am required to file for the birth certificate for any birth I attend as the primary midwife.  

​Just as in other states, Kansas collects demographic data such as the highest level of education for each parent, what job and industry each parent works in, if there was prenatal care and so on.  I like for my clients to know what information the state wants so I ask them to fill out the application that I use to file for the birth certificate.

I file online. I actually prefer this for several reasons. The biggest reason I like to file online is that my handwriting is not an issue, no one has to try to figure out if I wrote an e or an a.  I also like to file online because I can print off a sample copy of exactly what the birth certificate will look like so the family can look it over and correct any errors before I do the final submission with the state. I am able to print an official birth confirmation letter which may be helpful or needed to get baby on health insurance.  As part of filing the birth certificate, I also include information about any newborn tests I may have done like the critical congenital heart defect screening so the state has that information and doesn't need to contact the parents about the newborn tests.

Kansas is actually pretty fast in getting the birth certificate completed and available to parents. Kansas has birth certificates ready in about 10 days, and if you are really in a hurry, you have the option of driving to the office of the Department of Vital Statistics and getting a copy even sooner in person. You do have to pay a $20 fee to get the birth certificate.  You can request it by mail, or online, or in person if you need it sooner than 10 days after birth.

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There are times when we need to transfer during birth.  If baby lets us know they are not happy, or Mom is having challenges and things have moved outside of normal then it can be time to seek the care and help a hospital offers.

Here are the things I want my clients to understand:

• I want the best possible outcome for Mom and baby, that's why we transferred.
• Hospitals have tools that I do not have, and those tools will be helpful or necessary for the situation.
• I value the skills and expertise of the hospital providers, and I am grateful they are able to help.
• If hospital policy allows, I will stay with Mom at the hospital through birth and for a short while after birth.
• If hospital policy does not allow me to stay, I will be available by Skype or another platform if preferred.
• ​I do not have privlieges to practice midwifery in the hospital, so I will shift into more of a doula role providing labor support. I will assist as much as hospital staff are comfortable with. This varies among hospitals.
• Hospitals have protocols they have to follow, and they may not have much wiggle room within those protocols. The protocols may be in place to allow the hospital to be more efficient, or may be required by the liability insurance of the hospital. If we have time, we will go to a hospital that does not have protocols prohibiting a desired outcome such as VBAC.
• I will share pertinent information from the chart, and provide lab results to hospital staff to facilitate a smooth transition, and to make sure they have all the information they need to provide the best care they can for Mom and baby.
• I will provide postpartum care once Mom and baby are released from the hospital.

Hospital care can be beneficial and lifesaving when labor and birth move outside of normal, and I am thankful we can turn to them if needed.  I know transferring is stressful.  I will do my best to make the transfer as smooth and stress free as I can.

There are times when we need to transfer during birth.  If baby lets us know they are not happy, or Mom is having challenges and things have moved outside of normal then it can be time to seek the care and help a hospital offers.

Here are the things I want hospital staff to understand:

• We recognized the need for help and appreciate that the hospital has tools that are not available at home.
• We all want both Mom and baby to have the best outcomes possible, that's why we transferred.
• Everyone is tired so a little more time may be needed to process what is being done, what is being recommended and what options are available during the transition from a home birth environment to the hospital environment.
• If the client is asleep, please come back at a later time to make introductions and to discuss care, or have these conversations with family members who are present. If there are going to be several practitioners coordinating care, it would be helpful in the first hours to meet with one or two practitioners that can explain everything instead of trying to meet everyone.
• The client and family may need to have medical terminology explained, and may ask a lot of questions to understand what is being recommended and to make fully informed decisions.
• The midwife wants to be as helpful as possible. She has important information such as lab results, and a record of how labor was progressing she can share with the medical team. She will provide labor support, and would be happy to help as much as the hospital staff are comfortable with. She is not trying to take over for any of the hospital staff, and truly values their skills and expertise.
• The client may have made decisions regarding newborn procedures or other things before birth, and may wish to stay with those decisions unless the situation calls for changes. Please ask the client's preferences.
• The midwife will provide follow up care after Mom and baby leave the hospital. ACOG recommends at least two in person postpartum appointments in the first six to twelve weeks.  My standard is to do four. I will track baby's weight and provide breastfeeding support as well as monitor my client's recovery.

​Transfers are stressful for everyone involved. An understanding and collaborative effort on the part of everyone involved will result in a smoother and less stressful transfer.  I look forward to the day when home birth is recognized as an acceptable and legitimate option for low risk pregnancies by medical providers in the area I serve.

I am a home birth midwife. I would not be attending home births if I did not feel they were safe. No one who cares for pregnant women wants to have a bad outcome, and home birth midwives aren't any different. If anything, I am more vigilant because I recognize I am not equipped to handle serious complications. 

Home birth was the standard in the US until about 100 years ago. Home birth is still fairly common in many European countries. In the Netherlands, 30% of births are home births. There have been studies through the years looking at the safety of home birth. Many of these studies had flaws, like including unplanned home births, and home births without a trained birth attendant. Recent studies have been better designed, and the data used has been better screened to reduce including births outside the criteria set for the study.  

​The newest study affirms that home birth is just as safe as hospital birth for low risk pregnancies, and that mothers and fathers are more satisfied with the home birth experience than the hospital birth experience.  Having a home birth also increases the likelihood that breastfeeding will be successful compared to birthing in a hospital. The latest study also matches the conclusions drawn from a 2018 study.  As we get more data, the evidence just keeps growing that home birth is a safe option.  

As I wrote in an earlier blog post, I became a midwife because of hospital care that needlessly put a mother's life at risk. In the US, our maternal mortality rates keep rising which means there is something seriously wrong. I can change that, one client at a time, one home birth at a time.