Homebirth Midwifery Care
As a chiropractor and midwife, I blend preventative holistic health care with traditional midwifery knowledge and support. My care focuses on prevention and optimizing your experience while addressing complications with the least side-effects and trauma, leaving more invasive medical tools for when truly necessary.
Although medically thorough, my focus is to provide a supportive environment that encourages decreased stress and increased confidence in your ability to grow and deliver your baby.
- Dr. Joella Folk
DOCTOR OF CHIROPRACTIC (DC), LICENSED MIDWIFE (LM), CACCP
Why choose a homebirth with a Chiropractor - Midwife?
In our modern culture, moms and babies tend to experience more difficulties in childbirth than are truly necessary. My #1 goal as a midwife and chiropractor is to lessen that negative impact.
I believe a midwife's greatest role at a birth is to observe and assist with non-invasive techniques early when needed, in order to avoid complications or invasive interventions whenever possible.
I pay close attention to labor patterns and can often address early issues with chiropractic adjustments, craniosacral bodywork, rebozo techniques or simple position changes for optimal fetal positioning. We can release tension in the body and restore normal labor progression.
As a chiropractor, I have worked with hundreds of newborns and infants.
My chiropractic expertise gives me additional advantages as a midwife in challenging births, allowing me to intervene in the most efficient and least traumatic ways possible. I am also able to address the strain on the newborn's body in the immediate postpartum period.
Since my clients and their babies are also receiving chiropractic care, I tend to see them more often in the postpartum period than is typical.
Postpartum care in my midwifery practice includes home visits the first week after birth and every 1-2 weeks following until 6 weeks postpartum. I address any challenges you may be facing, particularly nursing and newborn weight gain.
Consists of 45-75 minute appointments during which we have informed discussions regarding tests and protocols, changes in pregnancy, and any personal or health challenges affecting your health or upcoming birth. Vitals are evaluated, appropriate testing completed and holistic treatments for mild to moderate symptoms will be recommended, if desired. Visits end with a chiropractic adjustment.
In active labor, I offer as much hands-on support as desired or needed, while monitoring vitals intermittently. I bring medical equipment as well as holistic tools to address common complications that can arise during childbirth, including hemorrhage and newborn resuscitation. After birth, a newborn exam is performed, mom is sutured if necessary, and both are monitored for a minimum of two hours.
For those who start labor under my care:
- 90% successful home births
- 86% VBAC success rate
- 7.6% hospital transfer during labor
- 6.3% primary cesarean rate
- Average length of active labor for all deliveries 3h 27min
- Average length of active labor for first deliveries 5h 17min
8.8% of clients transfer out of care prior to onset of labor due to maternal complications no longer appropriate for home delivery.
I support VBACs at home on a case by case basis. During our consult we will discuss the reason for your prior cesarean(s), how they were performed and your body healed as well as your general health. Much of the time, home birth is a safe option for VBACs.
In the chance that you are not a candidate for home birth, you may still choose the option of co-managed care with an Obstetrician (provider dependent) and receive midwifery support prenatally and during the postpartum period.
I have supported many clients who have generally been considered high-risk such as VBAC clients and those who have had previous pregnancies with blood pressure problems. There are times that full midwifery care and planned home birth can still be appropriate and situations where co-managed care with an obstetrician is necessary.
Holistic and supportive care can often decrease the high-risk circumstances, allowing for a normal healthy delivery. If complications arise making home birth unsafe, transfer of care for hospital birth will be necessary. I have also supported many high-risk clients, when hospital birth is the only safe option, with midwifery prenatal and postpartum care. In these circumstances, hospital and obstetric care is truly needed for the medical safety of them and their baby but midwifery care fills the need for emotional and information support that is not generally a component of obstetric care.
Most insurance in Washington state does cover midwifery care and home birth. Dr. Joella does not contract with any insurance companies which means care is paid and a superbill will be provided for you to submit to your insurance for reimbursement. Many insurance companies cover non-contracted providers at 60-90%. Medical bill-sharing companies such as Samaritan Ministries, CHM, and Medishare reimburse 100%.
Billing insurance for pregnancy and birth care is very different than any other type of health care billing. It is billed as a bundle, one fee, for prenatal care, birth, and postpartum care. This is based on the obstetric model of care which typically consists of 15-minute prenatal appts, obstetrician present for the delivery of baby (but not for most of the labor or immediate postpartum) and one routine postpartum visit.
As you can see above, midwives generally provide a much greater amount of time and services to their clients. Unfortunately, we are not allowed to bill for all the work we do which is typically covered by nurses and pediatricians in the hospital and billed separately. A contracted midwife is also not allowed to bill the client separately for these services. This disparity requires many midwives to take on a much larger client load. I prefer to keep my client load smaller, give the amount of time and energy I feel is appropriate to each of my clients and be reimbursed accordingly. You can read more about insurance billing HERE.
Are you considering midwifery care? Trying to choose between several midwives? It’s an important decision, and there are many factors to consider to make an informed choice. Here are the top 6 questions I believe should be asked when interviewing a home birth midwife. Interested in learning more about my practice as a Licensed Midwife…keep reading...